Quantification of Neurologic Deficit.

Quantification of Neurologic Deficit

Edited by Munsat M. Stoneham, MA, 02180, Butterworth Publishers, 1989, hardback, 357 pp, illus, $59.95

This book is actually the proceedings of a 1986 international symposium, Quantitation in Clinical Neurology. The contributors are primarily doctors, but therapists are also included. The symposium title is a more accurate reflection of the book's contents than is the book title. The emphasis is not on methods used to analyze and quantify neuromuscular dysfunction (eg, electromyography and Hoffman reflexes), but rather on clinical assessment scales for patients with neurological problems, designed to rate symptoms, signs, and functional disabilities. Part 1, Principles and Methodology, consists of six reports on general aspects of assessment scale development and use. it includes discussions about the need for reliability and validity evaluations of new scales, development of data banks for comparison of patients with appropriately matched control subjects, ordinal versus interval versus ratio scales, and appropriate statistical analyses.

Part 2, Clinical Applications, consists of 17 reports on various neurological disorders and the clinical assessment scales that have been developed for those specific types of patients or problems. Disorders covered include multiple sclerosis, amyotrophic lateral sclerosis, neuropathies, Huntington's disease, Parkinson's disease, and Alzheimer's disease. More general clinical topics, such as testing cutaneous sensation, muscle fatigue, gait, reaching, and specific developmental disorders (reading and language problems), also are considered. Some chapters include only discussions of the various assessment scales available in the literature, whereas other chapters include appendixes that contain a sample assessment scale. illustrations are mostly of clinical research data, and each chapter includes a current bibliography.

In view of its price and technical style, this book probably would not be of interest to most general therapists, but it may be useful to those conducting clinical research on patients with neurological problems. The first part could be helpful for anyone developing new assessment scales for a patient group and perhaps for faculty members who are teaching research methods courses. The second part may be useful to faculty members who are looking for a resource that summarizes and provides some comparative evaluations of the clinical evaluation scales available to share with students. Clinical therapists could find most of the assessment scales through a literature search.

Marjorie Moore, PhD