Pulmonary Therapy and Rehabilitation: Principles and Practices, 2d ed.

One glance at the thickness of the second edition of Pulmonary Therapy and Rehabilitation tells you that this is a greatly expanded version of the first edition, which was published in 1979. The editors have divided this subject into two sections: (1) principles and (2) practice.

The first three chapters of section 1 are devoted to respiratory physiology, exercise physiology, and pathophysiology of obstructive and restrictive pulmonary diseases. Topic coverage within these chapters is brief, but understandable, and the bibliographies refer the reader to sources that win provide more detail. Subsequent chapters outline disability evaluation and exercise stress testing as they apply to patients with pulmonary disorders. Detailed explanations of pulmonary function tests and interpretations of chest radiographs, however, are absent. The chapters on pharmacological therapy and ambulatory oxygen therapy cite recent research and advances. The chapter on oxygen therapy is especially well illustrated with figures and photographs. Also included in this section are two chapters that address nutrition in chronic obstructive pulmonary disease (COPD) and smoking cessation. Both of these content areas are vital to a complete manual on pulmonary rehabilitation and are a welcome addition. These chapters and the two preceding chapters seem out of context for the "Principles" section and might have been better placed in the "Practice" section.

Section 2 begins with a history of pulmonary rehabilitation and the general philosophy of a pulmonary rehabilitation program. This introduction is followed by three chapters of particular importance to physical therapists. These chapters cover chest physical therapy for COPD, strength and endurance training in pulmonary rehabilitation, and relaxation techniques and biofeedback. The standard evaluation procedures of inspection, palpation, auscultation, mediate percussion, and the review of pertinent medical data are covered too briefly for the beginning practitioner. In addition, the principles of breading retraining and bronchial drainage procedures are not addressed in enough detail in terms of rationale and technique. The illustrations in this chapter are unique but contain too much information to be of practical use. Principles of strength and endurance training and relaxation/biofeedback are more detailed. It is interesting to note that physical therapists did not write these chapters. Several chapters are devoted to pulmonary rehabilitation of special populations, such as those with cystic fibrosis, asthma, and paralytic/restrictive pulmonary syndromes. included here are expanded versions of chapters from the first edition on psychosocial aspects of pulmonary rehabilitation, vocational rehabilitation, and sexual aspects of the person with a pulmonary impairment. Home care and mechanical ventilation complete the discussion. Whereas the content in section 2 is appropriate, the placement of certain chapters seems illogical at times.

This second edition fulfills the editors' primary goal of disseminating a more contemporary practice of pulmonary rehabilitation. The additional chapters and the expansion of chapters from the first edition give the reader a good foundation in the physiological principles and an excellent overview of the team approach to pulmonary rehabilitation. Clinicians involved with new or existing programs will find this book to be a worthwhile resource. This book is written on a level appropriate for most health care workers. The lack of depth in the discussion of pulmonary practice from a physical therapy perspective, however, makes this book a supplemental source rather than a primary textbook for students.