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tion information with the latest research and technology including all the current options-available to A Guide for Physiotherapists physiotherapists for equipment. The much loved illustrations are by Ida Bromley MBE FCSP. Churchill still there with some new updated Livingstone, Edinburgh, 1995,5th edn (ISBN 0445 058725). Illus. 261 pages. ones also. f27.50. The only area not mentioned is The fifth edition of this book the more recent advances in elecremains true to its previous trical stimulation in the upper limb principal theme and reason: to to offer high lesion tetraplegic provide clear factual information patients greater functional indepabout the effects of spinal cord endence. I t may be that space injury on a n individual and the constraints determined that some physiotherapeutic management areas must be omitted and this for this patient group, while not particular work is often led by our forgetting to give a background of colleagues in occupational therapy. the whole team management and There is a n excellent appendices a holistic view of the treatment section which offers examples of approaches. Physiotherapists are outcome measures and useful tabugiven exact advice and offered inforlated summaries; also contact mation about how to manage a addresses. patient from acute onset of injury This text will remain the absolute through rehabilitation and reintemust for all physiotherapists who gration into the community. treat spinal injuries or encounter Particular attention is paid to them in their work a t some stage. It rehabilitation ethos utilising a Swing-through gait for patient with should be found in any physiopatient centred approach which is complete lesion below TI2 - shown in therapy department library and the axis around which spinal cord Tefraplegiaand Paraplegia hopefully in nursing and medical injury rehabilitation revolves. libraries also. It provides excellent There are some chapters with step by step. There are chapters guidance for students and junior guest co-authors who offer greater concentrating on specialised skills staff but is still a comprehensive depth and expand on research refer- and areas unique to spinal injuries bibleor senior staff. ences in specific areas. Such rehabilitation. Up-to-date referenI liked the hardback version this chapters include The incomplete ces are offered throughout the time as all our previous copies have spinal cord injury and Children text to support the comments. become battered and well thumbed. This edition is an excellent develwith spinal injuries. Value for money? Definitely. The whole book is totally readable opment from its predecessors; i t Sue Rowley MCSP and is logically set out, taking us includes all the important founda-

Tetraplegia and Paraplegia

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 readable introduction to the concept of evidence-based medicine, and addresses some of the misconceptions and debunks some of the myths surrounding this process. The book is loosely structured around Sackets 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 examines 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. Assessingmethodological quality and Statistics for the non-statistician (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 relevance to most physiotherapists, provide useful insight into these areas of research and their evaluation. 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 (systematic 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 statistical 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 articulates 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 t h a t qualitative research is soft research. She makes the point that qualitative research is becoming more accepted by the medical community, who were

traditionally reluctant t o embrace this type of investigation and indeed qualitative research is now considered 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 a n excellent section on changing the behaviour of health professionals. Finally, appendices A-D are a series of lists that reinforce many of the main points in the book and should serve a s a useful aide memoire. This is a very readable introductory 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 anecdotes that demonstrate in a n occasionally amusing way how evidence-based medicine is applicable in everyday clinical situations. Each chapter is extensively referenced 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 a n 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 a s a basis for medical and paramedical 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 therefore do not add particularly t o the chapters. Each chapter is colourcoded a t the edge of the page which makes it easy to identify the separate 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 interspersed with snippets of clinical relevance denoted by a picture of a stethoscope.

It is well illustrated in colour using a range of photographs, Xrays, 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 practical 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 practitioners. 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 a s a core book for students. It is essentially a n introductory text to be used before moving on to more detailed anatomy books.

K Heathcote
MCSP DipTP MMEd DMS

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