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linical Gait Analysis: Theory and Practicehris Kirtley, Churchill Livingstone, 2006, 328 pages,39.99, ISBN 0-4431-0009-8

This book would be a welcome addition to the libraryf any physiotherapy department and will be very useful tonyone who has to analyse gait in their clinical work.

In some ways, the first half of the book (Theory) is veryonventional, taking the reader through the theory of humanalking in easy stages, from the terminology of the gait cycle,

hrough kinematics and kinematic measurement, to groundeaction forces and their measurement, to joint moments,uscle electromyogram and power calculations. This part

f the book is a more detailed version of Michael Whittle’sook, ‘Gait analysis: an introduction’ [1], and the two can beead in tandem for those setting out to understand walking.

hittle’s book scores very highly for its small size and withts accompanying CD-ROM which allows the student to run

walking skeleton (constructed from real kinematic data)rom any angle or speed, and view it with the accompa-ying ground reaction force vector; an invaluable tool forearning.

However, Chris Kirtley’s book is much more than anntroduction to the theory of gait, as you might expectrom his history. He runs the Clinical Gait Analysis web-ite (http://www.univie.ac.at/cga); another invaluable tool.e has worked in gait laboratories all over the world, and he

s now at the Catholic University of America in Washington,C. Although trained originally as a medical doctor, his PhDas in bio-engineering at Strathclyde and he has also worked

s a lecturer for physiotherapy students at Curtin University,ustralia. Out of this comes a strong clinical interest and

hat is what informs the second half of the book (Practice).n introductory chapter summarising how different patholo-ies affect gait is less useful than the chapters that follown loading, support and forward progression, and propul-ion and swing. These chapters are full of useful pieces ofnformation, from the impact of ankle foot orthoses on sup-ort at the knee in stance, to some examples of how newigh-tech orthoses for amputees can compensate for muscleeficiencies. A final chapter looks at observational gait analy-is where technology is not available, with the message beinghat without an understanding of the previous chapters’ mate-ial on theory and practice, many observational judgementsill lack authority.The only obvious deficiency of the book (apart from some

inor discrepancies in labelling of diagrams) is in its whollyiomechanical emphasis. What about the processes of motorontrol and initiation in the central nervous system? How doontrol networks change after injury, and how does knowl-dge of these areas impact on clinical decisions?

Kirtley’s text is enlivened throughout by multiple choice

ests, debating points, and some entertaining text boxes onistory and art (e.g. the relationship of the talus to dice, andhe history of shoe widths!). All in all, this is an essentialook for the rehabilitation clinician and is excellent value.

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eference

1] Whittle M. Gait analysis: an introduction. 3rd ed. Butterworth; 2002.

Andrew KingCoventry University, Physiotherapy and Dietetics,

Charles Ward Building, Priory Street,Coventry CV1 5FB, UK

Tel.: +44 2476 888554; fax: +44 2476 888020.E-mail address: a.king@coventry.ac.uk

oi: 10.1016/j.physio.2006.03.002

tronger and Longer: Improving Erections with Pelvicloor Exercises. Dorey, 2005, 22 pages, £6.95, ISBN 0-9545393-3-8

This booklet has been written to inform men of the author’sesearch into the benefits of performing pelvic floor exercisesor some types of erectile dysfunction. The introductory pas-age comments on the traditional role of pelvic floor exercisesn the prevention and treatment of female urinary inconti-ence, and advocates that pelvic floor exercises should ben essential part of male health education and promotion torevent and restore normal erections.

The title is rather ambiguous and may give rise to unre-listic expectations regarding penile length. This confusion,owever, will soon be cleared as the text is comprehensivend well organised. The booklet is primarily aimed at menand their partners) with erectile dysfunction as a guide tovailable treatments for erectile problems. It is also intendeds an instruction booklet for men without this problem, ands an introduction to the subject for students and other health-are professionals.

The first section on anatomy contains useful informationn normal erectile function, although the diagrams are per-aps a little small and unclear. The next section deals witherminology, and facts and figures associated with erectileysfunction. The risk factors are discussed, both medical andifestyle related. It is of concern that cycling and horse ridingre included in a list of risk factors, alongside drug abusend cigarette smoking. The exercise benefits of cycling andorse riding are obvious, and they should not be discouragedr included in such a list without explanation and advice.

The pelvic floor muscles are then described in detail, fol-owed by instruction on performing a pelvic floor exerciserogramme. Other treatments for erectile dysfunction areentioned, and the booklet ends with a section entitled ‘a

oving relationship’. The cartoons used in this book are gener-

lly inappropriate to this serious problem. Issues of same-sexelationships are not portrayed, or the fact that some men withrectile difficulties may not even be in a relationship but areevertheless greatly distressed by the loss of their erections.

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The teaching of prophylactic pelvic floor exercises to6-year-old boys is recommended to prevent future erectileifficulties associated with pelvic floor damage. This claimor health promotion needs further research.

In summary, this booklet is recommended for physio-herapists and other clinicians who are unfamiliar with thereatment of erectile dysfunction. It is reasonably priced forhe amount of information included.

The text is too detailed and complicated for the averageatient and the cartoons may offend some people. A concisenformation leaflet with more appropriate cartoons address-ng the diversity in our society may be more useful for someatients.

Professor Dorey is to be commended for raising awarenessf a very distressing condition, and highlighting a promisingew therapy in the form of pelvic floor exercises. These cane taught by all physiotherapists who are suitably trained inelvic floor treatments.

Stephanie KnightBradford Royal Infirmary, Bradford, UK

Tel.: +44 1274 364121; fax: +44 1274 366946.-mail address: stephanie.knight@bradfordhospitals.nhs.uk

oi: 10.1016/j.physio.2006.03.003

ommunity Care Practice and the Law, 3rd ed.. Mandelstam, Jessica Kingsley Publishers, 2005, 560

ages, £39.95, ISBN 1-84310-233-1

This book is a guide to community care law and practice,roviding quick reference as well as detail. It is written for alltakeholders of community care and practice, from lawyerso recipients of services, and is designed to be user friendly,escribing legislation in plain language rather than legalargon.

The first part of the book provides a brief overview of theegal framework, a view of mechanisms underlying commu-ity care, and the key principles applied by the law courtsnd local ombudsmen. There are four additional parts whichescribe in more detail: (1) specific elements of communityare in relation to local social services authorities, includ-ng assessment, care planning, service provision, direct pay-

ents and charging for services; (2) the provision of homedaptations by local housing authorities and National Healthervices; (3) a selection of prominent issues in communityare, including adult protection, decision-making capacity,nformation sharing, human rights and disability discrimi-ation; and (4) health and safety at work and care standards,ith a specific section on manual handing. Although the book

ocuses primarily on England, many of the topics covered are

elevant across the UK. Additional points are included wherepplicable to Scotland, Wales and Northern Ireland.

The book could be used by physiotherapists as a refer-nce tool as well as a source for gaining detailed knowledge.

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t meets the challenge of being extensive (it is difficult toapture this topic comprehensively due to its vastness andver-changing nature) and up to date, and has been revisedue to the substantial legal and policy changes that affecthe community care field. It is well referenced and pro-ides examples of legal cases and ombudsman investigationshat facilitate an understanding of the law, and will allowhysiotherapists to reflect on real-life experiences. The maintrength of this book is that information is easy to access.

This book is an excellent resource for all physiothera-ists, from policy developers to students. Community careaw and practice applies universally to all members of theK population. Changes in health policy and populationemographics suggest that the number of individuals requir-ng community care will increase in future years. A greaternowledge of community care can facilitate the managementf participation restriction by physiotherapists within a multi-isciplinary and biopsychosocial approach.

Ross WilkieKeele University, Primary Care Sciences

Research Centre, Keele, Newcastle-under-Lyme,Staffordshire ST5 5BG, UK

Tel.: +44 1782 583927; fax: +44 1782 583911.E-mail address: r.wilkie@cphc.keele.ac.uk

oi: 10.1016/j.physio.2006.03.004

ed Flags: a Guide to Identifying Serious Pathology ofhe Spine. Greenhalgh, J. Selfe, 2006, 200 pages, £19.99, ISBN-4431-0140-X

The principal focus of this book is the identification oferious pathologies in patients with spinal conditions. Withodernisation of the National Health Service, blurring of

rofessional boundaries, widening access to physiotherapynd increasing autonomy comes increased responsibility.he ability to recognise and refer the 1% of patients witherious pathology for specialist investigations is paramount.ubjective and objective probabilities discussed within thisook will help practitioners to make informed clinicalecisions.

This pocket-sized book is well written and organised withtwo-colour layout, presenting information in an accessible

ormat. Numerous tables, figures and bullet points are usedhroughout to clarify and complement the text. The book alsoontains a useful index and reference section.

The book contains introductory sections on red flagathologies and clinical reasoning, including incidence, aeti-

logy, risk factors, early detection, and progression of seriousathologies including cancer, infection and human immun-deficiency virus. Case histories and scenarios are usedffectively to determine the increasing probability of seri-