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Spinal Cord Injury Rehabilitation

Journal of Neurologic Physical Therapy: March 2010 - Volume 34 - Issue 1 - pp 50-51
doi: 10.1097/NPT.0b013e3181d0ba13
Book Reviews

Note from the Reviews and Abstracts Editor and the Editor-in-Chief: As we went to press with this issue of JNPT, we learned that a fourth SCI rehabilitation text has just been published: Somers, Martha Freeman. Spinal Cord Injury Functional Rehabilitation, 3rd edition. Upper Saddle River, NJ: Pearson Education, Inc; 2010. 464 pages. ISBN-13: 978-0-13-159866-9. $73.33 We regret that we did not know of this publication in time to include a review of this text in the current issue of JNPT. However, we will review this text in a future issue of JNPT.

Sisto SueAnn, Druin Erica, and Sliwinski Martha Macht. Spinal Cord Injuries: Management and Rehabilitation. St. Louis: Mosby Elsevier, 2008; 552 pp, ISBN: 978-0-323-00699-6. $79.95

This recently published textbook is aimed at a broad interdisciplinary audience, including physical and occupational therapists, nurses, physicians, rehabilitation professionals, psychologists, and case managers. The authors state that it is also meant to provide a useful resource for patients and families. The 55 contributors include experienced authors, researchers, and expert clinicians.

The content is organized to follow a progression of the individual through the various stages of rehabilitation to community reentry. Content is organized in a fashion that progresses through specific steps in the care of individuals with spinal cord injury (SCI), beginning with perspectives from medicine, nursing, and respiratory care. Related to physical therapy, the use of standardized outcome measurements in everyday clinical practice is emphasized in the Evaluation chapter, something that should be useful to clinicians. A useful feature of this book is that as functional skills are presented and discussed, the authors address how they would be executed by someone with either a complete or incomplete SCI. Illustrations and pictures augment the detailed text descriptions of techniques that are unique to this population. Topics that would be expected in a comprehensive reference of SCI rehabilitation are included (eg, evidence related to SCI rehabilitation, medical management, complications, respiratory treatment, psychological adjustment, transfers and activities of daily living, and mobility training including wheelchair skills and ambulation). Additional topics included are challenges related to community reintegration such as assistive technology, fitness and exercise, transportation, aging with an SCI, and quality of life.

“People first language” is used throughout the book. Excerpts of thoughts and feelings from those living with an SCI are included in each chapter. Each chapter includes tables that highlight key points. “Clinical notes” included throughout the book emphasize important points and are easy to find. The case study examples included with each chapter are presented using the format outlined in the Guide to Physical Therapist Practice and, in combination with the review questions, emphasize critical thinking and reflection. Each chapter includes an extensive list of current references, and more than 500 illustrations are used to enhance the material presented in the book. A companion DVD is included, which provides visual examples of functional skill training typically performed during rehabilitation. The viewer is able to see both the performance of the patient and the techniques used by the therapist for 38 different functional skills (each 1–2 minutes in length) as they are performed by different patients of varying skill levels. The DVD is easy to navigate, and the narration provides step by step trainer tips as each skill is demonstrated. Overall, the DVD is an excellent adjunct to the textbook.

This book provides a comprehensive, up-to-date resource for readers interested in reviewing the broad spectrum of SCI rehabilitation and community reintegration. Some information overlaps between the Nursing and Medical Management chapters. Future editions of this text could include updated versions of SCI-specific outcome measures and address psychometrics of outcome measures. This textbook will be useful for anyone entering the SCI rehabilitation field and for the experienced clinician wishing to review specific aspects of care.

Mary Schmidt Read, PT, DPT, MS

Magee Rehabilitation

Philadelphia, Pennsylvania

Lisa Harvey. Management of Spinal Cord Injuries: A Guide for Physiotherapists. Philadelphia: Churchill Livingstone, 2008; 297 pp, ISBN: 978-0-443-06858-4. $72.95

This new textbook is intended for students of physical therapy (PT) or physical therapists who have not worked extensively with people with spinal cord injury (SCI).

The book is divided into three major and two smaller sections. The first section (two chapters) includes a review of spinal cord anatomy and a comprehensive description of the American Spinal Injury Association (ASIA) classification system. A short summary of several common complications that interfere with rehabilitation after SCI is included. Although the author's stated intent is to give a brief overview of these complications, this section lacks adequate explanations of their pathophysiology and their implications for rehabilitation. Also included in this portion of the book is a discussion of patient management within the framework of the International Classification of Function and Disability (ICF). Goal setting and predicting independence according to level of injury are both addressed within the context of the ICF model. In subsequent parts of the book, Harvey acknowledges the variability among patients with the same ASIA classification; however, this early chapter is somewhat simplistic in its descriptions of potential functional outcomes. This chapter contains a very useful summary of several standardized tools for assessing activity and participation in the SCI population.

The second section of the book (four chapters) is devoted to the descriptions of basic mobility skills for the person with SCI, including transfers, bed mobility, wheelchair mobility, ambulation, and upper extremity function. The skills are well described and accompanied by valuable drawings. Each skill is further divided into subtasks, and each subtask is supplemented by suggested strategies for practice. This is an excellent section for new therapists because it also supports the development of realistic short-term goals.

The third section (six chapters) of this book addresses impairments seen in people with SCI and includes chapters on training of motor tasks, strength training, contracture management, pain management, respiratory management, and cardiovascular fitness training. The impairments are presented in terms of their impact on mobility and their influence on general well-being throughout life. This section also describes general strategies for training that can be applied to all mobility skills, making it extremely useful in clinical problem solving.

Harvey's fourth section, a single chapter on wheelchair prescription, is basic but contains sufficient information related to prescribing a manual wheelchair. The information presented on power wheelchairs is very brief, thus the therapist will need to turn to additional sources on power mobility. The final section of this book consists of a very short (3 page) chapter on evidence-based PT; this information could have been integrated into the other chapters.

This textbook is appropriate for the entry-level therapist; however, the advanced clinician who is looking for more detail will need to refer to additional sources. This book focuses almost exclusively on direct PT interventions and management, largely omitting other relevant topics such as psychosocial issues facing people with SCI, or bowel and bladder management. It does not include a CD, though it is associated with a Web site containing videos that demonstrate mobility skills for people with SCI. Finally, this textbook would benefit from inclusion of case studies to promote clinical decision making.

Sondra G. Siegel, PT, PhD

Program in Physical Therapy Husson University

Bangor, Maine

Edelle Field-Fote. Spinal Cord Injury Rehabilitation. Philadelphia: F.A. Davis Co; 2009; 592 pages, ISBN-13: 978-0-8036-1717-9. $88.95

This new textbook is the latest addition to the Contemporary Perspectives in Rehabilitation series and is written for both practicing clinicians and physical therapy students.

The textbook is organized into three sections and 24 chapters. Section one (chapters 1–5) addresses both the basic and applied sciences of spinal cord injury (SCI). Specific topics covered in this section include a review of current animal models of SCI, musculoskeletal plasticity, current clinical trials, and neuroprosthetics. Section 2 (chapters 6–18) addresses the restoration of function after SCI. Specific topics covered in this section include approaches to improve mobility, upper extremity function, lower extremity function, psychological wellness, respiratory and cardiovascular health, bowel and bladder function, pain, and spasticity. Section 3 (chapters 19–24) addresses special topics that are of great importance to individuals living with SCI, yet usually receive little attention from clinicians. Specific topics covered in this section include adaptive sports, adaptive driving, assistive technology, sexuality, and fertility.

In addition to bringing her considerable clinical and scientific knowledge to the table, the author assembled a top notch group of contributors (a “who's who in SCI management” according to Steven Wolf, PhD, PT, FAPTA, FAHA, who wrote the foreword). Each chapter is written by experts in their respective fields and lays out a comprehensive, state of the art, evidence-based approach to SCI rehabilitation. All of the chapters have well-defined objectives, an outline, a summary, and review questions to help with reader comprehension and retention of the information. In addition, many chapters effectively use case studies to emphasize clinical relevance and promote evidence-based clinical decision making.

Shortcomings of this text include (1) some issues with flow and overlap/repetition between chapters, commonly seen in textbooks with multiple contributors; (2) some out of focus and/or inadequately labeled figures (especially for entry level student readers); and (3) the lack of additional DVD or web-based resources to augment the written text. However, this book is clearly a necessary addition to the library of all physical therapists who treat or plan to treat individuals with spinal cord injuries. It is also a valuable resource to be incorporated into entry level DPT neurorehabilitation coursework.

James V. Lynskey, PT, PhD

Department of Physical Therapy

A.T. Still University

Mesa, Arizona

© 2010 Neurology Section, APTA