Traumatic Brain Injury. Physical Medicine and Rehabilitation State of the Art Reviews.

Traumatic Brain injury. Physical Medicine and Rehabilitation State of the Art Reviews Edited by Horn LJ, Cope DN. Philadelphia, PA 19107, Hanley & Belfus, 1989, hardback, 278 pp, illus, $28

This volume has two stated purposes: to provide information about state-of-the-art care of individuals who have traumatic brain injury and to set the stage for future innovations. The 14 chapters are by a diverse group of professionals from across the United States. included are physiatrists, psychiatrists, psychologists, a physical therapist, a social worker, and an attorney. All make valuable contributions. Each chapter has a complete, varied, and up-to-date reference list. The variation from chapter to chapter in the reference style (sometimes alphabetical, sometimes in order of citation) is a minor annoyance.

The book's content is broad, reflecting the range of services needed by persons who have traumatic brain injury. The pathophysiology of traumatic brain injury is discussed in the context of primary damage versus secondary damage and focal injury versus diffuse injury. Functional prognosis and early rehabilitation management are covered from a medical standpoint; emergency care of traumatic brain injury is not covered. The chapter co-authored by a physician and a physical therapist addresses evaluation and treatment of motor and sensory disturbances associated with traumatic brain injury.

Sections on alterations in neuromuscular tone, coordination, and balance are addressed from medical, pharmacologic, and physical therapy perspectives. Cognitive, emotional, behavioral, psychosocial, and family issues in treatment of traumatic brain injury are covered in a thorough manner. Three chapters are devoted to the oft-neglected issues of systems of care, legal aspects, and public policy related both to individuals with traumatic brain injury and to traumatic brain injury as a major public health problem in the United States.

The concluding chapter reviews the literature on the efficacy of rehabilitation for persons who have traumatic brain injury. The authors conclude that, although the literature suggests that rehabilitation efforts can produce substantive change in individuals with traumatic brain injury, additional methodologically sound research is needed to establish a causal link between improvements and rehabilitation. The authors offer specific suggestions for improving research.

Physical therapists who work with clients who are brain injured-whether in acute or community setting-will consider this concise, complete, well-referenced volume a welcome addition to their libraries.

Elizabeth Domboldt, EdD