Prevention Practice: Strategies for Physical Therapy and Occupational Therapy.

Rothman JR, Levine R, eds. Philadelphia, PA 19106-3399, WB Saunders Co, 1992, 515 pp, hardback, illus, $58.

This timely text is organized into four parts that consist of 30 chapters, and has 43 contributors representing the United States, Canada, and England. Most of the chapters are well referenced and well illustrated with drawings, photographs, and tables. The table of contents is specifically detailed listing chapters and sub-chapters, and the index is extensive. The book has the appearance of a text that is designed to be used in an academic setting as the accompanying reference for a course on prevention practice.

The editors describe, in the preface, a broad interpretation of the concept of prevention that includes health promotion, disease prevention, and prevention of further "progression of disease at any point along its course." They describe health promotion as maintaining or improving general health, primary prevention as specific protection against disease, secondary prevention as early diagnosis and prompt treatment, and tertiary prevention as prevention of complete disability. The contributing authors are consistent in their liberal definition of prevention within the individual chapters.

Part 1, "Promoting a Healthy Lifestyle," has 3 chapters describing promotion of good health through public policy, activity for the elderly in a long-term care setting, and general exercise. Part 2, "Prevention and Treatment Strategies for Specific Problems," consists of 16 chapters and represents the largest part of the book. Each chapter in this section was written so that it may stand alone and can be read out of chronological order without sacrificing meaning. The trade-off is a tendency for repetition and overlapping information.

I thought the chapter entitled "Prevention of Musculoskeletal Injury" relied too much on McKenzie's theory of mechanical diagnosis and treatment. The overreliance on this approach was evident in the sections on upper-extremity disorders in which little, if anything, addressed prevention even in its broadest interpretation. I also found the accompanying illustrations to frequently be unnecessarily large and adding little to the text, as in the full-page drawings of wrist flexion, extension, and neutral position.

Part 3, "Workplace and Environment," deals with corporate fitness, ergonomics, and physical and mental strain associated with computer use. The five chapters in this section offer practical advice to the therapist interested in interfacing with employers to help prevent occupational injuries.

Part 4, "Issues for the Therapist and Educator," contains pertinent chapters on a variety of topics including program evaluation, ethics, equipment assessment, and marketing.

The reader who expects a book on primary prevention, as in preventing illness or injury, may be disappointed with this text. A small part of this text is devoted to this more common concept of prevention. The majority of the book contains information on general background, anatomy, recognition of disease or injury, and treatment approaches. The result is an encyclopedic presentation that is perhaps longer than necessary with a cost that is also unnecessarily high. Nevertheless, this book is the most complete single text on prevention practice that I have read.