Clinical exercise: a case-based approach.
Author: Smith, Cath
Pub Date: 07/01/2011
Publication: Name: New Zealand Journal of Physiotherapy Publisher: New Zealand Society of Physiotherapists Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2011 New Zealand Society of Physiotherapists ISSN: 0303-7193
Issue: Date: July, 2011 Source Volume: 39 Source Issue: 2
Accession Number: 288537998
Full Text: Clinical exercise: a case-based approach. Melanie Cameron, Steve Selig, Dennis Hemphill (Eds). Churchill Livingstone, Elsevier, Sydney 2011. ISBN: 9780729539418. Soft cover (supplementary DVD), 388 pages. RRP: $129.00

This book summarises evidence for exercise as a therapeutic intervention in chronic health conditions and special populations, and links this evidence to 'real life' clinical examples. The authors are predominantly exercise scientists with contributions from physiotherapists and other clinicians. The book is organised into two sections: Section One includes nine chapters, each reviewing current evidence for exercise as a therapeutic intervention in musculoskeletal, cardiovascular, respiratory, neurological and metabolic conditions. Section One also includes children, elders, athletes, and occupational rehabilitation. Section Two details 11 case studies offering narrative insights into the clinical application of therapeutic exercise. In addition, three chapters reflect on practitioner self-care, weight management, and practitioner trial and error.

In Section One, topics of key interest for many New Zealand physiotherapists (e.g. musculoskeletal conditions of mechanical origin) were explicitly given cursory coverage as the authors felt that exercise interventions for these conditions were covered in more depth elsewhere in the literature. Nonetheless, evidence of exercise benefits for health conditions prioritised by New Zealand's health strategy were discussed in some depth in these chapters. As a physiotherapist working with persons with multiple sclerosis, I was a little disappointed in Chapter Five which focussed predominantly on neuroplasticity with only short summaries outlining exercise interventions in stroke, traumatic brain injury, Parkinson's disease, cerebral palsy and motor neuron disease. There are more detailed exercise recommendations for people with neurological conditions elsewhere (Myers and Nieman, 2010). The editors purposefully chose to use the generic term 'exercise practitioner' to refer to all health care professionals. This term however, was not used consistently and at times could be confusing, necessitating detective work from the reader in order to work out 'who was who'. Chapters in this section were peppered with small grammatical errors detracting from what was overall a reasonable synthesis of current evidence.

The case studies in Section Two were insightful and interesting to read. In contrast to the evidence summaries in Section One, the authors focused on clinical consideration of personal factors such as motivation and self-efficacy. This perhaps highlighted a dearth of evidence from Section One for the value of psychological and psychosocial considerations in exercise prescription. I particularly enjoyed Case Study 2: Exercising for romance (p. 216) which illustrated for me that many individuals exercise for more meaningful reasons than health per se.

I appreciated the philosophy of the book and the attempt by the editor to illustrate evidence with clinical examples. This was a valuable strategy to quickly explore both parity and discord between evidence summaries and clinical reality with case examples and evidence-based chapters clearly cross-referenced. The inclusion of a DVD held promise as a useful teaching adjunct; however, in my opinion, was not of particularly high quality and did little to augment information from the book.

In summary, the book provided a reasonable account of evidence for therapeutic exercise in a wide range of health conditions. This publication would be useful for experienced physiotherapy practitioners looking to widen their scope of practice; however, I feel that novice therapists and undergraduate students might be confused by the evidence-practice link and the use of the generic term 'exercise practitioner'.

Cath Smith PhD, mnzsp

Research Fellow, Centre for Physiotherapy Research, School of

Physiotherapy, University of Otago

(1.) Myers J and Nieman D. (Eds.) (2010). ACSM's Resources for Clinical Exercise Physiology: Musculoskeletal, Neuromuscular, Neoplastic, Immunologic, and Hematologic Conditions: American College of Sports Medicine. Philadelphia: Lippincott Williams & Wilkins.
Gale Copyright: Copyright 2011 Gale, Cengage Learning. All rights reserved.