Physiotherapy January 2000/vol 86/no 1

53Book reviews

Weidenfeld and Nicolson, London1999 (ISBN 0 297 84247 1). 277 pages

by Tom Kirkwood £20This scholarly book gives a comprehensive insight into thescience of human ageing.

Tom Kirkwood, who is professor of biological gerontology atManchester University, has published over 160 scientific paperson a wide range of subjects connected to human ageing and isrenowned for his ‘disposable soma’ theory of ageing or in layterms his ‘wear and repair’ theory.

The text draws on the author’s wide range of knowledge,discussing myths surrounding old age as well as providing awealth of hard facts. Tom Kirkwood knows from his teachingexperience how to keep readers’ interest and this isdemonstrated as he draws readers into the book by getting theminvolved in the decision-making process. One is also treated tointeresting little titbits such as: ‘If you want a long life it is best tobe born Japanese and female.’ He appreciates that somestudents will remember this better than having to extract theinformation from statistics. Graphs and tables have been kept toa minimum.

The author clearly defines his target audience to whom thebook will appeal. It is ‘written to be intelligible to the reader whohas no training in science, but has an interest to know’.Undoubtedly this text will be of value to this readership and inmy opinion his objective has been achieved.

If AGILE had a small reference library this is the type of

publication I would wish to buy. The loose cover tells one thatthe book will show why ageing is neither inevitable nor necessaryand the contents fulfil this promise. It is fascinating, written withclarity and sensitivity, and must be relevant to physiotherapists,postgraduate and undergraduate students alike. It provides anexcellent source of scientific fact about a topic that is rarelyspoken about and yet concerns us all.

When one considers that early in this new century almost 20%of the population of the United Kingdom will be 65 years old ormore, then the ageing process will grow in importance.

The book has 15 chapters in total, the first being called ‘Thefuneral season’. This chapter, like the book, is full of surprises.Other topics covered are ‘Attitudes to ageing’, ‘Longevityrecords’, ‘Why ageing occurs’, ‘Cells in crisis’, and ‘Eat less, livelonger’, to name but a few.

‘The cellular and chemical factors which are responsible forageing are described mainly in the current research literature,and the latest information summarised in chapters 7 and 8 arenot easily found in any single source.’ However, if TomKirkwood’s prediction of the future is correct, then I am glad Ilive in the present. I do not intend spoiling this book for readers,you should find out for yourself.

The student of ageing will find the extensive bibliography mosthelpful. In my time as an undergraduate, relatively littleemphasis was placed on the ageing process. Having read thisbook I just wish it had been published 40 years ago.

At £20 this book is good value for money as it provides suchinteresting and specific information.

Olwen Finlay MBE FCSP HT DMS

Time of Our Lives

Churchill Livingstone, Edinburgh1999 (ISBN 0 443 058024). Illus. 185 pages

by Carolyn Richardson, Gwendolen Jull, Paul Hodges and Julie Hides £25This book about dynamic stabilisation of the spine in thetreatment of low back pain combines a vast amount of researchevidence with clinical expertise into a very readable text.

After a brief introduction, section 2 provides the scientificbasis, which systematically argues the case for the need of a localmuscle system to support the spine. These chapters areextensively referenced and draw together research findings,especially in relation to transversus abdominis and multifidus.

Having provided a convincing argument, the followingsections apply science to practice. These chapters are still verymuch based on research evidence in relation to the training of

motor control and the underlying principles of the exerciseprogrammes. However, readers are also provided with aninvaluable source of clinical guidelines and practical suggestionswith regard to training correct muscle activity in the stabilisingmuscles, and preventing undesirable muscle activity. Clinicaltests and exercises are clearly described, which are feasible forany therapist to learn and apply. In addition, electromyographicand ultrasound imaging techniques are discussed.

The book is about treating low back pain but many of theprinciples can be applied to treating any part of the body.

The final chapters consider the progression of exerciseprogrammes into dynamic function, planning of treatmentprogrammes and, finally, looking to the future in terms ofresearch and clinical practice. My only criticisms of the book arethe scarce mention of some muscles involved in lumbopelvicstabilisation, most notably the hip muscles, and the brevity ofchapter 10 ‘Integration into dynamic function’.

The book is well laid out and easy to follow. Numerousdiagrams and photographs enhance the text.

This book has been long awaited and I would highlyrecommend it to all physiotherapists treating patients with lowback pain and to any therapists advocating clinical practice basedon research evidence. It is excellent value for money.

Gabrielle Rankin MSc MCSP MMACP

Therapeutic Exercise for SpinalSegmental Stabilization in Low Back Pain Scientific basis and clinical approach