Page 12 P H Y S I O T H E R A P Y June, 1970

B O O K  R E V I E W S

MATERNAL RESPIRATION IN  LABOUR—An initial 
comparative study o f the effects o f various ante-natal 
training programmes. By R. St.J. Buxton, M.B., B.S., 
Ph.D., D .C.H . Written for the O.A.C.P. Price 2/-.

Unfortunately many o f the “systems” o f training for 
childbirth have become labelled, chiefly on account o f the 
variations o f breathing techniques employed during labour. 
Each exponent or disciple has been convinced that his or her 
method was superior to all others. According to their 
personal powers o f persuasion, influence has been brought 
to bear on the medical profession, the antenatal teachers 
and the mothers-to-be in turn, and a lot o f confused thinking, 
bias and jealousies have ensued.

However, antenatal training is now emerging from its 
initial and historic phase and it is imperative that it be 
prepared to present itself for scientific review and investiga­
tion. It is therefore a great pelasure to write a critique on 
this work o f research on maternal respiration in labour.

During this 2-year project, mothers who had been trained 
in the techniques o f three well known methods were under 
investigation, and a fourth group who had had no training 
was used for comparison. The breathing patterns were 
recorded, and an analysis made o f the alveolar and blood 
gas samples. Arising out o f the synthesis was the conclusion 
that the psycho-physical technique was the superior method. 
I must be forgiven for taking a particular interest in this 
point since this mode most nearly approximates my own 
practise. The report recommends that further modification 
o f this technique is required to obviate the tendency for the 
patient to hyperventilate under stress.

The importance o f this project cannot be sufficiently 
emphasized and we are grateful to Dr. Buxton and the 
O.A.C.P. for their contribution and hope that it is but the 
forerunner o f many more. »

Rosemary Harte, M.C.S.P.

THE WHEELCHAIR BOOK: Mobility for the Disabled—
by H. L. Kamenetz, M .D. Publisher Charles-C. Thomas.
301-327 East Lawrence Ave., Springfield, Illinois, U.S.A.
1969. 267 Illus. $14.75.

This book is divided into three parts: Indoor vehicles 
for the disabled, wheelchairs, and wheelchair operation and 
training with appendices and a very adequate bibliography. 
Part one has an interesting history o f wheelchairs through 
the ages. According to a recent survey there is one wheel­
chair to 677 individuals in the U.S.A. and in England and 
Wales the figure is one in 600. Walkers, stretchers, scooters, 
crawlers and lifting devices, e.g. hoists, are described with 
the pros, and cons, o f different vehicles. Brief mention o f the 
wheelchairs o f the future such as “moonwalkers” and chairs 
operated by the patient’s voice is made and perhaps a 
picture o f the motorised chair operated by the quadriplegic’s

chin ;could have been .included for physiotherapists who 
have not yet had the joy o f seeing these patients “whizzing” 
around the hospital and up and down slopes.

Part two is excellent and discusses the different types o f 
wheelchairs, accessories and selection o f wheelchairs. The 
majority o f these are made in the U.S.A. but are familiar 
to us in South Africa. Little mention is made o f the very 
robust wheelchair required, for example, by the African who 
is to use a wheelchair far away from a hospital workshop 
or supplier, but otherwise the adaptations are obtainable 
in South Africa. These chapters are most useful in that the 
advantages and disadvantages o f the adaptations are men­
tioned in detail and are most helpful, however from one’s 
own experience it is most difficult to advise a patient on 
the type o f wheelchair most suitable for them in the home, 
work and sport or recreation situation. The assessment of 
the patient’s requirements is not given in detail and one 
would wish for more guidance here, though one is advised 
to try out all the available wheelchairs.

Part three deals with chair operation and training, 
transfers, sports etc. and there is a useful chapter on the 
care o f wheelchairs. The appendices deal briefly amongst 
other subjects, with clothing, travelling with the chair, 
there are useful hints.

This book is well produced and has many useful explicit 
illustrations and descriptions and emphasis is laid on func­
tion throughout. Each chapter is headed by quotations 
which may sometimes be irritating. This book should 
definitely be read by all who have anything to do with 
advising patients about wheelchairs and will be very useful 
in reference libraries for physiotherapists as there is plenty 
o f useful advice for the student and the inexperienced for 
whom this book is most warmly recommended.

F. de B.

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