B o o k R e v i e w H u m a n P o s t u r a l R e a c t i o n s - LESSONS FROM PURDON MARTIN A u th o r: J o h n F o ley P ublished: 1998 by T h e F rie n d s o f th e C h e y n e C e n tre fo r C h ild r e n w ith C e re b ra l P a ls y , m h is b o o k is a b o u t static eq u ilib riu m - h o w w e sit, rise, I sta n d , tu rn a n d e v e n lie- a n d a b o u t th e m a n y reflexes A . th a t are n e e d e d if th e b o d y is to re ta in its balan ce in th e face of th e d o w n w a rd p u ll of g rav ity ". T h u s b eg in s th e in tro d u c tio n th e b o o k w h ich h a s essentially b een w ritte n as a trib u te to J P u rd o n M artin. P u rd o n M artin w a s a n e u ro ­ logist, w h o se b ook " th e Basal G anglia a n d P o stu re " w as p u b lis h e d in 1967. It d o c u m e n te d th e o b servations h e h a d m a d e re g ard in g chronically d isab led p a tie n ts - m a in ly tho se w ith p o st -encephalitic park in so n ism , a n d the logical analysis of th eir p o s tu ra l deficits. H e classifies a n d describes the v ario u s n o rm a l p o stu ra l reflexes; a n tig ra v ity m echanism s, p o stu ra l fixation, tilting reactions, tilting, rig h tin g a n d p ro tectiv e reactions etc. This b o o k let ( 81 p ag es) is p ractical a n d easy to re a d a n d p h y sio th e ra p ists w o rk in g w ith a d u lts o r c h ild re n w ith n e u ­ rological im p a irm e n ts w ill be able recognize th eir p atie n ts m o v em en t pattern s in the descriptions of the various p o stu ral reactions, eith e r fro m th e text o r th e n u m e ro u s d raw in g s. Little in fo rm atio n is giv en reg a rd in g rehabilitatio n . H o w e v e r his u n d e rly in g m o to r co ntrol m o d e l - th e h iera- chical m o d e l - w ith its co n cep t of b alance resu ltin g fro m a series of hierarchically o rg a n iz e d reflexes a n d reactions, w h ile u se fu l in th e clinic to h e lp id en tify th e ap p ro x im a te level of in ju ry an d to h e lp p re d ic t to w h a t ex ten t reco v ery w ill occur, h as som e significant lim itations in term s of current m o to r control research. T he hierarch ical m o d e l led to the d e v e lo p m e n t of asse ssm e n t tools th a t m e a su re d th e p re ­ sence or absence o f reflexes a n d in te rv e n tio n s th a t focused o n in h ib itin g p rim a tiv e a n d p ath o lo g ical reflexes a n d facili­ ta tin g th e em erg en ce of n o rm a l e q u ilib riu m reactio n s. C u rre n t research indicates th a t b alan ce can be v ie w e d as a m o to r skill th a t em erges from th e in te ra c tio n of m u ltip le sy stem s th a t are o rg a n iz e d to m eet fu n ctio n al ta sk goals a n d th a t are c o n strain ed by e n v iro n m e n ta l context. Balance v ie w e d as a m o to r skill su g g e sts th a t like an y skill, b alance can im p ro v e w ith practice.(1) In conclusion w h ilst this bo o k let m ay be of clinical interest, b ecau se it d oes n o t tak e in to sufficient acco u n t th e d e v e lo p ­ m e n ts in th e field of p o stu re , b alan ce a n d m o v e m e n t con­ trol, it h as lim ited valu e in c u rre n t th erap eu tic rehabilitation. LYNN FEARNHEAD REFERENCE. 1. H orak FB, Henry SM , Shum w ay-C ook A. 1997 Postural preturbations: N ew insights for treatm ent o f b a lance disorders. P h ysic a l Therapy 7 7 :5 ;5 17-533. 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