Evidence Based Physical Therapy by L. Fetters and J. Tilson; Publisher: F. A. Davis Company; 1st Edition (May 15, 2012). Paperback: 192 pages; ISBN-10: 080361716X; ISBN-13: 978-0803617162.
The purpose of this book is to support the learning of skills underlying evidence-based physical therapy practice. The text is intended for physical therapy students and clinicians.
Chapter 1 defines evidence-based practice (EBP), describes 5 EBP steps, and discusses strategies to overcome barriers of using EBP in the clinic. Chapter 2 presents literature search strategies, search engines, and databases. Chapters 3 to 10 focus on appraising different types of studies (determining "applicability" and "quality"), interpreting results, and summarizing the clinical bottom line. Chapters 3 and 4 focus on the randomized control trial for an intervention question, common statistics (chi-square, analyses of variance), and interpreting mean difference confidence intervals, effect size, and the number needed to treat. Chapter 5 discusses diagnostic studies (cohort studies), common statistics (sensitivity, specificity, likelihood ratios), and clinical prediction rules. Chapter 6 discusses prognostic studies (cohort, cross-sectional, and case-control studies) and common statistics (correlation, regression, relative risk, risk ratio, and odds ratio). Chapter 7 discusses systematic reviews and meta-analyses. Chapter 8 focuses on finding and appraising clinical practice guidelines. Chapter 9 addresses single-subject research and qualitative research. Chapter 10 discusses studies of outcome measures, including psychometric properties and clinical meaningfulness. Chapters 11 and 12 describe how to communicate with clients and other decision makers, using EBP concepts, write a critical appraisal topic, and use technology to facilitate EBP in the clinic.
The authors deserve kudos for making EBP "real," including the use of clinical cases, excerpts from research articles, and clinical interpretations of common statistics. The book will appeal to different types of learners, utilizing figures to assist with learning concepts and seeing the "big picture." Each chapter also includes "Digging Deeper" (in-depth material) and "Self Tests" (to allow readers to assess their learning). Despite its many strengths, the book is missing some "foundations." Different study designs are distributed throughout the chapters, giving the impression (especially to the novice) that they may be applicable only to that chapter topic. For example, the treatment chapters discuss only randomized control trials. The chapter focusing on prognostic studies defines a cohort study as "a group...followed into the future to observe if they develop the condition." Although this is true, many cohort studies are interventional cohort studies (pre-post design) with the purpose of answering a treatment question. Distributing study designs throughout the chapters results in the loss of the important concept that different types of questions (intervention, prognostic, diagnostic) have different evidence hierarchies. Similar to study design, statistics are also distributed throughout different chapters. For example, regression is presented in the prognostic chapter as a way to identify variables that help predict an outcome. While this is true, regression is also very common in other study designs, including intervention studies.
This book does a great job of providing concrete clinical examples and applications that students will find very helpful. If this book is to be used for teaching, however, it may be necessary to add some foundations.
Kari Dunning, PT, PhD
Associate Professor & Epidemiologist
Department of Rehabilitation Sciences
University of Cincinnati
Cincinnati, Ohio
Clinical Neuroscience for Rehabilitation by M. L. Schenkman, J. P. Bowman, R. L. Gisbert, and R. B. Butler. Paperback: 720 pages; Publisher: Prentice Hall; 1st Edition (July 20, 2012). ISBN-10: 0133024695; ISBN-13: 978-0133024692.
This neuroscience text represents a collaborative effort among physical therapist educators, a neurologist, and a neurobiologist. The authors' goal was to present the material in a layered approach, building complexity and revisiting content as the chapters progressed. They also sought to integrate functional clinical significance throughout the text. The resulting product is a well-designed, innovative, in-depth neuroscience text with an abundance of functional and clinical applications.
The text is organized such that the first 4 chapters (part I) cover basic design, development, blood supply, cell types, and cellular neurophysiology of the nervous system. Part II (Chapters 5 through 7) includes basic neuroanatomy of each of the anatomical regions of the nervous system (spinal cord, brainstem, cortex, etc). Parts III and IV (Chapters 8 through 15) cover the sensory and motor systems of the body and head and neck. In Part V (Chapters 16 through 20) special sensory and motor functional systems are described such as pain, vestibular, visual, cerebellum, and basal ganglia. The section ends with a chapter that explains the basis for voluntary movement by integrating information across functional systems and neuroanatomical areas. Part VI (Chapters 21-23) covers special cognitive systems of cognition, emotion, and memory, and a chapter on the aging to the nervous system. The text concludes with part VII (Chapters 24-26) on injury, disease, and recovery including topics such as stroke, brain injury, and neuroplasticity.
Each chapter includes features such as Clinical Previews, where brief patient cases are presented and designed to pique the readers' interest and direct their attention to certain, yet-to-be-discussed applications. "Thought Questions" are strategically placed in each chapter to help the readers assess their own understanding of the material just presented. Chapter sections called "Clinical Connections" include relevant information on clinical syndromes, assessments, and interventions. Chapters also include "Neuropathology" and "Neurophysiology" boxes that highlight an interesting detail or experiment relevant to the text. The book is well illustrated and visually appealing with a number of different ways to access the information including well-designed tables. The text, while detailed, is quite readable.
The authors achieved their goal of layering complexity on a foundation of basic neuroscience that is constructed in the early chapters. They consistently revisit information presented in earlier chapters and build complexity and integration as they proceed. The level of integration they achieve in the later chapters is unique for a neuroscience textbook. The clinical content is particularly pertinent to rehabilitation but generally enhances the text, making the neuroscience detail applicable.
The authors have created an exceptional offering in this text, pairing the detail of neuroscience with the volume and depth of clinical correlates. This text would certainly be appropriate for adoption by any physical therapy curriculum. The neuroscience is presented in considerable detail, making this text also appropriate for any undergraduate, graduate, or medical course in neuroscience. Even experienced practicing clinicians would find this text a helpful resource to better inform the foundational science of their neurologic practice.
Marianne Beninato, PT, PhD
Associate Professor, Department of Physical Therapy
MGH Institute of Health Professions
Boston, Massachusetts
Stroke Rehabilitation: Insights From Neuroscience and Imaging by L. M. Carey. New York, NY: Oxford University Press; 258 pages; 1st Edition (July 2012) ISBN-10: 0199797889; ISBN-13: 978-019979788-2.
Stroke Rehabilitation: Insights From Neuroscience and Imaging aims to "inform and challenge rehabilitation clinicians to adopt more restorative and scientific approaches to stroke rehabilitation." The text provides a concise presentation of current literature and multiple examples of how to translate science into the different domains of stroke rehabilitation. The audience for this text is new and experienced clinicians (physical therapists, occupational therapists, speech-language pathologists), rehabilitation specialists, and neurologists.
The content presented in Stroke Rehabilitation is ordered in a way that mimics the delivery of therapy services provided in the clinic (understand the disease process, identify key impairments, select interventions). Part A (Chapters 1-5) presents core concepts in stroke rehabilitation. These include a discussion of recovery, the role and goals of rehabilitation, the basis of neuroplasticity, imaging techniques, and multimodal investigations. Part B (Chapter 6) investigates the medical diagnosis of stroke and its implications for prognosis and potential for recovery. Part C (Chapters 7-10) provides details on organizing delivery of care in the context of different factors (organization of care, training principles, adjunctive therapies) to maximize rehabilitation. Each chapter in Part D (Chapters 11-16) explains the neural mechanisms underlying a key stroke impairment and then presents the neuroscience-based interventions for that impairment. Impairments include movement, touch and body sensations, vision, attention and working memory, executive functions, and language. Part E (Chapters 17-18) concludes with future directions of clinical practice and research.
The book provides an in-depth review of neural changes after stroke and the application of rehabilitation to facilitate maximal functional recovery. Each chapter is written by experts in the field and referenced heavily. Concepts of neuroplasticity in the context of rehabilitation are explained (restitution, substitution, compensation, adaptive, maladaptive, use-dependent, and learning-dependent) and their role discussed in clinical practice. In addition, imaging techniques and their relevance in rehabilitation are presented in the initial chapters and then used to explain the neural mechanisms behind interventions presented later.
Most chapters have a clinical summary or conclusion that concisely states the take-home message for clinical practice. This allows the book to be a quick reference for the busy clinician. Clinical examination is not the focus of the text. Although some standardized assessments are mentioned, the text is written for the clinician who has already identified impairments and is looking to select the interventions that will maximize function.
Rehabilitation clinicians are continually challenged to provide the best evidence-based care for each individual patient. Stroke Rehabilitation provides a concise, easy-to-read summary of current best practice that both new and experienced clinicians can read and apply to their current practice to optimize patient outcomes after stroke.
Marghuretta D. Bland, PT, DPT, MSCI, NCS
Instructor, Program in Physical Therapy
Washington University School of Medicine
St Louis, Missouri