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tion information with the latest research and technology including Tetraplegia and Paraplegia

A Guide for Physiotherapists by Ida Bromley MBE FCSP. Churchill Livingstone, Edinburgh, 1995, 5th edn (ISBN 0445 058725). Illus. 261 pages. f27.50. The fifth edition of this book remains true to its previous principal theme and reason: to provide clear factual information about the effects of spinal cord injury on an individual and the physiotherapeutic management for this patient group, while not forgetting to give a background of the whole team management and a holistic view of the treatment approaches. Physiotherapists are given exact advice and offered infor- mation about how to manage a patient from acute onset of injury through rehabilitation and reinte- gration into the community.

Particular attention is paid to rehabilitation ethos utilising a patient centred approach which is the axis around which spinal cord injury rehabilitation revolves.

There are some chapters with guest co-authors who offer greater depth and expand on research refer- ences in specific areas. Such chapters include ‘The incomplete spinal cord injury’ and ‘Children with spinal injuries’.

The whole book is totally readable and is logically set out, taking us

Swing-through gait for patient with complete lesion below TI2 - shown in ‘Tefraplegia and Paraplegia’

step by step. There are chapters concentrating on specialised skills and areas unique to spinal injuries rehabilitation. Up-to-date referen- ces are offered throughout the text to support the comments.

This edition is an excellent devel- opment from its predecessors; i t includes all the important founda-

all the current options-available to physiotherapists for equipment. The much loved illustrations are still there with some new updated ones also.

The only area not mentioned is the more recent advances in elec- trical stimulation in the upper limb to offer high lesion tetraplegic patients greater functional indep- endence. I t may be that space constraints determined that some areas must be omitted and this particular work is often led by our colleagues in occupational therapy.

There is an excellent appendices section which offers examples of outcome measures and useful tabu- lated summaries; also contact addresses.

This text will remain the absolute must for all physiotherapists who treat spinal injuries or encounter them in their work a t some stage. It should be found in any physio- therapy department library and hopefully in nursing and medical libraries also. It provides excellent guidance for students and junior staff but is still a comprehensive ‘bible’ €or senior staff.

I liked the hardback version this time as all our previous copies have become battered and well thumbed.

Value for money? Definitely.

Sue Rowley MCSP

How to Read a Paper The Basics of Evidence Based Medicine by Trisha Greenhalgh. BMJ Publishing Group, London, 1997 (ISBN 0 7279 1139 2). 196 pages. f 14.95. In this very enjoyable book Trisha Greenhalgh sets out to do more than just inform the reader ‘How to read a paper’ although she does this comprehensively with nine of the 12 chapters devoted to the critical appraisal of research papers.

This book provides a very read- able introduction to the concept of evidence-based medicine, and addresses some of the miscon- ceptions and debunks some of the myths surrounding this process.

The book is loosely structured around Sacket’s ‘five essential

steps’ of evidence-based medicine. Chapter 1 gives a broad overview and serves as a good introduction to the first of these: ‘Formulating the problem’.

‘Searching the literature’ is the second and longest chapter in the book and very thorough. For those of us who have slashed and hacked our way through MEDLINE and CINAHL this chapter gives welcome advice as to carrying out systematic, structured searching and should save hours of labour.

Chapters 3 to 12 are the meat and potatoes of this book. ‘Getting your bearings’ (chapter 3) briefly exam- ines some different research designs from case studies to randomised

controlled trials. The layout of this chapter is punchy with many text reinforcement boxes and bullet points.

The author also makes very good use of the question-and-answer format.

‘Assessing methodological quality’ and ‘Statistics for the non-stat- istician’ (chapters 4 and 5) I approached with more than a little trepidation (having bolted from university on the day of my ‘methods of investigation’ exam). It is testimony to the writing skills of Trisha Greenhalgh that these chapters are not only informative, they are also interesting! The author maintains that a paper will sink or swim on the strength of its methods section and after reading these chapters the reader should

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a t least be able to attempt that assessment.

‘Statistics for the non-statistician’ also includes some very useful checklists for assessing the adequacy of the statistical analysis of research papers. I particularly enjoyed the tongue-in-cheek section entitled ‘Ten ways to cheat on statistical tests when writing up results’.

Chapter 6 ‘Papers that report on drug trials’ and chapter 7 ‘Papers that report diagnostic or screening tests’, although not of great rele- vance to most physiotherapists, provide useful insight into these areas of research and their evalua- tion.

For those of us who do not sit comfortably with statistics, meta-analysis tends to present a particular pain in the rear. Trisha Greenhalgh understands this and in chapter 8 ‘Papers that summarise other papers (syste- matic reviews and meta-analyses)’ explains that meta-analysis ‘is the statisticians’ chance to pull a double whammy on you. Firstly they phase you with all the statis- tical tests in the first paper and then they use a whole new battery of tests to produce a new set of odd ratios, confidence intervals, and values for significance’.

Chapter 8 required slightly more concentration than the previous chapters. The question-and-answer format is again used to good effect and the reader should come away from this chapter with a greater understanding of meta-analysis.

In chapter 9 ‘Papers that tell you what to do’ the author clearly artic- ulates the arguments for and against the use of guidelines and how to evaluate their usefulness - a timely piece of work considering the number of guidelines that are currently being published.

Chapter 10 ‘Papers that tell you what things cost (economic analysis)’ is useful for background information. However, chapter 11 ‘Papers that go beyond the numbers (qualitative research)’ is interesting and relevant; here the author gives a brief overview of the nature of qualitative research and rejects the notion that qualitative research is ‘soft’ research. She makes the point that qualitative research is becoming more accepted by the medical community, who were

traditionally reluctant to embrace this type of investigation and indeed qualitative research is now con- sidered ‘trendy’ in some areas.

Chapter 1 2 ‘Implementing the evidence base’ notes some of the difficulties in implementing new evidence into practice (something we can all identify with) and provides an excellent section on changing the behaviour of health professionals. Finally, appendices A-D are a series of lists that rein- force many of the main points in the book and should serve as a useful aide me‘moire.

This is a very readable intro- ductory text which addresses the concept of evidence-based medicine in a comprehensive manner.

Although some of it is not directly relevant to physiotherapists Trisha Greenhalgh refreshingly does not focus her attention solely on the

medical profession and refers t o health professionals throughout the book (physiotherapists even get a mention).

The book is peppered with anec- dotes that demonstrate in an occasionally amusing way how evidence-based medicine is applic- able in everyday clinical situations.

Each chapter is extensively refer- enced for those who wish more in-depth study of any particular area. (I have even sent for a series of articles on statistics!)

If there is a downside to this book I have not been able to identify it. I feel it is an excellent book for any physiotherapists trying to get to grips with the concept of evidence-based medicine and, dare I say it, an excellent stocking filler for Santa to consider!

Joe McVeigh BSc MCSP MSOM

The Concise Handbook of Human Anatomy by R M H McMinn, R T Hutchings and B M Logan. Manson Publishing Ltd, London, 1998 (ISBN 1 874545 53 7) Illus. 192 pages. f12,95.

The preface of this book states that i t is a ‘short synopsis’ which is intended for those looking for a concise account of human anatomy as a basis for medical and para- medical studies. This relatively short book fulfils that intention. The text is somewhat basic but the book as a whole gives an acceptable overview of human anatomy.

Each chapter begins with a brief summary of the anatomical region and ends with a resume of key anatomical points identified in the chapter. The rbsumes however are by necessity very basic and there- fore do not add particularly t o the chapters. Each chapter is colour- coded at the edge of the page which makes it easy to identify the sepa- rate chapters. It would have been helpful if the contents page also correspondingly colour-coded the chapters.

The book is well organised in short, clearly headed sections which makes it easy to find the relevant information. The text is inter- spersed with snippets of clinical relevance denoted by a picture of a stethoscope.

It is well illustrated in colour using a range of photographs, X- rays, dissections and diagrams, although the lines on the diagrams indicating specific features are not always very clear. The illustrations showing surface anatomy are useful for their relevance to prac- tical anatomy.

The book is very readable and easily understood although it will not take readers beyond the rudiments of human anatomy. I t would appeal to all students new to the study of anatomy and would be a useful prompt for new practi- tioners. For physiotherapy students in particular, it has less detail with reference to the locomotor system than in the sections for head, neck and vertebral column, and the abdomen, this however is fairly typical of anatomy texts which tend to have a bias towards medical students.

This is an attractive, handy-sized book and would probably appeal to individuals rather than as a core book for students. It is essentially an introductory text to be used before moving on to more detailed anatomy books.

K Heathcote MCSP DipTP MMEd DMS

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