Neuromuscular Electrical Stimulation: A Practical Guide, 3d ed.

Baker LL, McNeal DR, Benton LA, et al. Downey, CA 90242, Los Amigos Research Education Institution Inc, 1993, paperback 227 pp, illus, $22.50.

The aim of this monograph is to provide a practical approach to clinical uses of electrical stimulation. It is well written, and the authors have demonstrated a unique ability to convert what many physical therapists find to be a challenging topic into a sound, easy-to-read, and understandable text.

The first four chapters include a historical overview of the different uses of electrical stimulation, physiological basis of excitable tissues, principles of electrical stimulation, and clinical uses of stimulation. Chapters on the physiological basis of excitable tissues and principles of electrical stimulation contain excellent graphs and figures that aid readers in descriptions of physiological concepts (ie, action potentials, strength-duration relationships, rheobase and chronaxie, and length-tension relationships) as well as stimulation principles, such as impedance, Ohm's Law, and stimulation parameters.

Examples of clinical uses of stimulation addressed in chapter 4, such as range of motion, facilitation and reeducation of voluntary motor control, orthotic substitution, edema management, and inhibition of spasticity, come from the authors' clinical experience. Especially interesting is the presentation on muscle strengthening programs in regard to power training, endurance training, and hybrid programs. The treatments outlined use sound rationale, and references cited come from recently published articles.

Chapters 8 and 9 are the highlights of this monograph. They provide excellent descriptions and explanations of electrical stimulation treatment plans for upper and lower extremities, respectively. These chapters provide superb photographs of electrode placements. Desired movements produced with electrical stimulation in all upper- and lower-extremity joints are thoroughly addressed and visualized. Chapter 10 is well written and addresses uses of electrical stimulation with traditional treatment programs. It reaffirms that electrical stimulation is best used in conjunction with other treatments and "blended into a total therapy plan."

There is a brief, interesting, final chapter that involves administrative considerations in the application of stimulation, but, like the first chapter on the history of electrical stimulation, does not add to the overall purpose and quality of this monograph. A large, encompassing list of references concludes this monograph and allows readers to obtain more detailed information.

Physical therapy students, physical therapist assistant students, and physical therapy educators would benefit from this monograph. It may be most useful, however, for practicing clinicians as an excellent review and as a refresher of electrical and physiological principles. Clinicians who rarely or frequently use electrical stimulation will find this monograph an excellent reference guide for electrode placement and electrical stimulation programs. Overall, this monograph is highly recommended.