Spinal Cord Injury Rehabilitation
sions into a comprehensive consideration of this disability. Throughout the text the author (Therapy in Practice Series No 45) maintains her argument for a by Karen Whalley Hammell. Chapman and Hall, London, 1994 (ISBN 0 412 47680 0). client-centred approach towards Illus. 349 pages. f14.99. rehabilitation. More instruction and This is not a manual of treatment practical direction t o support this techniques, goals and aims for ther- philosophy would be beneficial t o apists involved in the management facilitate its implementation within of patients with spinal cord injuries. the existing framework of today’s Instead, this author presents ‘an health care. However, the lack of approach t o rehabilitation that is set answers and solutions to the based on a client-centred model of problems of spinal cord injury practice’. This explores the rehabili- management probably does much tation process from the perspective to endorse her reasoning. of occupational performance, while This book serves as a useful examining the interaction between resource t o expose the limitations the spinal cord injured person and of the medical model of rehabilitahis environment. It achieves this tion management and facilitates a most successfully and, as such, it greater understanding of the beneprovides a clearly presented argu- fits of an educational approach. ment for expanding the focus on Each chapter is extremely well physically directed goals of spinal referenced and provides compreinjury rehabilitation to more global hensive support to the text. issues. It supplements existing texts of practical information on the techniques and acquisition of physical Community Based skills and is written for health Rehabilitation professionals who are seeking to by Malcolm Peat. W B Saunders, Philadelgain greater awareness of the wider phia. British distributor Harcourt Brace and concept of rehabilitation and inter- Company Ltd, Foots Cray High Street, Sidcup, Kent DA 14 5HP, 1997 (ISBN 0 disciplinary working. The layout of the book is clear, 7020 194 1 0). 165 pages. f25. although not always presented in This is not a text for therapists on the most logical sequence, since how to rehabilitate their community many of the themes overlap bet- patients. Those looking for a recipe ween chapters. Diagrams and text on physiotherapeutic modalities photographs are used sparingly to for use with a community caseload support the text. There is occasional should look elsewhere. The direct imbalance of detail in certain sect- relevance t o physiotherapy and its ions, such as detailed description part in community based rehabiliand diagrams of hand splinting tation (CBR) is, therefore, minimal. The text provides a review of the in the chapter on acute care, with only a cursory mention of aspects current literature, both formal and of respiratory care. This probably informal, and contains a good many reflects the author’s occupational useful references, but as Malcolm Peat states: ‘This is a basic text therapy background. The section on cushions and which examines the development of wheelchairs disappointingly pro- CBR and the factors influencing its design and implementation.’ vides little information on posture. The easy-to-read 12 chapters span However, the inclusion of chapters on management of high 160 pages while the topics discussed lesions, living with a spinal cord include planning, management, injury, long-term issues and ageing, education, research, evaluation and the way forward, are of great and policy issues. ‘Community’ is significance with the current trends defined as incorporating locality, and developments in spinal cord organisation and commonality with injury management. The explo- reference t o the Oxford English ration of issues such as community Dictionary (1975) definition. The re-entry, productivity and leisure, term ‘community’ has many diffwomen, children, adolescents, and erent meanings and i t has been older people with spinal cord injury, used in many ways. The text describes CBR in many pain, personal care attendants, selfneglect and suicide, advocacy and forms and cultures, hence there is quality of life, are invaluable inclu- no conclusive definition of it. CBR as
Spinal Cord Injury Rehabilitation is easy t o read and well presented, and is excellent value for money. It is recommended as a n essential text to therapists involved in the rehabilitation of persons with spinal cord injury, whether in specialised units, general hospitals or in the community. I t also has relevance to therapists working with other client groups. The sections on self-determination, education as the key t o rehabilitation and psychological adaptation are useful reading material for therapy students prior t o undertaking initial clinical placements. It is highly desirable that the concepts presented in this book are read by medical personnel to enable rehabilitation of those with spinal cord injury to be undertaken t o greatest effect and benefit.
Dorothy Tussler MCSP defined by ILO, UNESCO, WHO 1994 is a useful starting point and is quoted in the text, as are the WHO definitions of impairment, disability and handicap. I found the chapter on CBR models very interesting, particularly the objectives and activities of the organisations described, a s in many instances they echoed my own wishes for the much smaller community in which I practise physiotherapy. As previously stated, the text does not describe the application of physiotherapy or any other named therapies in the community, so who is the text aimed at? Malcolm Peat says it is ‘primarily for those in the application of CBR and in the education of the key stakeholders in the CBR process’. I believe the book will mainly be of interest t o researchers, those involved in the planning and provision of the CBR service and library book purchasers. This is not a text for the majority of the CSP membership. The level of detail presented may not satisfy community rehabilitation specialists, though disability service co-ordinators, and therapists involved in the provision of services, may find the references throughout the text useful and the text as a whole is a quick and easy read.
Keli Beamon GradDipPhys MCSP
Physiotherapy, November 1997, vol 83, no 11