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Physiotherapy for Torture Survivors - A basic introduction by Karen Prip, Lone Tived and Nina Holten. International Rehabilitation Council for Torture Victims, Copenhagen, 1995 (ISBN 87 88882 15 2). 100 pages. Illus. DKK 75AJS $7 5. Written by health professionals from the Rehabilitation and Research Centre for Torture Victims in Denmark, this book is made up of papers presented a t various conferences. Out-patient physiotherapists will find it partic- ularly useful, both for its in-depth coverage of soft tissue injuries and for guidance about the considera- tions required when a survivor of torture arrives in the out-patient department. The book aims to ‘break the silence’ around this difficult subject.

There is background informa- tion on the prevalence of torture, its purpose, and the interdisciplinary approach used a t the RCT. The roles of interpreter, counsellor, dentist, vocation adviser and others are explained. Integration of the family is also emphasised. A case study demonstrates the outcomes that can be achieved by this approach.

The chapters on musculoskeletal problems are invaluable for physio- therapists working with people who have suffered trauma of any description, and are enriched with diagrams to explain the mechanism of the damage and its treatment. The emphasis on soft tissue injuries reflects the fact that 92% of survivors manifest such problems.

The chapter on pain is useful but does not provide much more infor- mation than many standard physiology books, and misses the opportunity to explore the complex mind-body interractions specific to survivors of abuse. Hyperventila- tion syndrome, a common outcome of severe pain or stress, is not addressed.

The chapter on methods of torture is necessary so that readers understand the nature of the injuries and the likely effects on the person, but I found the drawings of people being tortured intrusive,

distracting and unnecessary. Indeed I felt abused myself a t seeing them.

However, the book fills a signifi- cant gap in our education, and I hope that more will come from the RCT in the future. Further publications should have an index, which was missing from this one, but I hope the translation style will remain the same - I enjoyed reading about ‘acute and chronical trauma’.

I would recommend that physio- therapy managers ensure that a copy of this book is available in their departments. Any physiotherapist may find unexpectedly that a patient has suffered torture or other deliberate abuse, and it is useful to have an understanding of the sensi- tive handling required and how to deal with flashbacks. Educational- ists would also find that different aspects can be incorporated into appropriate modules so that grad- uates are prepared with a basic understanding of the issues involved.

Alexandra Hough BA MCSP DipTP

Physiotherapy with Older People by Barrie Pickles, Ann Compfon, Cheryl Cuff, Janet Simpson and Anthony Vander- voorf. W B Saunders, London, 1995 (ISBN 0 7020 1931 3). Illus. 498 pages. f 33.

This book is written as an inter- national undergraduate physio- therapy textbook by educationists and a clinician from Canada and the United Kingdom. It is an ex- cellent book well suited to all physiotherapy departments, given the age range of the majority of patients. Of the students I have canvassed in the UK none would be able to afford it. Thus several copies are essential for all educational establishment libraries and it

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would be an essential purchase/ loan as background knowledge for ‘Care of older people’ components in specialist diploma/master’s courses.

The book is divided into seven sections:

Background to ageing The ageing process Working with older people Management of impairments

Handicaps of ageing Integrated case management

*Future directions. They cover extensively the know- ledge base that physiotherapists working with older people in all care areas need to have, including the clinical conditions of postural instability and falling, osteoporosis, incontinence, stroke, psychiatric problems, and pain. This may seem a limited list of ‘medical conditions’ but the role of the physiotherapist in multiple pathology is to solve movement problems. The informa- tion to help students become good problem-solvers with older people is all there, it just needs to be put into practice. To help with this, case studies are included in the book. Examples of assessment forms are also given.

A strong emphasis is given to the need for effective goal setting, and outcome measurement. As the conclusion states: ‘Physiotherapists must decide what to teach or treat, how to evaluate the results and market their potential. Others are waiting impatiently to seize the opportunity’. The chapters are well referenced from international sources. I have one fault with the book, which is the poor manual handling techniques illustrated in the ‘Sabine solution to dealing with a fall’. A final niggle is the need to use Canadian, American and UK care terms which does make the whole continuing carehocial care area a bit confusing.

This book demonstrates that older patients are treatable, they are teachable and that appropriate physiotherapy is valuable to their quality of life.

Margaret Hastings BA GradDipPhys

and disabilities

Physiotherapy, April 1996, vol82, no 4

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