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Fibromyalgia, Chronic Fatigue Syndrome, and Repetitive Strain Injury edited by Andrew Chalmers MD, Geoffrey Owen Littlejohn MD, Irving E Salit MD, and Frederick Wolfe MD. Haworth Medical Press, 10 Alice Street, Binghamton, New York 13904-1580 USA, 1995 (ISBN 1 56024 744 4). 182 pages. $45.

This book contains the proceedings of a conference on chronic fatigue syndrome (CFS), fibromyalgia (FS), and related disorders such as repet- itive strain injury (RSI) as it is referred to here. An international panel of contributors from the United States, Canada, England, Australia, Sweden and Finland are drawn together from a diverse range of backgrounds including general medicine, rheumatology, infectious diseases, neurology and psychiatry, with even a paper from a chiropractor and the medical director of an insurance company. There are 23 chapters which are the summaries of the papers presented and the book covers a wide range of topics including diagnosis and management on four main pain syndromes.

Despite the different focus of

each of the contributors there is an over-riding consensus of opinion concerning pain syndromes. First there is significant overlap between fibromyalgia, myofascial pain, chronic fatigue syndrome, RSI and certain depressive disorders. Common symptoms include sleep disorders, extreme fatigue, my- algias, mood disturbances, and psychiatric problems. Secondly, chronic pain syndromes are not due t o persistent tissue damage or injury, although there may have been an initial trigger, but to changes in the central nociceptive system. Various hypotheses for these changes are proposed including central sensitisation, altered psychological state, meta- bolic or neurotransmitter abnorm- alities, and possible biomechanical causes such as glucocorticoid deficiencies. The obvious question for a physiotherapist reading this book is where do we fit in? According to the research presented there is very little evidence that any treatment in particular is effec- tive be it focal treatment, NSAIDs, or cognitive behaviour therapy and, due t o the range of presenting

symptoms, a multidisciplinary approach is recommended.

This book is useful for anyone who treats chronic pain disorders, espe- cially those working from outside a multi-disciplinary setting and there- fore less aware of the direction in which recent research outside physiotherapy is leading. The book provides an overview of the present understanding of these disorders and therefore the appropriate emphasis in a treatment strategy.

I t is of interest also t o physio- therapists in occupational health dealing with upper limb disorders to understand the multifactorial causes which are not always the result of poor ergonomics in the workplace, and perhaps for managers who need t o make deci- sions on serivices and resources, as evidence suggests these patients seek out high levels of physical therapy.

While it is of interest, this book is not specifically written for physio- therapists and is therefore not an essential reference book for indi- vidual departments.

C L Albert MCSP

Functional Progressions for Sport Rehabilitation by Steven R Tippett and Michael L Voight. Human Kinetics, Champaign, Illinois, USA, 1995. (ISBN 0 87322 660 7). Illus. 120 pages. $19.50.

This book aims to provide an insight into the scientific principles and practical applications of sports specific functional rehabilitation. I t has been written by two American sports physical therapists.

I t is divided into two main sections. The first covers basic components of functional progres- sion, physiological principles and functional testing. The second section covers sports specific functional progression in contact and combat sports and jumping, running and throwing activities.

The emphasis in the second section is on the level of function required for specific activities rather than ‘recipes’ for rehabilitation of different injuries. I t gives some good ideas for adapting drills and specific exercises for various sports but also covers the more common injuries associated with easy activity. The only draw- back is the natural bias towards

American sports such as baseball, American football and ice hockey. However, the principles are devel- oped in such a way that they can easily be adapted to the equivalent sports more commonly played in the UK.

The first chapter covering compo- nents of a programme discusses the physical and psychological benefits of early sports specific functional work, how t o incorporate such work into a formal rehabilitation programme, and evaluation of progress.

The second chapter briefly covers the principles of motor control and learning, classification of mechano- receptors, and functional implic- ations of proprioception. The chapter on functional testing explains the importance of testing and the difference between this and functional training. I t also shows how to progress testing as the goals change with recovery.

The chapter on collision and combat sports has clear tables describing the common mechanisms of injury, rehabilitation concerns and a progression checklist. This would be very useful for students or clinicians unfamiliar with this type of sport looking for a brief overview of typical injuries and problems. The section on running injuries has a similar format.

The functional drills in each sport specific chapter appear varied and appropriate with sound physiolog- ical and mechanical principles. The soft cover format keeps the price affordable for individuals to buy and it would certainly be a useful adjunct to departmental libraries.

Nicola Phillips MCSP

Physiotherapy, October 1996, vol 82, no 10