Traumatic Brain Injury: Rehabilitative Treatment and Case Management, 2nd ed.

Traumatic Brain Injury: Rehabilitative Treatment and Case Management, 2nd ed Ashley MJ, ed. Boca Raton, FL 33487, CRC Press, 2004, hardcover, 800 pp, illus, ISBN: 0-8493-1362-7, $149.95.

Traumatic Brain Injury: Rehabilitative Treatment and Case Management is a text designed to be both a clinical reference tool and a teaching text for clinicians working with people with acquired brain injury. The text is comprehensive and meets the editor's stated objectives of addressing treatment, education, and advocacy issues for clinicians working with people with brain injury. The content richness of this book comes in part from the diverse background of the 43 contributors who represent the work of researchers and clinicians. The book is not meant to provide an all-inclusive reflection on the many unique challenges facing people with brain injury, but it thoughtfully addresses issues affecting the quality of life of people with traumatic brain injury. The text is divided into 3 parts, with chapters organized around the themes of medical, allied health, and case management.

The 10 chapters comprising the part on medical themes (part 1) present strong basic science grounding for the allied health chapters that follow. Chapters on the management of posttraumatic epilepsy and on neurotransmitters and pharmacology are particularly useful as reference chapters for clinicians. The chapters on visual and auditory assessment and function provide a neuroscience review with intervention-specific ideas for clinicians specializing in vestibular dysfunction and the challenges of postural control. These chapters could be stand-alone readings used to organize specific units in a professional or postprofessional curriculum. The chapter on aging and related neuromedical issues recognizes the chronicity of traumatic brain injury, and although not intended for a lay audience, reflects the editor's desire to provide information for caregivers that allows for planning for the future.

The chapters in the allied health section (part 2) have a strong emphasis on cognitive rehabilitation and behavioral analysis and planning. One chapter in this section is dedicated to the management of physical deficits. This chapter reads as 2 parts: examination and intervention. The examination section is a good resource, providing sample tools and testing procedures for a variety of impairments and functional limitations. The intervention section is categorized by common problems encountered during the rehabilitative process, including pain, mobility dysfunction, impaired postural control and balance, cerebellar dysfunction, and sensory dysfunction. Specific challenges, such as a return to driving, are addressed as well. Future editions of the text should include additional in-depth information on interventions to promote cardiovascular fitness. Special rehabilitation concerns are addressed in separate chapters--most notably, the strategies for school participation and transition. Most, but not all, chapters in the allied health section make teaching points through addition of thoughtfully presented case studies.

The final part addresses issues of case management. Although this section is shorter than the medical- or allied health-themed parts of the text, the inclusion of specific chapters addressing issues of case management, litigation and settlement, bioethics, and discharge planning in this text illustrates the editor's attempt to address more than the medical or rehabilitation aspects of brain injury recovery. The bioethics chapter in particular provides the opportunity for reflective discussions about driving, restraints, and informed consent for beginning practitioners who may not have yet experienced these challenges in direct care delivery. The chapter is organized around specific bioethical principles and then features a targeted case study to translate principle into practice.

The text meets the needs of beginning or experienced clinicians who want a comprehensive reference text for brain injury rehabilitation. Chapters are well referenced and provide the reader who wishes to explore additional literature for further information. The book has a bias toward the challenges that cognitive and behavioral impairments present in the return to pre-injury function. That said, often the cognitive and behavioral challenges limit recovery most, so the bias reflects many therapists' practice realities. Figures, tables, photographs, and charts are used to augment teaching points throughout. Although a large number of experts contributed to this text, the editor has paid careful attention to readability, and the depth of contributors is a strength, not a distraction. The text as a whole is likely too population-specific to be a primary text for a beginning clinician. Physical therapists will find that the emphasis on examination strategies in many chapters will make this book a welcome reference.

Kathryn R Zalewski, PT, PhD

University of Wisconsin Milwaukee

Milwaukee, Wis

Zalewski is Interim Program Director for the University of Wisconsin System Consortial Doctor of Physical Therapy programs at the UW--Milwaukee campus and currently researches the impact of aerobic activity on the lives of adults with disabilities caused by stroke or brain injury.