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The Physical Self From Motivation to Well-Being edited by Kenneth R Fox. Human Kinetics Europe Ltd, Leeds, 1997 (ISBN 0 87322 689 5). Illus. 329 pages. €31. sensitive chapter on ‘Body image,

Kenneth R Fox, senior lecturer in the Department of Exercise and Sports a t Exeter University, has edited and contributed chapters to this collection of essays. Overall, the target readership appears to be clinical psychologists who intend to specialise in exercise and health promotion research. However, there is much to interest physiother- apists, provided tha t one is not deterred by the over-academic tone of the first two chapters.

The book is divided into two parts. Par t 1 comprises a detailed analysis of the physical self-concept and its measurement. Those readers interested in the minutiae of psychological research will probably cope better than I did with the first two chapters. There are endless abbreviations, lengthy sentences, incomprehensible tables and very few clinical references to satisfy the practically minded. Stuar t Biddle’s contribution on

‘Cognitive theories of motivation and the physical self comes as a welcome third chapter, far more relevant to our profession and very readable.

Chapter 4: ‘Reflections on the socially constructed physical self provided for me the highlight of Part 1. It explores the way in which our ‘narrative of self can be used to cope with age-related changes, illness or injuries - factors tha t may impact on our physical self- image and functioning.

Part 2, subtitled ‘Populations and practice’, analyses and compares aspects of the physical self-concept in specific age groups, clinical groups and between the sexes. There is more clinical relevance here, particularly for physiother- apists working with people with eating disorders and problems of body image. Caroline Davis, professor of kinesiology and health sciences, writes a detailed and

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exercise and eating disorders’. Angela Page and Kenneth R Fox are co-authors of a n excellent chapter on ‘Adolescent weight management and the physical self.

The only mention of mental health problems comes in the last chapter, by Nanette Murie, who writes about the benefits of exercise on mental and physical well-being. She has researched exercise as a treatment for depression for her doctorate.

In summary, this book could be recommended to physiotherapy students or qualified physiother- apists who wish to broaden their knowledge of body image and the factors influencing its development. I would only urge the less acad- emically-minded (like me) to skim the first two chapters. I t is quite possible to derive much benefit from reading any of the chapters individually.

Pamela Elstub MCSP

video reviews Cryot herapy TWO-VIDEO PACKAGE produced by Ken Knight. Published by Human Kinetics, PO Box 1 W14, Lee& LS16 6TR. 1996. VHS. 30 minutes total. €57.

Cryotherapy for First Aid This video is aimed a t sports medicine professionals to help athletes understand and comply with cryotherapy techniques. I t may also be used to teach on sports first aid or athletic training courses.

The video is based on Cryo- therapy i n Sports Injury Manage- ment by Ken Knight and lasts 11 minutes.

The video has obviously been produced for a North Amercian audience, narrated by the ‘school baseball coach’, with advice on cryotherapy given by the athletic trainer.

After a general introductory

scenario, a brief summary is given of the chain reaction following injury - damage to blood vessels causing bleeding + clotting causing reduction of blood flow to adjacent cells which die as a result of lack of oxygen + deadldying cells release chemicals which result in swelling + this in turn causes increased pressure on blood vessels, further cutting off oxygen to the cells.

Ice can slow down this chain reaction by reducing metabolism and the cellular demand for oxygen, limitation of cell death and release of chemicals and resultant limit- ation of swelling - aptly described

as damage control. The narrator then notes what happens if heat is applied immediately after injury, and advocates tha t heat should not be applied until 48-72 hours following injury. Unfortunately, there is no mention of the degree of severity of injury, which is a n important issue when making decisions about the appropriate time for the application of mod- alities such as heat.

Inserted here in the video is what almost appears to be a n aside, a brief rksumk of the benefits of exercise in a rehabilitation programme, and how ice is more effective than heat in pain control, to facilitate the rehabilitation programme. This is included in the rehabilitation video (see overleaf),

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and there appears t o be no real logic for its inclusion here.

The video goes on to list the effects of the total R(est), I(ce), C(ompression), E(levation), S(tabi1i- sation) programme, linking the effects back to the chain reaction of injury. The stabilisation element of this programme can be equated with the protection element of the PRICE regime with which we are more familiar in this country.

The video moves on to provide guidelines on the application of the RICES regimen. 1. Apply ice within ten minutes of injury - crushed/cubed ice in a plastic bag is shown applied directly to the injured part. 2. Apply a six-inch bandage over the entire region. 3 . Elevate the injured part six to ten inches above the heart. 4. Remove ice after 30 minutes. 5 . Apply a brace or sling or use crutches to avoid weight-bearing.

The athlete is then advised to apply ice for 30 minutes every two hours for the next 24 hours, and t o keep the limb elevated and wrapped in an elastic bandage.

This is generally an informative, useful video, clearly presented. There are a few criticisms: 1. There is no indication as to what happens after 24 hours.

2. It is probably advisable to place a video dealing with cryotherapy in damp towel between the ice-pack rehabilitation (see below). and the skin. 5 . The contra-indications to the use 3. There is no information of ice are brushed over. Parti- regarding the differing degrees of cularly, there is no mention of the severity of injury. dangers of application of ice over 4. The section on rehabilitation is superficia1 nerves. superfluous as there is a companion

Cryotherapy for Rehabilitation Like its companion video ‘Cryo- therapy for First Aid’, this video is based on Cryotherapy in Sport Injury Management by Ken Knight and is aimed at sports medicine professionals and athletes. It lasts 15 minutes.

The first part is a repetition of the introduction to ‘Cryotherapy for First Aid’, and indeed the first four to five minutes of the video either repeat sections of the first aid video, or duplicate elements of the same video.

The most useful par t of the video comes in the las t ten minutes, when the concepts of exercise and cryotherapy (cryo- kinetics) and stretching and cryotherapy (cryostretch) a re introduced. Claims are made that both approaches return athletes to competition fitness more quickly than other more trad- itional methods.

This video does refer to the different degrees of severity of

injury, but only with respect to the time-scale of the introduction of cryokinetics or cryostretching.

Reasonably clear descriptions a re given of both techniques - perhaps more detailed for the cryokinetics than the cryo- stretching, although the actual stretch/PNF technique is well explained.

Although the subject of contra- indications is mentioned in both videos, neither of the programmes expands on this to suggest specific conditions or situations.

In summary, these two vidoes are useful and informative, perhaps more so to athletes than to well qualified sports medicine professionals. However, in view of the amount of repetitiodoverlap, it seems to me that the two videos should be combined.

Kate Kerr PhD BA MCSP CertEd

PostGradDipHE

Normal Movements in the First Year of Life presented by Helen Stevens MCSP of the Royal Hampshire County Hospital, Winchester. Produced by the video unit of Teaching Support and Media Services at the University of Southampton. 7997. VHS. 38 minutes. Available from TSMS, Mail Point 800, Southampton General Hospital, Tremona Road, Southampton SO 76 6YD, €35 including postage, payable to ’University of Southampton’.

This video gives an excellent over- view of the development which occurs during the first year of a child’s life. It illustrates the major changes which occur each month and its commentary draws viewers’ attention to some interesting points which could otherwise be over- looked.

Each month it looks at the child’s progress in the same basic positions

of supine, prone, sitting and the upright posture. It emphasises how each new skill is built upon those previously acquired and i t is the only video I have seen which draws attention t o the significance of weight shift.

It illustrates well how the baby goes from asymmetrical patterns of movement t o ones of symmetry, gains head and trunk control and

finally independent walking. It looks not only a t gross motor development but also a t the acquisition of fine motor skills, play development and social interaction.

The commentary would help people starting out in paediatrics to observe the significant changes, while for the more experienced, the video could be used to high- light other, more subtle changes. Importantly, too, it reminds us of the speed at which normal children develop and how much they achieve in their first year of life.

This is an excellent video which would certainly be an asset to any paediatric therapist and is an ideal teaching tool.

Lyn Campbell BSc MCSP

Physiotherapy, June 1998, vol 84, no 6