Student Workbook for Neuroscience: Fundamentals for Rehabilitation.

Student Workbook for Neuroscience: Fundamentals for Rehabilitation

Lundy-Ekman U Philadelphia, PA 19106, WB Saunders Co, 1998, paperback, 147 pp, illus, $15.95.

These recent additions to the rapidly growing neuroscience literature are directed specifically at professional students in the physical rehabilitation professions. They provide a concise, well-organized introduction to the basic vocabulary and concepts of neuroscience and discuss how these concepts are applied in the evaluation and management of clinical problems typically seen in rehabilitation settings. Throughout the textbook, clinical case information is integrated with the presentation of basic concepts. The workbook reviews facts and concepts, but also offers several laboratory exercises that demonstrate the use of standard clinical instrumentation in evaluations.

The textbook is organized in the following manner: (1) the first and last chapter provide general anatomic information; (2) chapters 2 through 5 contain an initial description of cellular neurophysiology and neural development; (3) chapters 6 through 10 discuss functional sensory, autonomic, and motor systems; and (4) chapters 11 through 17 provide an analysis of function by region. An appendix discusses neurochemistry in more detail and presents a very brief introduction to basic neuropharmacology. A general photographic atlas is provided at the beginning of the book, and a glossary of terms is included.

The majority of the chapters use the same format. The chapters contain an introductory, real "case," presented in the first person. The body of the information follows, including explanatory illustrations, diagrams, and tables, most of which are in color. At the end of the chapter, a number of review questions are posed, some in case format, but it is not the same case that was used to introduce the chapter. Lists of both specific references and suggested readings are presented at the conclusion of each chapter. Information concerning the clinical application of concepts of somatosensation and motor control is presented in expanded chapters that follow the chapters that introduce these topics.

The text is clearly written and well organized, and it does not assume prior familiarity with neuroscience, but does require previous basic competence in general anatomy and physiology. The book provides sufficient information to satisfy the needs of professional students before they begin more extensive coursework in clinical applications. Clinical research information as well as clinical problems are used extensively to illustrate the concepts being presented. The information, with the supporting references, is as current as can be expected in a reference text. I regret that the book lacked a discussion of the historical development of neuroscience concepts. Although such an omission is not unusual in a basic text, the absence of this material does not permit the student to recognize the constantly changing nature of this rapidly developing field. With only a few exceptions, the entire text is organized so that it permits cumulative and noncontradictory building of concepts when read sequentially. In some cases, chapters could be presented out of sequence, but this would usually require information that would have been acquired in a sequential reading.

The visual information is somewhat disappointing because of one major flaw--the size of the illustrations. All of the illustrations are small, and some are reduced so much that reading the labels or following the lines on a diagram is difficult (even on a good morning with trifocals). This situation is particularly unfortunate because the illustrations are exceptionally well executed. The larger format of the workbook could have presented some of these illustrations in a more accessible size, but unfortunately the author chose to depend instead on black-and-white diagrams that are drawn less clearly. Other than this difficulty, the visual information is excellent, well presented, clear, accurate, and thorough. Because of the limited number and size of atlas illustrations in this book, a standard human neuroanatomy atlas should also be available to students.

Both the chapters in the text and the corresponding units in the workbook provide review and study questions. In the text, the questions are divided into "Clinical Notes" and "Review Questions." The clinical notes present several brief cases with 2 or more related questions. The review questions are all of the identification or short-answer type. In the workbook, the questions are in multiple-choice, matching, and short-answer (including diagram-labeling) formats. The questions in both the text and workbook are of the close-ended type, focusing the student's learning at the level of identification and basic analysis. The workbook covers the same material as the text, but expands the diversity and type of questions. Specific answers to all questions are provided at the end of both the text and the workbook. The student who becomes comfortable with these questions will have the necessary vocabulary and basic concepts that can be used to explore open questions in neuroscience and clinical practice.

The workbook includes a section that provides 6 laboratory exercises that demonstrate several principles of neurophysiology of particular relevance to clinical evaluation. These exercises include tests of equilibrium and sensation, functional evaluations of cranial nerves, demonstrations of skeletal muscle facilitation and inhibition, tests of mechanisms of muscle lengthening, and tests of peripheral sensorimotor reflexes. Some of these exercises include possible discussion questions.

These works would be a useful addition to the resource library in neuroscience available to professional students in physical therapy and occupational therapy. However, the information concerning cranial nerve evaluation and function is too limited to support studies in speech-language pathology and audiology. Although there is a good basic presentation of normal cortical function, this text would be insufficient to provide a basis for the discussion of difficulties in perception and other higher cortical functions or psychological dysfunctions. Because of the book's strong emphasis on physical rehabilitation, there is decreased emphasis on cellular neurophysiology. Students who intend to continue studies in this area, whether for teaching or research purposes, will need a more detailed text.

Elizabeth H Littell PhD, PT Evaluation and Development Services Albuquerque, NM

Dr Littell is the owner of Evaluation and Development Services, which provides consultation on the development and revision of professional education programs in physical therapy.