Therapy for Amputees, ed 3.

Therapy for Amputees, ed 3 Engstrom B, Van de Van C. Philadelphia, PA 19106, Churchill Livingstone Inc, 1999, hardcover, 332 pp, illus, ISBN: 0-443-05975-6, $49.

Therapy for Amputees is intended to be an introductory text for health care providers, especially those in the fields of physical therapy and occupational therapy. This third edition includes new topics concerning the psychological impact of amputation, wheelchair assessment, and pain management. The authors address practical and theoretical topics as they apply to the population with amputations worldwide.

There are 23 chapters, each starting with a table of contents and concluding with a bibliography. Frequent photographs, tables, flow charts, and line drawings help clarify the text. All stages of rehabilitation are addressed from pathology of amputations in developing and developed countries, to pre-and postoperative treatment, to complex cases. Appendix 1 lists resource organizations for sports, travel, and support groups, all in Great Britain. Appendix 2 is a checklist for wheelchair prescription. The book concludes with an extensive list of additional readings and an index.

Seven chapters address specific levels of amputation such as transfemoral, bilateral lower-limb, upper-limb, and congenital amputations. Each chapter lists prosthetic components and the fit and alignment of the prosthesis. Functional activities, such as donning or doffing the prosthesis, walking on level surfaces and stairs, and rising from the floor, are discussed in detail. Line drawings with the prosthetic side shaded and alternate strategies for the same activity provide in-depth clarification. The chapter on upper-limb management includes unilateral and bilateral activities and lists the advantages and disadvantages of electric prostheses.

The chapter on pain management classifies the types of pain as phantom sensation, phantom limb pain, and residual limb pain. Causes of preoperative, acute, and long-term pain are described. Treatment of pain is broken down into physical therapy interventions, medical and surgical management, and multifaceted chronic pain management. The physical therapy section includes detailed "subjective" and "objective" assessment and treatment modalities ranging from physical agents to exercise and education.

Students and physical therapists will find Therapy for Amputees a useful resource for their library. The information is well organized and covers basics such as postoperative exercises and biomechanics of both normal and prosthetic locomotion. The book also addresses the needs of people with additional complications such as visual impairment, stroke, and fractures. The authors conclude with the important message that the physical therapy profession needs to advocate for clients and that the of individual therapist is responsible for professional development.

Bonnie Bauer Swafford, PT
University of Kansas Medical Center
Kansas City, Kan

Ms Swafford is Teaching Associate, Department of Physical Therapy Education, and Clinical Director of Physical Therapy, Department of Rehabilitation Services, which includes inpatient acute care, outpatient clinics, and an accredited general and traumatic brain injury rehabilitation unit.