Physical Rehabilitation Laboratory Manual: Focus on Functional Training.

Physical Rehabilitation Laboratory Manual: Focus on Functional Training

O'Sullivan SB, Schmitz TJ. Philadelphia, PA 19103, FA Davis Co, 1998, paperback, 388 pp, illus, $22.

This book has been designed for use as a laboratory manual in rehabilitation courses, especially those courses that focus on the treatment of patients with neurologic conditions. The book's intended audience is professional physical therapist students. Because few laboratory manuals for courses in neurological rehabilitation are available, faculty members may welcome this new textbook. This text will also be useful to practicing clinicians who wish to upgrade their skills because of the changing focus of neurological rehabilitation and the recent demands for a functional outcomes orientation.

This textbook focuses specifically on treatment and assumes prior knowledge of diagnosis, clinical symptomatology, disease progression, medical treatments, prognosis, and recovery. It presents an integrated treatment model that emphasizes functional outcomes through specific functional training activities and techniques. Traditional remediation and compensatory interventions are covered briefly and are integrated into newer motor-control and motor-learning strategies.

Because the book places heavy emphasis on proprioceptive neuromuscular facilitation (PNF) techniques, supplemental classes may be necessary in order for students to fully comprehend specific techniques. Each chapter provides references along with supplemental readings. The frequent references to the, Physical Rehabilitation: Assessment and Treatment suggest that textbook would work well with the Physical Rehabilitation Laboratory Manual for didactic and laboratory applications.

The book is organized into 3 major, well-written sections. The information appears to be correct and up to date. Section I covers concepts of functional training, including foundations of therapeutic exercise, stages of motor control (ie, mobility, stability, controlled mobility, skill), traditional therapeutic approaches, basic terminology, application of therapeutic techniques with stages of motor control, and the motor-learning approach.

Section II illustrates how to apply the information and techniques from section I to promote motor skills. The motor skills are presented in developmental sequence, beginning with supine activities, through rolling, prone, quadruped, kneeling, and upright postures. Gait activities, balance training, and upper-extremity activities are also included. This section is quite comprehensive and describes general characteristics of each posture, various intervention strategies and considerations, movement transitions, goals, and functional outcomes. The abundant photographs in sections I and II will enhance learning.

Section III expands on the concept of clinical decision making and applies it to functional training. Definitions of impairment, disability, handicap, disease, and functional limitation are given, and the Functional Independence Measure (FIM) is explained. This section then presents a series of 30 realistic clinical problems, along with questions to help the reader identify the intervention techniques and goals needed to address the problems. Following the clinical problems, the text presents 10 comprehensive case studies in a workbook format and in progressive order of difficulty. As the readers advance through each case study, realistic and changing parameters prompt them on the collection of patient data, data analysis and formation of a problem list, the identification of outcomes, the development and implementation of interventions, and the assessment of patient response and outcomes of treatment. Appendixes A and B contain the suggested answers to the clinical problems and case studies, respectively. The authors warn readers that there may be more than one treatment approach to each clinical problem or case study and more than one answer to each question. Students are advised to obtain additional feedback through suggested readings and references, interaction with peers and faculty, and participation in classroom discussions. A comprehensive index follows the appendixes. This book is relevant to physical therapy education.

Sondra E Dunkle, EdD, PT Pocatello, ID

Dr Dunkle has taught in professional physical therapy programs/hr 21 years, with an emphasis on neurological rehabilitation. Her current specialty areas include gerontology and balance issues.