1. Bruce, Joy A. MSPT, NCS

Article Content

Purpose: This third edition of the rehabilitation textbook provides concepts and techniques relevant to the treatment of persons with spinal cord injury (SCI). With the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) (2002) serving as its anchor, this text addresses the guidelines and evidence generated to enhance clinical practice and achieve optimal outcomes after SCI.


Audience: This text has been written for students learning rehabilitation techniques and for practicing clinicians who care for persons with SCI or those with similar impairments.


Organization/Structure: Each of the fifteen chapters of this text contains problem-solving exercises and proposed solutions, suggested resources, and copies of nonproprietary assessment tools. Additional helpful features are the drawings and diagrams, as well as the "Physical Prerequisite" checklists associated with patient training. The prerequisite checklists help clinicians identify how preserved muscle function can and/or will translate in attaining mastery of functional skills.


Information: Chapter 1 introduces the ICF model and explains how this model is used to evaluate patients' health conditions and function within the context of their environments. Chapter 2 provides the etiology and epidemiology of SCI in the United States, its evaluation, its presentation, and possible sequelae. Chapter 3 covers early medical management of SCI, including trauma care, surgery, nursing care, and the use of orthoses. Chapter 4 explores the psychosocial impact of SCI and provides strategies for therapists to help to guide patients through the many stages of recovery. Chapter 5 describes prevention and management of pressure ulcers. Guidelines, assessment tools, and positioning devices and cushions are highlighted here. Chapter 6 addresses management of respiration and the ventilatory pump. Chapters 7 and 8 outline examination, evaluation, and goal setting for patients. Chapter 9 addresses mat and bed mobility skills that are appropriate for patients of different neurological levels. Chapter 10 reviews transfer skills from the most basic to those with the highest physical demands. Chapter 11 covers wheelchair management and skills and provides techniques for training. Chapter 12 describes the retraining of walking after SCI. Later in the text, Chapters 13 and 14 address the genitourinary issues associated with SCI, including reflex activity or areflexia, incontinence, and sexual functioning. Finally, Chapter 15 addresses architectural adaptations that may need to be considered for home or workplace environments after SCI.


Summary: This text has been transformed by the integration of the ICF and current research. The latest edition considers the context in which SCI rehabilitation is currently being provided (ie, managed care and health care reform). This text is appropriate for students and clinicians who are just entering SCI rehabilitation or clinicians who are looking for ways to improve their management of persons with SCI. The textbook is concise and well-organized, and the techniques and strategies provided are based on the best-available evidence.


Joy A. Bruce, MSPT, NCS


Physical Therapist/Clinical Researcher


Shepherd Center


Atlanta, Georgia