Physical Therapy in Arthritis.

Walker JM, Helewa A, eds. Philadelphia, PA 19106, WB Saunders Co, 1996, hardback, 438 pp, illus, $55.

The editors of Physical Therctpy in Arthritis recognized the need for a state-of-the-art textbook that would provide a comprehensive approach to the management of arthritis. The management of arthritis, one of the oldest and most common diagnoses, has a history of tradition, intuition, and empirical knowledge. Because of the large number of individuals with arthritis and the growing population of aging baby boomers who will add to this number, researchers are developing and testing new management strategies based on objective criteria and scientific foundations. This text brings the reader up-to-date on the contemporary methods and philosophy of management of numerous types of arthritic conditions.

The book opens with a historical perspective, documenting arthritis in extinct societies through paleopathology and discussing traditional attitudes and beliefs. The following chapter on epidemiology and economics elucidates the need for this book. A current review of the pathophysiology of inflammation, repair, and immobility is presented in the third chapter. Diagnosis, assessment, and management of arthritic conditions, such as osteoarthritis, rheumatic arthritis, gout, spondylarthropathies, and fibromyalgia, are discussed with helpful illustrations and tables.

The multidisciplinary theme of the text is evident in the middle chapters. Surgical interventions, psychological factors, and pharmacology are presented with regard to their connection with physical therapy. An occupational therapist has contributed a chapter on orthoses, splinting, and lifestyle Factors. A chapter from a physical therapist focuses on cardiovascular health and physical fitness. Several chapters are devoted to specific populations: children and adolescents with juvenile rheumatoid arthritis, individuals with rheumatoid and other inflammatory conditions, and individuals with ankylosing spondylitis.

An important chapter on the community-based physical therapy management of arthritis is written by a Canadian physiotherapist, with more references to Canadian than to US health services. An appendix, however, provides addresses for resource materials, such as patient education pamphlets and videotapes, peer-reviewed journals, and organizations. Other appendixes provide physical therapy competency guidelines and assessment and outcome measurement instruments. The final chapter of the book focuses on the skills needed by a physical therapist to evaluate current literature and new treatment strategies.

This textbook is well written and organized and includes ample tables and illustrations that make it easy to read and use as a reference. I highly recommend it to clinicians who treat individuals with an arthritic condition, researchers who are looking for contemporary problem issues, and physical therapist students who are learning the principles of management. The editors have attempted to fill a void in the existing literature with this book, and they have done their job well.

Maggie Fillmore, PT, OCS 

Kaiser Permanente

Oakland, Calif

Ms Fillmore is Clinical Specialist at Kaiser Permanente in orthopedic manual therapy, with additional interest in lymphedema management and pediatrics.