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‘movement sections’ with personal demonstrations of any specialised techniques that you wish to use. The Open Learning Course will require commitment on the part of the ‘student’ and considerable support and guidance from the provider. Though the course mate- rial is excellent and the instruction sheet stresses the need for all prac- tical sessions to be supervised by a competent practitioner, I have some reservations about this programme. There is an ever-present danger that some establishments will be tempted, due to time and resource constraints, t o issue the open learning course t o new staff members, without further guidance and support. They will then rely upon this DIY approach as a suit-

able and sufficient programme of training - which it is not! Compe- tence may be likened to a triangle whose sides consist of knowledge, skill and experience. If any one side is missing the triangle does not have form. The open learning course may well provide the user with know- ledge, but unless this knowledge is applied to practical work under competent supervision, the skill and experience will never be developed. The open learning course may be valuable as part of a broader refresher course.

As with any other product each user will appreciate some sections more than others. I was impressed with the anatomy and biomechanics graphics and the sections on hoists, but I found the brief mention of

ergonomics frustrating, as I wanted much more.

Like any audio-visual training package the application will only be as good as the individual trainer who presents it. This package should enable most trainers to be proficient and meet the needs of their organisations’ statutory oblig- ations.

In my view LMT and CHT is good value and as it is being constantly updated and the views of users are encouraged, it should have a long and useful life. I would recommend that you borrow the preview tape as this will give some idea of the contents of this comprehensive training programme.

Christopher R Hayne FCSP MErgS MIOSH MllRSM

Physiotherapy for Hyperventilation A breathing retraining programme produced by the Hyperventilation Clinical Interest Group, 1995, available from Ms A Pitman, Princess Grace Hospital, 42-52 Nottingham Place, London W I M 3FD. 40 min. f 10.

This video is in two main parts. The first deals with the explanation of hyperventilation, as if describing the syndrome t o a patient. The explanation is clear and com- prehensive, easy t o follow and understand by anyone with some basic knowledge of respiratory physiology. Technical language is used, which indicates that it must have been produced for use by physiotherapists, rather than by patients; with this in mind more detail could be given.

The second part demonstrates

objective examination and treat- ment of hyperventilation. Again, this is clearly demonstrated, with a therapist teaching a patient about her breathing pattern, then care- fully showing her how t o alter it. The treatment progresses from teaching the patient in supine, through to sitting, and then during everyday activities. I needed to watch this part several times in order to pick up on all the subtlety of treatment used, but there is a clear re-cap at the end of the treat- ment session.

There is an introduction and conclusion, but the editing seems slightly disjointed, with the location and presentation appearing out of context with the style of the production.

The video is certainly interesting and should prove helpful to anyone

with limited experience in this field. I did however feel there was an important piece missing: guidance in the subjective examination, and thereby identification of hyper- ventilation. Making sense of the difficult histories given by these patients, pinpointing the important information, and how to develop a line of questioning, are essential parts of a therapist’s skill, before explanation of the symptoms and treatment.

With increasing confidence in assessment, and its wider applica- tion, many more sufferers may be identified. Help in this, from such experienced and skilled practitoners as those presented on the video, would be invaluable for therapists, who may then be able to help in diagnosing people with hyperventi- lation.

Sally Martin MCSP

Reprints from Physiotherapy The following booklets comprise articles which have been published in the Journal, conve- niently bound together. If you wish to send for any, please send payment with your order to the Journal Department, The Chartered Society of Physiotherapy, 14 Bedford Row, London WC1 R 4ED, England. All reprints are post free (air freight overseas).

Benesh Movement Notation f l Bioelectricity and Electrotherapy (1 990-91) f 5

Oncology and Palliative Care Tying a Shoe-lace One-handed, five single sheets

Parkinson’s Disease Therapeutic Ultrasound

f l (December 1994) f 8

f2 Outcome and Audit (April 1995) f15

(March, April 1987) €2 Neurology (August 1995) f15

Orthotics (June, August 1987) f 3 Electrotherapy Reviews (new edition) f10

Physiotherapy, April 1996, vol82, no 4