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Pack Footwear: Equipment, advice and information compiled by Rosemary Ruston. Disabled Living Foundation, 380-384 Harrow Road, London W9 2HU. lllus. f25.

An information pack relating to footwear could be extremely useful to all therapists who are involved in footwear provision, so I eagerly read the latest enlarged information pack from the Disabled Living Foundation. Previous packs were published in 1988,1990 and 1992.

This publication is presented in a sturdy loose-leaf binder and consists of individual books and information sheets. Easy access to information is obtained by division into six categories:

Footwear and where to get it; footwear for difficult feet; dressing advice; footwear for specific needs; advice for people with sensitive feet; care of the feet.

Availability of all types of footwear (eg commercial, semi- bespoke and made-to-measure) is clearly presented and provides useful information, especially for difficult patients with ‘unique’ prob- lems. I liked the overall presentation and i t made easy reading (to such an extent that I am unsure whether this publication was aimed a t the lay person or the professional).

The navy and white colour scheme was effective and well illus- trated with clear line drawings and patterns for such items as leg warmers and bootees.

The whole edition tended to be spoilt by an over-abundance of advertising, especially in favour of the main sponsor (mentioned 33 times) almost double the number of times of a firm providing a similar product. This bias tended to unbal- ance a nicely produced manual.

An abundance of advice is provided on the 93 pages (adver- tising pages not included). Although I do not agree with all the advice given, eg ‘elastic laces can be used to convert lace-up shoes into slip-ons’, while this is true it is in my opinion dangerous practice for older people to adopt and therefore it would be better not to promote such a prac- tice without clarification. Again ‘low cut, slip-on shoes may cause the top of the foot to swell but these styles may be preferred for a smart occa-

sion or for easy dressing’. This statement may be fact, a more posi- tive statement discouraging this would have been more helpful to the professional who often has a diffi- cult task in persuading patients otherwise. Again ‘fabric shoes (which also include some trainers) may be a good idea as not only do they give but they also support the heel’, a rider of caution on their use for older people would have been helpful as recent literature shows tha t trainers can increase falls in older men (Robbins et al, 1993). ‘Some people have found that firm knee-length boots can reduce the amount of swelling’. Graduated pressure stockings would be more cost effective, adapt to swelling vari- ations and be lighter. I t should be remembered tha t the weight of a product is of vital importance for many people, especially the frail elderly.

Possibly a section relating to the specific needs of the elderly would be helpful as this group of people are particularly vulnerable, often requiring help with supply.

Although I have criticised some of the advice given, this publication provides much sound advice and should be a useful adjunct to the experienced professional who provides a footwear service.

Hopefully in the future a fifth edition will bring more clarification to encompass the needs of specific groups of people and include recent literature searches. Provision of footwear is becoming more and more important as awareness increases of the interplay between walking, balance and footwear (Dunne et al, 1993). Therapists now recognise tha t poor footwear can have a substantial but indirect effect on health.

Olwen Finlay FCSP HT DMS

References Dunne, R G, Bergman, A B, Rogers, L W and Rivara, F P (1993). ‘Elderly persons’ attitudes towards footwear - A factor in preventing falls’, Public Health Reports, 108, 2, 254. Robbins, S, Gouw, G J and McClaren, J (1992). ‘Shoe sole thickness and hardness influence balance in older men’, JAGS, 40, 1089-94.

Manual Therapy ‘Nags’, ‘Snags’, ‘MWMs’ etc by Brian Mulligan, Houghtons, Manchester (3rd edn), 1995 (ISBN 0 473 03039 X). Illus. 127pages. f 10.50, plus f2 p&p.

This third edition with 20 more pages, which include about 22 more illustrations, brings the reader up to date on the latest developments in this concept. It makes easy reading and complements the Mulligan Concept courses held around the country.

The first part of the book deals with an explanation and description of the treatment of the spinal joints using nags and snags and remains largely unchanged. Two new chap- ters introduce and describe spinal mobilisation with limb movements, an exciting new aspect of mobilisa- tion with movements giving interesting results to those clini- cians tha t are using them. The chapter on ways to improve straight leg raise is extended and illustrated. There is also a section on a chair

tha t Mulligan has designed for people with back pain.

The second part of the book has been expanded to bring therapists up to date with further examples of the application of mobilisations- with-movement (MWM) techniques in the periphery. The treatment of the ankle, hip and tibio-fibular joints with MWM’s are described and illustrated for the first time.

The third part outlines the princi- ples behind the use of compression and ‘pain release phenomena’ (PRP’s) as a treatment procedure. The final part of this section covers a variety of conditions and treat- ments Mulligan has found useful. These sections are largely unchanged and the references are the same.

The price is relatively unchanged, easily affordable and is a ‘must’ for the practising innovative clinician.

Linda Exelby BSc(Physio) GradDipManTher

MMACP

Physiotherapy, February 1996, vol 82, no 2