Physiotherapy July 2000/vol 86/no 7

387Book reviews

Stanley Thornes, Cheltenham1998 (ISBN 0 7487 3315 9). Illus. 336 pages

by Stephen Bird, Andy Smith and Kate James £26.50This book combines the topic areas of the health benefits of exercise, and the principles and practice of exerciseprescription. The book opens with a chapter giving an overviewof the benefits/health benefits of exercise and physical activity,but the authors emphasise that degenerative disease processesare multifactorial in aetiology and exercise is only one factor to be considered alongside diet, stress, smoking and geneticpredisposition.

The additional benefit of gaining improved quality of life bymaintaining an active lifestyle is also emphasised.

Definitions of physical activity and exercise are explored, andspecific topics include the risks and benefits of exercise/physicalactivity for children and for older people, and the real butunusual scenario of sudden death in exercise.

It is in the second chapter on the topic of the physiologicalbasis of health-related exercise and fitness, that the authors make a specific statement setting the level of the content as first-year undergraduate, but also provide references to textswhich cover the topic in greater depth.

The biochemistry of energy production is described clearly,and theories of fatigue are discussed. The chapter concludeswith a brief review of the relationships between exercise/physicalactivity and health-related fitness and physical capacity.

Chapter 3 addresses the issues of exercise and mental health,using case studies to illustrate approaches to education of healthprofessionals in the area of exercise and mental health, and thedevelopment of exercise programmes for older people inresidential care. The links between exercise and mental healthare explored.

Before moving on to the principles and practice of exerciseprescription, the authors discuss the problems of adher-ence/compliance to exercise programmes, and approaches tocommunity-based and individual interventions.

The next five chapters cover the major elements of exerciseprogrammes, looking first at common elements andunderpinning principles of exercise prescription, and theassessment procedures (both physiological and psychological)

from which the programmes are formulated. The content andstructure of programmes aimed at aerobic and activity-basedexercises, muscular strengthening exercises and flexibility andjoint mobility are described in detail, with a chapter devoted toeach element. There are several illustrative examples in the formof simple stick figures. These are generally useful, but in someinstances, because of the lack of three-dimensional focus, theycan be rather confusing.

The latter part of the book covers the application of exercisein rehabilitation and the benefits of exercise in specificpopulations. These include coronary heart disease, diabetesmellitus, obesity, pregnancy, stroke, osteoporosis and COPD.Each area is treated individually, but in each case the specificbenefits of exercise are identified, and advice provided on thenature and intensity of exercise for each condition.

The penultimate chapter is one on basic terminology, whichmight more usefully occur at the beginning of the book, oralternatively as an appendix to which uninitiated readers mightrefer.

The final chapter sets out the authors’ thoughts for the future,in which they outline the good and bad news for the role ofexercise in everyday life. The bad news relates to how advancesin transport and information technology will reduce the amountof activity we perform, as more and more the need to travel towork diminishes, and ‘virtual sports’ and sedentary computergames replace participation in field sports and other forms ofphysical activity.

However, the book ends on an upbeat note with the good news– recognition of the health benefits of relatively small amounts ofphysical activity which can be easily incorporated into everydaylife, and the increasing contribution of expertise and resourcesto encourage active lifestyles supported by governmentinitiatives.

This is a useful book, covering a wide range of issues related toexercise and exercise prescription on an easily understandablelevel. Each chapter is liberally referenced, directing the readersto more in-depth investigation if desired. I would recommend itfor all those who are interested in promoting the role of exercise,not only to treat specific musculoskeletal problems, but also forits proven health benefits.

Kate KerrPhD BA MCSP Cert Ed PostGradDipHE

Exercise Benefits and Prescription

Left: Step-ups with emphasis on useof quadriceps. Step is slightly higherthan participant’s knee. This exerciseshould be performed slowly andprecisely

Right: Step-overs – one foot remainson bench while the other steps overand then back again. Non-steppingleg is extended each time the otherfoot is brought across the bench