SEPTEMBER 1980 P H Y S I O T H E R A P Y 81 BOOK REVIEWS Physiotherapy in Disorders o f the Brain. Shepherd, R. and C arr, J. (1980). W illiam H einem ann, London. P rice: £10,95. T he authors o f this boo k achieve th e goals which are stated in th e preface. T hey are obviously experienced, widely read and trem endously interested in im proving understanding and handling of patients suffering from b rain disorders. T heir opinions a re freely expressed, well substantiated and inform ation is well docum ented throughout. Section I has four subsections which fo rm an in te­ g rated and com prehensive background to th e follow ing sections. I t is pleasant to see ageing treated as an im portant consideration, an d not ju st briefly m entioned as is so often th e case. A ssessm ent and re-learning m ovem ent em phasise the problem -oriented approach to -.treatm ent w hich considers all aspects of th e p a tie n t’s . ^ h a b ilita tio n program m e. T his ap proach is carried thro u g h to Section II, which deals w ith aspects of th e m ore com m only encountered disorders. Section III covers other com m on problem s of n eu ro ­ logical disorders an d extends the field covered in the previous section and substantiates it. A lthough th e T echniques of T reatm en t listed in A ppendix i are d ealt w ith very briefly, th ere is a good deal of inform ation w hich will help th e reader to discrim inate betw een and clarify concepts. T he m aterial in this book should aid th e th erap ist to a b etter integration o f p a tie n ts’ problem s w ith treatm en t procedures, and a m ore discrim inatory ap proach to choice of techniques. T he book m akes pleasant reading and should be a valuable com panion to physiotherapists at various levels of experience an d to senior students. H . P. M aree Cash’s Textbook o f Physiotherapy in Some Surgical Conditions. Ed.: D ownie, P atricia A. (1979). 6th E dition. F ab er & F ab er, L ondon. R epresented by M acM illan South A frica. Price: + R12,75. T he 6th edition has been enlarged and up d ated in all sections and includes th ree new chapters. O ne addition is a ch ap te r on “ U sing M edical L ib raries” and has sections on th e U niversal D ecim al Classification, in­ dexing periodicals an d th e In d ex M edicus. A second new addition to the boo k is th e chapter on Plastic Surgery and includes in fo rm atio n on grafts, han d su r­ gery, as well as cosm etic surgery. T he th ird new ch ap te r is on A dvanced R e h ab ilitatio n by th e w ell-known au th o rity on th e subject, S. H . M cL aren o f th e H e r­ m itage R ehabilitation C entre. A ll three new chapters are welcome additions. This book, as over the years, continues to keep up w ith m edicine to-day and should rem ain a m ain reference in P h y sio th erap y b o th for qualified and train in g physiotherapists. M . F arq u h arso n M ultiple Choice Questions in Anatomy & N eurobiology for Undergraduates. Blunt, M. J. an d G irgis, M. (1979). B utterw orth. L ondon. P rice R8,90, plus GST. O btainable fro m : B utterw orth & Co. (S.A. Pty) Ltd. P.O. Box 792, D u rb an , 4000. T his b o o k of m ultiple choice questions has been com ­ piled fro m a question b an k collected over m any years in the D ep artm en t o f A natom y at the U n iv ersity of Sydney. T he questions are grouped according to a n a ­ tom ical regions and include three m ultiple choice question types. As these questions w ere p rim a rily set fo r m edical students m any o f them are unnecessarily detailed fo r param edics an d a m ore functional em phasis w ould be preferable in m ost of the sections. H ow ever, it is well set out w ith som e questions th a t can be used exactly as they are w ritten. M ore im portant, it is useful fo r ide?s on setting new questions and often questions need only one or tw o distractors changed to suit the students answ ering them . T his could be a valuable b ook fo r exam iners in u niversities and colleges training students in professions allied to m edi­ cine. A s an additional aid to learning it is n o t suitable fo r the student. I. Sellars . ) ABSTRACTS/OPSOMMINGS D e D om enico, G . (1979) T onic vibratory reflex. What is it? Can we use it? Physiother. 65, 44 - 48. A u th o r s Sum m ary T h e T o n ic V ib ra to ry Reflex (T V R ) is a v a ria n t o f the classical m y o tatic reflex. Essentially, it is the co n trac­ tio n of a m uscle in response to a v ib ra to ry stim ulus o f low am plitude ( < 3 m m ) at a frequency o f ab o u t 100 Hz. T he diagnostic an d th erap eu tic p ossibilities o f the T V R a re being investigated by a n u m b er o f authors. In general, they all su p p o rt th e view th a t this reflex has a significant role to play in th e diagnosis and treatm ent o f the p atien t w ith a neurological disability. Atkinson, B. W. (1978) A new concept in traction tables: K altenbom three-dimensional treatment table. A ust, J. P hysiotherapy 24, 219 - 220. T his is the d escription o f a highly v ersatile tractio n table w hich was designed in N orw ay. I t is divided into three sections w hich can be m an ip u lated independently, and the lower, o r lu m b ar section can be ro tated aro u n d its long axis to give three-dim ensional tractio n . A p art from its use as a tractio n table, b y tip p in g the low er end it can also be used fo r postural drainage. I t w ould ap p ear to be a very useful and versatile piece o f eq u ip ­ m ent and o f p a rtic u la r interest to physiotherapists who use o rth o p a e d ic m anipulative techniques in th e ir tre a t­ m ent o f the spine. H . C. W atts Twomey, L. T. and Furniss, B . I. (1978) The life cycle o f the intervertebral discs and vertebral bodies. A review. A u s t J. P hysiotherapy 24, 209 - 218. A w ell-docum ented and detailed d escription o f th e de­ velopm ent and stru ctu re and ageing process o f the vertebrae an d th e ir discs. T h e au th o rs stress th e need fo r a th o ro u g h understanding o f the fundam ental arch i­ tecture of th e b ack b y those involved in th e treatm ent of b ack p ain syndrom es. T h e fact th at vertebrae and discs grow an d age together as one fundam ental u n it is em phasised. “I t follow s th a t physical th erap y procedures should not be selective just to th e disc, b u t should in ­ volve th e to tal fu n ctio n al u n it . . . we need to be aw are of the fact th a t o u r techniques have a considerable effect upo n bon y structures as we are o f the effects R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) 82 F I S I O T E R A P I E SEPTEMBER 1980 w hich they have on the so ft structures o f disc, lig a­ m ents and in terstitial fluid.” T his a rticle provides valuable reading to those involved ir m anipulative p rocedures o f the spine. H . C. W atts Special supplement (1979) T he health and safety at work act 1974 — p olicy statement and codes of safe practice. P hysiotherapy 65 17 - 28. A d etachable b o o k let intended to p ro v id e guide-lines fo r D istrict, S u p erin tendent an d clinical physiotherapists and Safety R epresentatives. Policy statem ents fo r D is­ trict and S u perintendent Physiotherapists a re given, plus Codes o f Safe p ractice covering physiotherapists; rem edial helpers; clerical officers; an d p o rte rs’ duties. Safety p recau tio n s covering activities ranging fro m the storage o f oxygen to endotracheal suctioning, and covering th e m ain m odalities o f treatm en t a re given. T h e re is also a G en eral Section o utlining action in the event o f fire, burns, electric shock a n d cardiac arrest. C opies o f this b o o k let should be prom inently displayed, a n d read, m arked and inw ardly digested b y all. H . C. W atts Maitland, G. D . (1979) Examination o f the cervical spine. A ustr. J. Physiother. 25, 49. E x am in atio n of the cervical spine is discussed briefly in relatio n to history, neurological exam ination, v erte­ b ral artery insufficiency a n d X -rays. T h e general p rin ­ ciples of exam ination are presented. D etails of th e exam ination are discussed m ore fully u n d er th e follow ing headings: th e upper cervical spine and its exam in ation fo r cervical headache, th e m iddle cervical spine w ith its exam ination being related to spondylosis /arth ro sis; th e m iddle and low er cervical spine and its exam ination re la te d to w ry neck, nerve root irritatio n o r com pression, and w hiplash injury. A u th o r’s sum m ary Pevsner, D . N ., Johnson, J. R. G., Blazina, M. E. (1979): The patellofemoral joint and its implications in the rehabilitation o f the knee. P hys. Ther. 59, 869. Previously, little! has been done to correlate degene­ ration of the patellofem oral jo in t and the efficiency of the knee extensor m echanism . T h e authors have fo u n d in th eir experience of treating 1 800 patients th a t basal and age-dependant degeneration of the patellofem oral jo in t can be triggered during reh ab ilitatio n if care is not taken to m ain tain the pro p er alignm ent o f the patella in its groove and to m inim ize the com pression forces on it. Reviews of p atello fem o ral joint m echanics and pathology are stated to support th eir feelings. G u id e­ lines fo r suitable reh ab ilitatio n exercises are suggested. M . J. R unnals Kessler, R . M . (1979 Acute symptomatic disk prolapse. Clinical manifestations and therapeutic consider­ ations Phys. Ther., 59, 978. A clear clinical picture o f th e nu clea r prolapse stage o f a disc lesion is given un d er the headings: age, sex, occupation, onset, n a tu re o f pain, observation, active and passive m ovem ent, d ural m obility tests, n eu ro ­ m uscular tests an d p alpation. E x planations fo r the onset, n a tu re o f the pain and ab e rra n t active m ovem ents are given and these are related to th e m anagem ent o f the acute and postacute stages o f treatm en t. P rim ary goals of m anagem ent should include: resolution of th e acute problem , restoration o f optim a) segm ental m echanics, resto ratio n o f an optim al activity level, prevention o f recu rren t physical dysfunction and prev en tio n o f chronic pain beh av io u r patterns. M J. R unnals Bantjes, A . en Klomp, R . (1978) Onderzoek naar de overdracht van uMrageluidenergie door kontakt- stoffen. N ed. T ijdchrift Fysiotherapie, 88, 275. ’n H o o g leraar in m ateriaalteg n iek en ’n chemiese tegnoloog het ondersoek ingestel n a die effektiw iteit van energie-oordrag van u ltrak lan k d eu r m iddel van verskillende kontakstow w e. D ie akoestiese im pedansie (produk van digtheid m ateriaal en die snelheid van k lan k hierin ) van m enslike weefsel (bekend), m ateriaal b ehan d elk o p (bekend) en k o n tak sto f (w at vasgestel m oes w ord) is gebruik om d ie totale o o rd rag van u ltrak lan k -en erg ie te bereken. O m die akoestiese im pedansie van die verskillende kontakstow w e te be­ reken, is gebruik gem aak van ’n eksperim entele in ter­ fero m eter om d ie ultrak lan k sn elh eid te m eet en van ’n p ik n o m eter o m die digtheid vas te stel. A lle k o n tak ­ stowwe is gem eet by dieselfde tem p eratu u r van 35°C (die gem iddelde h u id tem peratuur). D ie verskillende stappe van die eksperim ent w ord uiteengesit en die resultate in tabeiie \asgele. K o n ta k sto w w e w at na- gegaan is, is o.a. a q u r'.s n ic gel, glycerol (88% ), glycerf-y (98% ), hirudoi'ed gel en salf, v loeibare paraffien »_ w ater. D it blyk dat d ie energie-oordrag van b eh an d el­ ko p n a k o n tak sto f ’n persentasie oplew er van 2 5 -4 2 % . D ie res w ord gereflekteer. By d ie oorgang k o n tak sto f — m enslike weefsel — is die persentasie 9 7 - 100%. D ie totale o ordrag-persentasie IS tussen 25% en 41 % (vloei­ b a re paraffien 25% , w ater 30% , aquasonic gel 32% en glycerol 4 0 -4 1 % ). D ie gevolgtrekking w at h ie ru it ge­ m aak k an w ord, is d a t d a a r o o r d ie algem een nie so ’n g ro o t verskil in energie-oordrag tussen d ie v erskil­ lende kontakstow w e is as w at vroeer a a n v a a r is nie. B.G. Harris, S. R . (1978) Neurodevelopmental treatment ap­ proach for teaching swimming to cerebral palsied children. P hysical Ther., 58, 979-983. A fter a review o f the general advantages o f h y d ro ­ therapy th e a u th o r gives a critical overview o f current sw im m ing program m es used fo r cerebral p alsied child­ ren, pointing o u t m isconceptions regarding the n atu re o f the disability, th e inclusion o f asym m etrical sw im ­ m ing strokes, th e inclusion o f strokes w hich will increase th e ab n o rm al p attern s and the inclusion of strokes w hich are beyond th e cap ab ilities o f m ost cerebral palsied children. She also p o in ts o u t th a t mojjt books recom m end a pool tem p eratu re o f 28 - 7 f ~' Celsius, a te m p eratu re w hich w ill increase spasticity V m ost children. T h e a u th o r, w ho has had experience b o th in teaching sw im m ing and in neurodevelopm ental therapy, recom ­ m ends a m in im u m pool tem p eratu re o f 35°C. She proposes a m odel fo r a sw im m ing pro g ram m e designed to im plem ent N .D .T . goals of facilitatin g n o rm al m ove­ m ent p attern s ag ain st a back g ro u n d of n o rm a l postural tone. Strokes taught a re lim ited to b reast-stroke and elem entary backstroke, both sym m etrical strokes p e r­ form ed w ith the head in m id lin e in o rd e r to avoid u tilizatio n o f to n ic reflexes o r reinforcem ent o f ab ­ n o rm al patterns. Sculling $nd finning, also sym m etrical strokes, are recom m ended fo r quadriplegics w ith lim ited u p p e r extrem ity m ovem ent. T h e p rogram m e, designed as a p ro g ram m e fo r teaching sw im m ing ra th e r than as an individual treatm en t program m e, includes in tro d u cto ry skills, secondary skills, sw im m ing strokes, w ater survival skills and functional skills. S econdary skills include breathing, relax atio n and floating and em phasize the use o f head and jaw control w here req u ired . F u n c tio n a l skills include sitting balance, standing balance, w eight- shifting, w alking, one-footed balance and stair-clim bing in different depths o f w ater. Suggestions regarding R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) ad ap ta tio n of different skills fo r different categories o f cerebral palsy are also made. S.I-C. SEPTEMBER 1980 P H Y S I O Lane, R . E. J. (1978) F acilitation o f Weight Transference in the Stroke Patient P hysiotherapy, 64, 260. T h e validity o f treatm en t o f p h y sio th erap y fo r stroke victim s m ust b e questioned if th e best use is to be m ade o f o u r lim ited resources. In this article th e prognosis fo r recovery in relatio n to th e severity o f the stroke is given. T he necessity fo r re-educating p o stu ral aw are­ ness as a basis fo r m ovem ent is stressed, and the essential role o f w eight-bearing described together w ith sim ple exercises th a t m ay safely be practise d by the p atien t o n his own. T h e a u th o r stresses th a t all people involved should be tau g h t th e m o st effective way o f ' p ip in g th e p a tie n t reach his m axim um p o ten tial. T his ^ / a very useful article, w hich w ill be o f great value to those w ho are n o t fa m ilia r w ith cu rren t m ethods of treatm ent. H.C.W . Frymoyer, J. W., Hanley, E., H ow , J., Kuhlmann, D . and Matteri, R . (1978): D isc E xcision and Spine Fusion in the Management o f Lumbar D isc Disease. A Minimum Ten-Year Follow-up. Spine 3. Seventy-nine percent o f 312 p atien ts w ho underw ent lum bar disc surgery w ere evaluated at least 10 years postoperatively (m ean — 13,7 years). R esidual back and nerve ro o t sym ptom s an d fu n ctio n al im p airm en t w ere equally as com m on am ong th e 143 p atien ts w ho u n d e r­ w ent fusion as they w ere am ong the 64 p atien ts who did not. T h irty percent o f th e p atien ts w hose spines w ere fused and 37,7% o f those p atien ts w hose spines w ere n o t fused w ere considered longterm failures because o f persistent sym ptom s o r th e need fo r re ­ operation. T h irty seven percen t o f the fu sio n p atien ts had persistent g raft d o n o r site sym ptom s. E xam ined p atien ts show ed a high percentage o f residual n e u ro ­ logical defects. A n u n explained positive T rendelenburg sign was present in 14,8% o f th e fu sio n p atien ts an d in 18,2% o f th e p atien ts w hose spines w ere not fused. Although retrospective studies often have problem s o f A ccuracy, this analysis confirms o th e r o bservations th at m idline spinal fu sio n offers few benefits in th e m anage­ m ent o f lum bar disc disease. A u th o rs’ sum m ary White, A . A . and Panjabi, M . M . (1978): The Basic Kinematics o f the Human Spine. A R eview o f Past and Current Knowledge. Spine 3. Spinal kinem atics concerns the kinds an d am ounts o f m otion the hu m an spine undergoes d u rin g its n orm al physiologic m ovem ents. T h is p ap er is a review of the research in this a re a and provides in fo rm atio n ab o u t past and cu rren t know ledge. T h e biom echanic term s essential fo r the precise an d accurate d escription o f spinal kinem atics are defined, described, a n d exem pli­ fied. R equirem ents fo r a com prehensive d escription o f spinal kinem atics are presented to pro v id e a perspective fo r present know ledge and fu tu re research. F in ally , the current status of spinal k inem atic research is described, and info rm atio n a b o u t the ranges o f m o tio n o f the hum an spine fo r various v erteb ral levels an d fo r m otion in different directions is provided. A u th o r’s Sum m ary T H E R A P Y “Spine” V olum e 3 N o . 1 March 1978. A sym posium an d several articles on A rach n o id itis are included. B. W inter. Hayne (1978): Safe . . . Sure? P hysiotherapy 64, 10 - 13. A lthough this article is prim arily w ritten for physio­ therapists in the B ritish N atio n al H ealth Service, m ost of it is ap p licab le to a P h y sio th erap y D ep artm en t any­ w here in the w orld. It spells out th e responsibilities and legal liab ilities of an em ployee in term s o f:— 1. The H ealth and Safety at W o rk A c t 1974 ( H M S O 1974). 2. Civil Law , w hich covers trespass, unlaw ful dam age, nuisance, defam ation and negligence — th e latter being the m ost relevant to th e practising physio­ therapist. 3. C odes o f Ethics, covering such aspects as:— (a) giving treatm ent prescribed by a doctor, know ing it to be dangerous; (b) confidentiality; the question o f know ledge of serious crim e is discussed. 4. Supervision o f patients undergoing treatm ent, together w ith instructions an d w arnings to the patient. “In ­ adequate w arnings m ay lead to substantial claims fo r dam ages”. 5. H elpers — their role, and th e responsibilities o f the physiotherapists training th em are described. 6. Safety in the D epartm ent: th e potential sources of accidents are detailed and include such items as flo o r surfaces, illum ination and equipm ent. U n d e r th e latter heading m any searching questions are asked. F ire- prevention equipm ent and d rill are discussed; also th e p o ten tial dangers in gymnasia an d hydrotherapy departm ents. T h e im portance o f regular equipm ent checks is stressed. 7. P hysiotherapists in Private Practice. T h e ir responsi­ bilities are likewise spelled out, an d include such aspects as th e p a tie n t’s consent fo r treatm ent, es­ pecially in th e case of children and the aged. C haperonage is discussed. T his is a com prehensive and valuable article which physiotherapists o f all ranks w ould do well to read, m ark and inw ardly digest. H . C. W A TTS Pieterse, M (1977): An Intervention Programme for M entally Retarded Infants: A Behaviour M odifica­ tion Approach. Australian Journal o f Physiotherapy 23, 141 - 144. A n interesting article describing the education p rin ­ ciple of behaviour reinforcem ent and its application to the treatm en t o f the D o w n ’s syndrom e child. “I f a child em its a b eh av io u r and the consequences are re­ w arded then the rates o f th at b e h a v io u r w ill increase. C onversely,if not rew arded it will dim inish” . “ Teachers and parents often unw ittingly rew ard undesirable behaviour by attending to it, an d extinguish desirable beh av io u r by ignoring it. T hey do n o t realise that ad u lt a tten tio n is rew arding to children and can in­ crease undesirable and well as desirable b eh av io u r.” “E xperience has sup p o rted the principle th a t increasing desirable b eh av io u r decreases undesirable behaviour. C hildren cannot play constructively an d destructively sim ultaneously” . T h e w riter feels th a t they are often victim s o f “ Low E x p ectatio n s” an d th erefo re do not a ttain th e ir m axim al potential: “ T he p aren t w ho accepts a one-w ord utteran ce w ithout setting a higher standard will continue to get one-w ord utteran ces” . R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. ) 84 F I S I O T E R A P I E SEPTEMBER 1980 MEDUNSA MEDICAL UNIVERSITY OFSOUTHERN AFRICA A p p l i c a t i o n s f r o m s u i t a b l y q u a l i f i e d p e r s o n s a r e i n v i t e d Tor t h e f o l l o w i n g v a c a n c i e s ; LECTURER a n d JUNIO R LECTURER i n i h c SUBDEPARTM ENT PHYSIOTHERAPY Closing date: 17 O ctobcr 1980 A p p l i c a t i o n f o r m s a n d a d d i t i o n a l i n f o r m a t i o n a r e o b t a i n a b l e f r o m : T h e R e g i s t r a r : A d m i n i s t r a t i v e M e d i c a l U n i v e r s i t y o f S o u t h e r n A f r i c a M E D U N S A 0 2 0 4 Telephone: (012) 58-2844/5/6/7/8/9 T h e M e d i c a l U n i v e r s i t y o f S o u t h e r n A f r i c a is s i t u a t e d i n t h e p r o v i n c e o f T r a n s v a a l , R . S . A . , 31 k m n o r t h - w e s t o f C h u r c h S q u a r e . P r e t o r i a , a n d a p p r o x i m a t e l y 8 k m w e s t o f R o s s l y n . D’Arcy Mac-M anus & Masius P 1014/E T h e article m akes p a rtic u la r reference to D o w n ’s syndrom e children, and describes a m ultidisciplinary model fo r th eir m anagem ent. It concludes th a t the results o f research based on this model “ su p p o rt the necessity fo r early intervention in the treatm en t of D ow n’s syndrom e children and particularly the need fo r a special e d u c a to r”. “T h e children are achieving and m aintaining m any skills o f norm al children their own age and are superior to o th er D ow n’s syndrom e children tested” . T his article w ill be o f interest to all those who are involved w ith retarded children. H C W A TTS Maitland, G. D . (1978) Acute Locking of the Cervical Spine. A ustr. Jnl. Physiother., 24, 3. A cute locking o f the cervical spine is described u n d er the headings, history, deform ity, site o f p ain , pathology, aim of treatm ent, selection of treatm en t techniques, physical exam ination and prophylaxis. T h e treatrrmpN techniques indicated i.e. m ob ilisatio n and m a n ip u la to r y are fully illustrated and detailed. M .J.R . IN D U ST R IA L PH YSIOTH ERAPY W ould any m em ber em ployed in industry o r com ­ m erce in a full-tim e, p art-tim e o r sessional basis capacity, please contact the undersigned. T his in fo rm a­ tio n is required by a sub-com m ittee o f the N .E.C. form ed fo r the p u rpose of pro m o tin g In d u strial Physio­ therapy in the R epublic o f S.A. W e w ould ap preciate y o u r co-operation together w ith any suggestions you may have regarding the im p lem entation o f this new and exciting venture. (M rs) B. M. Jaholkow ski 7 Irene R oad, N ew lands, 7700 Cape. NEW! A PORTABLE “PUFF” FOR ASTHMA AND BRONCHITIS MANAGEMENT The familiar Wright Peak Flow Meter now comes in mini-version ideal for use by patients in their own homes in the management of asthma and chronic bronchitis. It measures the patient’s maximum expiratory flow rate during a forced expiration. The patient keeps a record of the readings from which the physiotherapist is able to monitor response to treatment. It’s a valuable aid! ___ PRICE: R29,50 +GST MEDICAL DISTRIBUTORS |PTV][TD f; DMS (Rf'Ki P O BOX 337 0 J O H A N N E S B U R G 2000 P H O N E 29 061 1 P O BO X 195 CAPE T O W N 8000 P H O N E 47-4440 / P O BOX 5298 D U R B A N 4000 PH O N E 37-1501 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 3. )