The Diplegic Child: Evaluation and Management.

This book is the product of a symposium held in Charlottesville, Va, in 1991, where experts on cerebral palsy (CP) presented information and attempted to develop a consensus regarding current treatment practices. Many issues related to CP are included in the book, and an emphasis is placed on the child with diplegic CP. The book contains 40 chapters and is organized into 10 sections, with consensus statements given at the end of each section. The consensus statements were developed from small group discussions and discussions of participants at the meeting, and were intended to reflect current practices in the field related to CP. The editor mentions no intended audience, but the chapters were written primarily by medical doctors, doctors of philosophy, physical therapists, and occupational therapists.

The book is intended to be comprehensive in scope by covering spasticity related to CP, deficits other than spasticity, outcome studies, surgical decision making, surgical and nonsurgical interventions, specific clinical entities of CP (eg, crouch gait and varus foot), and coverage of goals and management of CP from a global perspective.

Much current information and clinical research related to CP is included. The first section, on the pathology and patho-physiology of spasticity, presents a complicated issue very clearly and at an advanced level to address the needs of the more experienced clinician. The second section, on deficits other than spasticity, is somewhat disappointing because motor control parameters other than balance and perception are addressed superficially. The need for research to document effectiveness of intervention was emphasized throughout this book. The sections on outcome assessment and surgical decision making highlight the pros and cons of various research designs and methodologies, including gait lab analysis, which is covered in great detail.

In general, this book provides pediatric physical therapists, especially those who have clinical experience with children having cerebral palsy, with much valuable information. Because this book is written by multiple authors, transitions between chapters, are not smooth, and some repetition exists. In some chapters, research findings, are simply presented, whereas in others, theoretical discussions are presented along with current research. Despite some shortcomings, however, this book would be a valuable resource for any pediatric therapy department.