Physical Agents: Theory and Practice, ed 2.

Physical Agents: Theory and Practice, ed 2

Behrens BJ, Michlovitz SL. Philadelphia, PA 19103, FA Davis Co, 2005, paperback, 274 pp, illus, ISBN: 0-8036-1134-X, $ 44.95.

The purpose of Physical Agents: Theory and Practice is to provide a textbook for teaching thermal, mechanical, and electrical modalities. The first edition was intended for physical therapist assistant students; however, this newer edition would work well for students in either physical therapist or physical therapist assistant education programs.

The book contains 4 sections. The first section, "The Concept of Adjunctive Therapies," provides background information necessary for the effective use of physical agents. Chapter 1 presents concise information about the physiology, assessment, and theories of pain and information about the process of soft tissue repair. Chapter 2 is rifled "Patient Responses to Therapeutic Interventions." One of the strengths of this book is the underlying concept of this chapter; it introduces methods for assessing a patient's response to treatment in terms of goals achieved. The importance of assessing a patient before and after a treatment as a means to determine the effectiveness of the treatment is emphasized throughout the book.

Section 2 covers ultrasound, aquatics and hydrotherapy, traction, and therapeutic heat and cold. The basic physics, physiological effects, safety considerations, and therapeutic goals for each modality are presented. Application techniques are described in detail. The importance of clinical decision making is emphasized, including choosing a modality, setting goals, and assessing whether the treatment is effective in achieving goals. The reader is reminded often to consider the patient's point of view. Research supporting the effectiveness of the physical agents is discussed.

Section 3 is titled "Electrical Stimulation." The first chapter in this section is a very good summary of the basic concepts, terminology, and physiology of electrical stimulation. Terminology conforms to the language recommended by the American Physical Therapy Association's Section on Clinical Electrophysiology and Wound Management. Throughout the chapter, the clinical effects of the various electrical parameters are detailed so that the reader will understand the rationale for clinical selection of specific electrical parameters for specific goals. This chapter does very well presenting a difficult topic. The remaining chapters in section 3 examine specific therapeutic uses of electrical stimulation: neuromuscular electrical stimulation and stimulation for pain management, tissue repair, and transdermal drug delivery. Specific guidelines for electrode placement and selection of parameters are outlined, along with the rationale for selection. Safety considerations are emphasized.

Section 4 is titled "Comprehensive Approach to Treatment." There is only one chapter in this section, which summarizes the important points common to therapeutic use of all physical agents. The reader is reminded of the many factors that should be considered when selecting a physical agent as part of a physical therapy plan of care. These factors include treatment goals, time constraints, sequencing, safety considerations, and integrating the use of the physical agent into the overall plan of care. The importance of evidence-based practice is emphasized.

A variety of teaching tools are used throughout the book. Each chapter starts with lists of objectives and key terms. Case studies that appear in the text are relevant to the information presented and seem realistic. Discussion questions at the end of each chapter encourage the reader to think about the practical implications of the information presented in the chapter. Well-chosen illustrations and photographs supplement the written material.

Although this edition has a format and a few features that are different from the previous edition, I don't believe that they are fundamentally different, and, therefore, in this reviewer's opinion, there is no need to replace the previous edition with the newer one.

Catherine Walls, PT, OCS 

Mount Auburn Physical Therapy Associates Watertown, Mass

Walls is a physical therapist specializing in the management of patients with orthopedic disorders.