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The most useful parts of the book other than for revisionwere the excellent chapter on psychology and sport, and thesection on the role of sport and exercise in active groups, asthe advice, exercises and concepts are relevant for all ourclient groups.

For physiotherapists who have has limited experience ofworking with sports injuries this book will give them a goodoverview of the knowledge needed to start work in this field,

and for those already working with active patients the bookwill give additional information and concepts which willenhance their practice.

I would recommend this as a very useful addition to anyphysiotherapy department library and for individuals whowork with active client groups.

Sandra Mellors MCSP

Butterworth-Heinemann, Oxford2002 (ISBN 0 7506 4712 4). Illus. 640 pages

by Janet Carr and Roberta Shepherd £35It is 20 years since the first edition of A Motor RelearningProgramme for Stroke was published, with the updated versionin 1987. This book, as the title suggests, is not a third editionbut does build on these previous publications.

The authors are still essentially using motor training andemerging scientific evidence as the basis for this book. Theyacknowledge this is taking neurophysiotherapy into adirection involving changes in practice based ondevelopments in scientific understanding and the results ofclinical trials, rather than a priority of clinical experience asa form of evidence.

It should not be forgotten however that many clinicians,rightly so, see clinical experience and the patients’ views stillremaining key areas of our treatment, evidence base andsubsequent outcome. This book will challenge these viewsand provide the scientific arm to our practice.

This is a long-awaited book and packed with the latestevidence (at the time of going to press), sometimes in theform of useful tabulated summaries, clear ideas andguidelines for exercises and recommended outcomemeasures for the areas described.

Four areas of training guidelines are included: balance,walking, standing up and sitting down, and reaching and

manipulation. A chapter on ‘Brain reorganisation, therehabilitation environment and measuring outcomes’introduces these topics.

Each of the ‘training guidelines’ chapters is clearly set out under the same sub-headings of introduction,biomechanical description, age-related changes, analysis of motor performance, guidelines for training, andmeasurements.

They also include a ‘notes’ section for the discussion ofany recent developments such as partial weight support andtreadmill use in walking and constraint-induced movementtherapy. There are substantial appendices, which discussamong other things motor and sensory impairments,adaptive features in soft tissue, strength training andphysical conditioning.

This book should be a welcome addition to the library of physiotherapists and occupational therapists in the field not only of stroke, but other forms of neurologicalrehabilitation. The ‘age-related changes’ section will also be welcomed by staff working with older people.

It should however be seen as an adjunct to our treatmentapproach; the quality of movement control in order to gainskill acquisition is not addressed in detail and this does needto be integral to our practice.

It will appeal to newly qualified and experienced staff toprovide clear guidelines for patients’ exercises, the scientificevidence, extensive references and, for many, food forthought. We have come to expect these authors to provideevidence challenging to our practice and this book does not disappoint.

Claire Guy MSc MCSP

Stroke RehabilitationGuidelines for exercise and training tooptimize motor skill

Butterworth-Heinemann, Oxford2001 (ISBN 0 750 64495 8). Illus. 272 pages

edited by Howard Vernon £41Perhaps one of the first problems with this book is its titleThe Cranio-cervical Syndrome, implying as it does that all headand neck pain can be grouped together under one categoryand managed in a similar fashion. As any clinician who dealsregularly with dysfunction in this region will know, this is

definitely not the case, and indeed this is not what thecontents of the book suggest.

This text is an attempt to explain the multifactorial man-ifestations and pathologies associated with cranio-cervicaldysfunction. Chapters deal with varied subjects including theneuroanatomy, physiology and biomechanics of the regionthrough to the psychological aspects of head and neck pain,and vertigo related to whiplash injuries.

Many of the authors of the text will not be familiar tophysiotherapists in this country as it is written primarily bychiropractors from North America. The different emphasisof chiropractic management of patients with cranio-cervicaldysfunction is evident in many features of the book.

The Cranio-cervical SyndromeMechanisms, assessment and treatment

Physiotherapy April 2003/vol 89/no 4

261Book reviews

I found the chapter on diagnostic imaging disappointing,in that it dealt largely with the mechanics of taking X-rays,rather than discussing the types of imaging most useful inassisting with the diagnosis of various pathologies. Themajority of the X-rays used to illustrate the text showevidence of serious pathology, such as metastatic disease,and are therefore not representative of the more usualfindings that give rise to the cranio-cervical dysfunction seenmore commonly in the clinical situation and amenable tophysiotherapeutic management.

The chapter on manual therapy in children provides somethought-provoking and at times controversial reading. Theinformation used to support the author's views is largely ofan anecdotal nature with little strong research evidence.

As ever, the anatomist, Nik Bogduk, contributes a conciseand articulate chapter that provides clinicians with research

evidence of the relationship between cervical dysfunctionand the presence of head and neck pain.

Likewise the chapter on whiplash injuries provides a goodreview of current literature including discussion of theevidence for various forms of management. Again thechiropractic nature of the book is evident in the lack ofinformation regarding neural tissue involvement or the roleof specific stabilisation exercises in patient treatment.

Although some chapters are exceptionally informative, I would classify this text as interesting but not essentialreading for physiotherapists with a specific interest in themanagement of patients with neck pain or headaches orthose undertaking postgraduate study in the management ofneuromusculoskeletal dysfunction.

Claire Small MPhtySt MMACP MCSP

Haworth Herbal Press, Binghamton, New York2002, 2nd edn (ISBN 0 7890 1266 9). Illus. 1138 pages

by Dennis J McKenna PhD, Kenneth Jones and Kerry Hughes MSc $80The number of people who regularly or casually use naturalplant derived medicines/supplements is steadily increasing.In America it is documented that 44 million people useherbal remedies regularly and some 90 million have used aherbal based product in the past year. This scale of usage isreflected in the UK and Europe.

When the general public want information about herbalmedicines/supplements, they tend to rely on what they readin the media or the mail shots advertising herbal products orlocal herbal retailers, some of whom are very well informed.Least frequently consulted are healthcare professionals, whoare generally not trusted on matters relating to naturalmedicines.

Because many of the users of herbal medicines self-diagnose and self-prescribe, with no knowledge about thepotentially harmful interactions between pharmaceuticaldrugs and plant derived medicines, it is vitally important thatthey are encouraged to seek advice from medical herbalistsand/or healthcare professionals.

However, until those in the ‘orthodox’ sector prove

themselves competent to provide such advice, the public will not seek their guidance. This book is designed to enable healthcare professionals to gain a sound, scientificbased knowledge about 34 of the most popular herbalmedicines/supplements and permit them to give theirpatients informed advice about the use of these particularherbal medicines.

The text consists of 34 very detailed scientific monographson a variety of herbs from astragalus, bilberry, black cohosh,chamomile, grape seed, horse chestnut and kava kava to St John’s wort and valerian. The information is providedunder the following headings: botanical data, history and traditional use, chemistry, therapeutic application, pre-clinical studies, clinical studies, dosage, safety profile andextensive references.

The information is up to date and relies on bothAmerican and European research. I checked on what waswritten about kava kava, St John’s wort and echinacea, as theseare probably the most popular herbal supplements in theUK, and it was reassuring to find that the authors were intune with current European thinking.

This book is the result of five years research by theauthors. It is scientific and comprehensive. It provides manyreferences for those who wish to conduct further studies. I believe this text would be a valuable asset in hospitalreference libraries, GP practices and physiotherapy centreswhere patients seek advice about the value and use of herbal medicines. It is a good reference source and the verydetailed information is readily accessible.

Christopher Hayne FCSP FRSH

Botanical Medicines The desk reference for major herbalsupplements

Read any good books lately?If you have come across a book or video that could be of interest to other readers,

and it has not been reviewed in Physiotherapy, please send details to the managing editor so that we can obtain a copy.