Physical Fitness: A Guide for Individuals With Lower Limb Loss. (R

This book is written as a physical fitness guide for persons with lower-extremity amputations. It is the authors, hope that this guide will assist persons with lower-limb loss to design a fitness program that allows them to exercise independently after some instruction and supervision from a trained individual. Overall, the authors seem to have accomplished this goal.

The book is divided into three parts: part 1 covers basic guidelines for developing physical fitness, part 2 covers specific conditioning exercises for various anatomical regions, and part 3 addresses specific physical activities and sports that may be used to develop physical fitness. The book also contains an appendix that details special resources related to sports for people with disabilities, a glossary that defines terms used throughout the book, and a bibliography that contains additional suggested readings for individuals wanting more information on various aspects of exercise pertaining to athletes with and without disabilities.

Part 1 (chapters 1-3) serves as an introduction to guidelines used when initiating a conditioning program. The relationship between fitness and the rehabilitation process following amputation is explored. The main components of physical conditioning, cardiovascular endurance, flexibility, muscular strength and endurance, and skill development are also defined and briefly covered in part 1.

Part 2 (chapters 4-12) deals with specific exercises that may be utilized in the conditioning program. Chapter 4 provides a basic introduction to conditioning exercises. There is minimal information on establishing intensity of aerobic exercise. Weight training guidelines are presented along with a basic beginning workout program of warm-up, stretching, and resistance exercises. Chapters 5 and 6 address calisthenics and stretching exercises, respectively. Exercises in these chapters are presented in a standardized way, listing the exercise with an accompanying picture, the purpose of the exercise, the correct procedure to be followed to perform the exercise, and modifications that may be required for an individual with a lower-extremity amputation and prosthesis. Some exercises are presented with a caution about safety in performing the exercise. A variety of calisthenic exercises are provided for both warm-up and cool-down activities. Flexibility exercises are shown for all major muscle groups, most of which are appropriate. The exercises that are shown for stretching the hamstring muscles, however, are of questionable effectiveness if done the way they are described in the text, and the quadriceps femoris muscle flexibility exercises are potentially injurious for any athlete. This is especially true of exercise 19 - the double quadriceps femoris muscle stretch, even though it does state that this stretch is not recommended for persons with chronic knee problems or back problems.

Chapters 7 through 12 describe resistance training exercises for the arms, shoulders, legs, abdominal muscles, chest, and back. As with the previously mentioned exercises, the descriptions of these exercises include purpose, procedure, modifications, and cautions. They also include a recommended skill level (beginner, intermediate, or advanced) for inclusion in the training program. As with the flexibility exercises, some of the resistive exercises are of questionable safety or benefit. The exercises for trunk hyperextension and reverse hyperextension are of particular concern due to the extreme stress placed on the low back.

Chapters 13 through 21 address various individual and team sports for persons with lower-limb loss. These chapters contain useful information, not only about each sport, but about types of prosthetic adaptations that may be required to participate in each sport. For individuals with minimal background in working with persons with lower-extremity amputations, these chapters would be very helpful.

Overall, the book is fairly well written and easy to read. It does not contain much information that a therapist does not already know, particularly about flexibility and strengthening exercises. It probably would be useful, however, for the individual who is working with persons with lower-limb loss in setting up fitness programs for that population, which is really the intended purpose of the book. Because of the questionable nature of some of the exercises presented in the book, the fitness programs should only be conducted with adequate supervision and training of its participants.