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Part-time Opportunities MADAM - I wish to comment on the letter in the February issue of Physiotherapy on 'Part-time prejudice'. As District steward for East Dorset I would like to agree with Verity Olswang's sentiments but say how lucky she is to live in the Bournemouth area, where there are many opportunities for part-time physio- therapists. Of all physiotherapists in post in East Dorset, 45% are in part-time positions ranaina from seven to 30 hours per week. There are part-time staff in all depart- ments and specialties. Jobs are advertised nationally and locally as being suitable for full-time, part-time or job-sharing candidates. Staff returning after maternity leave can be placed in mutually suitable part-time posts. Refresher training is offered for those physiotherapists wishing to return after a career break and this has proved very successful. As District steward I am confident that East Dorset complies with the CSP policy on equal opportunities for part-timers (1988). Bani staff are also employed for weekends and locum work. Bournemouth JUDY WILLIAMS MCSP Faulty Photographs Fail Physiotherapy MADAM - I would like to comment on the article 'The Gartnavel experience in health promotion 1986' (Physiotherapy, January). This excellent account by two very enthusiastic physiotherapists instilling in the public and staff the benefits of regular exercise as a preventive measure against coronary heart disease is something I heartily approve and have been involved in for many years. Unfortunately the excellence of the programme was marred by the photographic illustrations 5, 6, and 7 depicting various exercise tests. Figure 5 shows a lady with a smart blouse, skirt and fashionable shoes sitting on an exercise cycle, and a gentleman wearing a tie and long sleeved shirt buttoned at the neck and long trousers also sitting on an exercise bike. The caption is 'Exercise testing aerobic endurance assessment'. It gives the impression that the clients are out for a gentle pedal wearing their Sunday best clothes rather than aerobic endurance which is going to involve a submaximal heart rate of at least 70% of the predicted heart rate and a fair amount of sweating. Figure 6 shows a gentleman reaching forwards towards his toes in long sitting with the plantar aspect of his feet supported on a vertical board in order to hold his ankles in 90° of dorsiflexion. The legend is 'Sit and reach flexibility test'. Unfortunately he is wearing heeled shoes so that his feet are in plantarflexion, thus reducing the stretch on gastrocnemius. Also his knees are in slight flexion so that hamstrings are not at full stretch, thus giving a false indication of posterior muscular leg flexibility. Figure 7 shows a person in the crook Books in Brief Arthritis: The allergy connection, by Dr J Mansfield. Thorsons, Wellingborough, 1990 (ISBN 0 7225 1903 6). 192 pages. f4.99 paperback. The author of this book contends that almost all forms of arthritis are related to allergy, intolerance, or hypersensitivity to various environmental factors. It follows that by identifying these factors, according to his theory, many sufferers can become free of arthritis. The book describes a series of demanding tests and trials, mixed with opinions, evidence and case histories. The author also wrote a book on similar lines The Migraine Revolution with an equally positive approach. The Doctor's Heart Attack Recovery Plan, by David Lewis and Dr John Storey. Thorsons, Wellingborough, 1990 (ISBN 0 7225 1898 6).192 pages. €8.99. Offering a practical guide to a changed lifestyle for the 120,000 people who leave hospital each year after a heart attack, this book outlines a step-by-step plan for recovery. The authors acknowledge that insufficient exercise and poor diet are major risk factors in the development of heart disease, but argue that the predominating contributor is the emotional reaction to the stress engendered by the competition of modern life. Stress and Medical Procedures, edited by Marie Johnston and Louise Wallace. Oxford University Press, 1990 (ISBN 0 19 261763 0). 184 pages. f25. Some advances in medical technology have ameliorated previously stressful procedures; others, although opening the possibility of treatment where none existed before, have brought high levels of stress for staff and patients alike - in vitro fertilisation and brain scanning techniques are examples of the latter. This book aims to deal with the subject comprehensively, examining what is known about stress, and then showing it in relation to major areas of medical practice. Opinions on stress differ but the authors claim that as a barrier to patients' acceptance of treatment and a limitation on the effectiveness of procedures it must be seriously addressed. Down Syndrome: The facts, by Mark Selikowitz. Oxford University Press, 1990 (ISBN 0 19 261872 5). 205 pages. f5.95 paperback. Written as a source of information for parents to refer to between visits to professionals and as new problems occur, this book can also up-date members of the health care professions on developments in treatment and expectations of people with Down syndrome. The issues to be faced in adult life and controversial treatments are covered at the end of the book, which includes a list of useful addresses and an index. sitting position with her arms crossed in front of her chest and the tester holding and fixating her feet to the floor. The caption reads 'Sit-ups strength test'. With the feet anchored, most of the muscular work is performed by the iliopsoas, rectus femoris and anterior tibials. Most people can perform many sit-ups this way but hardly one if the foot anchorage is removed - try it! The arms-forward position also brings in pectoralis major and anterior deltoid and increases the forward weight lever and instigates the forward momentum when sitting up, thus further reducing the work of the abdominals. I feel this is a very poor test of abdominal strength. A more effective sit-up abdominal strength test for people with weak abdominals is in the crook lying position, hands resting on the anterior thighs; chin tucked in and shoulders clear of the floor. The exerciser sits up, sliding the hands along Sunday best? the thighs until hislher fingers reach the lower pole (or the upper pole if really weak) of the patella. The movement must be controlled so that concentric and eccentric abdominal contractions are performed (with no lifting of the buttocks, or shoulders touching the floor). I think more care should be taken when showing photographic demonstrations of exercises because we as physiotherapists should be the professional leaders in the field of exercise therapy and all demonstrations should be portrayed as perfect if we are going to maintain our high standard and profile to other exercise professionals and the community. BOB GARRETT MCSP MAPA Sydney, Australia Do Not Treat Unhappy Children MADAM - I was surprised to note that one of the posters supplied by the CSP for National Physiotherapy Week denotes a physiotherapist treating a distressed and crying child. The caption refers to a 'caring profession'. Is this the image that we are trying to project? ALEXANDRA HOUGH BA MCSP DipTP London SE1 Mr Stuart Skyte, CSP director of public relations, replies: This poster was introduced two years ago and was not specifically for National Physiotherapy Week. It is one of four career posters aimed at 17-year-olds. Children who are cared for still cry occasionally, as every parent would surely confirm. 216 Physiotherapy, April 1990. vol 76, no 4

Do Not Treat Unhappy Children

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Part-time Opportunities MADAM - I wish to comment on the letter in the February issue of Physiotherapy on 'Part-time prejudice'.

As District steward for East Dorset I would like to agree with Verity Olswang's sentiments but say how lucky she is to live in the Bournemouth area, where there are many opportunities for part-time physio- therapists.

Of all physiotherapists in post in East Dorset, 45% are in part-time positions ranaina from seven to 30 hours per week.

There are part-time staff in all depart- ments and specialties. Jobs are advertised nationally and locally as being suitable for full-time, part-time or job-sharing candidates. Staff returning after maternity leave can be placed in mutually suitable part-time posts.

Refresher training is offered for those physiotherapists wishing to return after a career break and this has proved very successful.

As District steward I am confident that East Dorset complies with the CSP policy on equal opportunities for part-timers (1988).

Bani staff are also employed for weekends and locum work. Bournemouth

JUDY WILLIAMS MCSP

Faulty Photographs Fail Physiotherapy MADAM - I would like to comment on the article 'The Gartnavel experience in health promotion 1986' (Physiotherapy, January).

This excellent account by two very enthusiastic physiotherapists instilling in the public and staff the benefits of regular exercise as a preventive measure against coronary heart disease is something I heartily approve and have been involved in for many years.

Unfortunately the excellence of the programme was marred by the photographic illustrations 5, 6, and 7 depicting various exercise tests.

Figure 5 shows a lady with a smart blouse, skirt and fashionable shoes sitting on an exercise cycle, and a gentleman wearing a t ie and long sleeved shirt buttoned at the neck and long trousers also sitting on an exercise bike. The caption is 'Exercise testing

aerobic endurance assessment'. It gives the impression that the clients are out for a gentle pedal wearing their Sunday best clothes rather than aerobic endurance which is going to involve a submaximal heart rate of at least 70% of the predicted heart rate and a fair amount of sweating.

Figure 6 shows a gentleman reaching forwards towards his toes in long sitting with the plantar aspect of his feet supported on a vertical board in order to hold his ankles in 90° of dorsiflexion. The legend is 'Sit and reach flexibility test'. Unfortunately he is wearing heeled shoes so that his feet are in plantarflexion, thus reducing the stretch on gastrocnemius. Also his knees are in slight flexion so that hamstrings are not at full stretch, thus giving a false indication of posterior muscular leg flexibility.

Figure 7 shows a person in the crook

Books in Brief Arthritis: The allergy connection, by Dr J Mansfield. Thorsons, Wellingborough, 1990 (ISBN 0 7225 1903 6). 192 pages. f4.99 paperback.

The author of this book contends that almost all forms of arthritis are related to allergy, intolerance, or hypersensitivity to various environmental factors. It follows that by identifying these factors, according to his theory, many sufferers can become free of arthritis. The book describes a series of demanding tests and trials, mixed with opinions, evidence and case histories.

The author also wrote a book on similar lines The Migraine Revolution with an equally positive approach.

The Doctor's Heart Attack Recovery Plan, by David Lewis and Dr John Storey. Thorsons, Wellingborough, 1990 (ISBN 0 7225 1898 6). 192 pages. €8.99.

Offering a practical guide to a changed lifestyle for the 120,000 people who leave hospital each year after a heart attack, this book outlines a step-by-step plan for recovery.

The authors acknowledge that insufficient exercise and poor diet are major risk factors in the development of heart disease, but argue that the predominating contributor is the emotional reaction to the stress engendered by the competition of modern life.

Stress and Medical Procedures, edited by Marie Johnston and Louise Wallace. Oxford University Press, 1990 (ISBN 0 19 261763 0). 184 pages. f25.

Some advances in medical technology have ameliorated previously stressful procedures; others, although opening the possibility of treatment where none existed before, have brought high levels of stress for staff and patients alike - in vitro fertilisation and brain scanning techniques are examples of the latter.

This book aims to deal with the subject comprehensively, examining what is known about stress, and then showing it in relation to major areas of medical practice. Opinions on stress differ but the authors claim that as a barrier t o patients' acceptance of treatment and a limitation on the effectiveness of procedures it must be seriously addressed.

Down Syndrome: The facts, by Mark Selikowitz. Oxford University Press, 1990 (ISBN 0 19 261872 5). 205 pages. f5.95 paperback.

Written as a source of information for parents to refer to between visits to professionals and as new problems occur, this book can also up-date members of the health care professions on developments in treatment and expectations of people with Down syndrome. The issues to be faced in adult life and controversial treatments are covered at the end of the book, which includes a list of useful addresses and an index.

sitting position with her arms crossed in front of her chest and the tester holding and fixating her feet to the floor. The caption reads 'Sit-ups strength test'. With the feet anchored, most of the muscular work is performed by the iliopsoas, rectus femoris and anterior tibials. Most people can perform many sit-ups this way but hardly one if the foot anchorage is removed - try it! The arms-forward position also brings in pectoralis major and anterior deltoid and increases the forward weight lever and instigates the forward momentum when sitting up, thus further reducing the work of the abdominals. I feel this is a very poor test of abdominal strength.

A more effective sit-up abdominal strength test for people wi th weak abdominals is in the crook lying position, hands resting on the anterior thighs; chin tucked in and shoulders clear of the floor. The exerciser sits up, sliding the hands along

Sunday best?

the thighs until hislher fingers reach the lower pole (or the upper pole if really weak) of the patella. The movement must be controlled so that concentric and eccentric abdominal contractions are performed (with no lifting of the buttocks, or shoulders touching the floor).

I think more care should be taken when showing photographic demonstrations of exercises because we as physiotherapists should be the professional leaders in the field of exercise therapy and all demonstrations should be portrayed as perfect if we are going to maintain our high standard and profile to other exercise professionals and the community. BOB GARRETT MCSP MAPA Sydney, Australia

Do Not Treat Unhappy Children MADAM - I was surprised to note that one of the posters supplied by the CSP for National Physiotherapy Week denotes a physiotherapist treating a distressed and crying child. The caption refers to a 'caring profession'.

Is this the image that we are trying to project?

ALEXANDRA HOUGH BA MCSP DipTP London SE1

Mr Stuart Skyte, CSP director of public relations, replies:

This poster was introduced two years ago and was not specifically for National Physiotherapy Week. It is one o f four career posters aimed at 17-year-olds. Children who are cared for still cry occasionally, as every parent would surely confirm.

216 Physiotherapy, April 1990. vol 76, no 4