Cognition in Schizophrenia
1
Physiotherapy June 2001/vol 87/no 6 330 Slack Incorporated, New Jersey, USA 2001, 3rd edn (ISBN 1 55642 452 3). Illus. 304 pages by Carol J Manheim MS MEd PT LPC $45 Myofascial therapy is defined by this text as the facilitation of mechanical, neural, and psychophysiological adaptive potential as interfaced via the myofascial system. The author seeks primarily to provide a learning tool for those with little or no knowledge of myofascial therapy. The subject is introduced in a comprehensive manner with effective use of metaphors and photographs to explain the underlying principles. Thereafter, the manual style format allows users to access various techniques efficiently, based upon anatomical category. The author also includes brief sections relating to advanced myofascial release techniques, trigger points and scar releases. Clear instruct- ions in conjunction with photographs to illustrate handholds and performance of techniques are excellent throughout. However, instructions are heavily duplicated in the main body of the text, adding unnecessary bulk to the book. This book presents an extended version of the author’s previous two manuals. Although this new edition aims to clarify the topic and answer frequently asked questions, the author openly recognises the lack of evidence base for this subject but appears to dismiss its importance, with little reference made to recent literature. A ‘do this because it works’ attitude is adopted with large emphasis placed on the importance of ‘finely tuned touch’ and feedback from patients. In addition, little attention is paid to objective assessment and evaluation of patients in relation to these techniques. A brief concluding chapter comprises some guidance on posture evaluation only. Throughout, the indications for these techniques remain quite vague and the author does little to place these techniques in the context of other therapeutic interventions. In conclusion, this book provides a well-constructed introduction to its subject, and while lacking discussion of a potential evidence base it succeeds in its aim as a learning tool for the acquisition and performance of these techniques. Its spiral binding and large pictures will make for ease of reference in a clinical setting. Lynne Dewar MCSP The Myofascial Release Manual Oxford University Press 2000 (ISBN 0 19 262993 X). Illus. 320 pages edited by Tonmoy Sharma and Philip Harvey £29.50 The aim of this book is to demonstrate that the impairment of cognitive functioning in schizophrenia has been misinterpreted. It argues that a focus on treating the positive symptoms of schizophrenia has ignored the clinical implications of cognitive impairment, on which traditional neuroleptics have no effect. Treatments aimed at improving cognitive function could have far-reaching outcomes in terms of improving social functioning of sufferers, thereby lessening the devastating effects this diagnosis can have. The various contributors write clearly, making difficult concepts understandable, with clinical examples and plenty of recent references. Each chapter stands alone, with some updating long-studied topics, while others offer new developments and ideas. While its primary audience will be clinical psychologists and psychiatrists, the book’s main message for physio- therapists is in explaining the relationship between cognitive functioning and the disease process. It questions the assumption that cognitive impairments result from positive symptoms, and demonstrates that many so-called negative symptoms, such as thought disorder, attention and speech abnormalities can improve with appropriate treatment strategies. On a practical level it will not change physiotherapy practice with these patients, but may help us better understand their communication and memory problems. It occurred to me while reading it that the recent study showing cognitive functioning in older people improved with exercise (Khadri et al, 2001), combined with existing evidence supporting exercise as improving negative symptoms in schizophrenia (Donaghy and Durwood, 2000), could suggest a role for physiotherapists here that has not yet been fully explored. Catherine Pope MCSP References Khadri, Blumenthal, Babyak et al (2001). ‘Effects of exercise training on cognitive functioning among depressed older men and women’, Journal of Ageing and Physical Activity, 9, 1, 43-57. Donaghy and Durwood (2001). ‘A report on the clinical effectiveness of physiotherapy in mental health’, Chartered Society of Physiotherapy, London. Cognition in Schizophrenia Impairments, importance and treatment strategies
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Transcript of Cognition in Schizophrenia
Physiotherapy June 2001/vol 87/no 6
330
Slack Incorporated, New Jersey, USA2001, 3rd edn (ISBN 1 55642 452 3). Illus. 304 pages
by Carol J Manheim MS MEd PT LPC $45Myofascial therapy is defined by this text as the facilitation ofmechanical, neural, and psychophysiological adaptivepotential as interfaced via the myofascial system. The authorseeks primarily to provide a learning tool for those with littleor no knowledge of myofascial therapy.
The subject is introduced in a comprehensive mannerwith effective use of metaphors and photographs to explainthe underlying principles. Thereafter, the manual styleformat allows users to access various techniques efficiently,based upon anatomical category. The author also includesbrief sections relating to advanced myofascial releasetechniques, trigger points and scar releases. Clear instruct-ions in conjunction with photographs to illustratehandholds and performance of techniques are excellentthroughout. However, instructions are heavily duplicated inthe main body of the text, adding unnecessary bulk to thebook.
This book presents an extended version of the author’s
previous two manuals. Although this new edition aims toclarify the topic and answer frequently asked questions, theauthor openly recognises the lack of evidence base for thissubject but appears to dismiss its importance, with littlereference made to recent literature. A ‘do this because itworks’ attitude is adopted with large emphasis placed on theimportance of ‘finely tuned touch’ and feedback frompatients.
In addition, little attention is paid to objective assessmentand evaluation of patients in relation to these techniques. Abrief concluding chapter comprises some guidance onposture evaluation only. Throughout, the indications forthese techniques remain quite vague and the author doeslittle to place these techniques in the context of othertherapeutic interventions.
In conclusion, this book provides a well-constructedintroduction to its subject, and while lacking discussion of apotential evidence base it succeeds in its aim as a learningtool for the acquisition and performance of thesetechniques. Its spiral binding and large pictures will makefor ease of reference in a clinical setting.
Lynne Dewar MCSP
The Myofascial Release Manual
Oxford University Press2000 (ISBN 0 19 262993 X). Illus. 320 pages
edited by Tonmoy Sharma and Philip Harvey £29.50The aim of this book is to demonstrate that the impairmentof cognitive functioning in schizophrenia has beenmisinterpreted. It argues that a focus on treating the positivesymptoms of schizophrenia has ignored the clinicalimplications of cognitive impairment, on which traditionalneuroleptics have no effect. Treatments aimed at improvingcognitive function could have far-reaching outcomes interms of improving social functioning of sufferers, therebylessening the devastating effects this diagnosis can have.
The various contributors write clearly, making difficultconcepts understandable, with clinical examples and plentyof recent references. Each chapter stands alone, with someupdating long-studied topics, while others offer newdevelopments and ideas.
While its primary audience will be clinical psychologistsand psychiatrists, the book’s main message for physio-therapists is in explaining the relationship between cognitivefunctioning and the disease process. It questions the
assumption that cognitive impairments result from positivesymptoms, and demonstrates that many so-called negativesymptoms, such as thought disorder, attention and speech abnormalities can improve with appropriatetreatment strategies.
On a practical level it will not change physiotherapypractice with these patients, but may help us betterunderstand their communication and memory problems. It occurred to me while reading it that the recent studyshowing cognitive functioning in older people improvedwith exercise (Khadri et al, 2001), combined with existingevidence supporting exercise as improving negativesymptoms in schizophrenia (Donaghy and Durwood, 2000),could suggest a role for physiotherapists here that has notyet been fully explored.
Catherine Pope MCSP
References
Khadri, Blumenthal, Babyak et al (2001). ‘Effects ofexercise training on cognitive functioning amongdepressed older men and women’, Journal of Ageing andPhysical Activity, 9, 1, 43-57.
Donaghy and Durwood (2001). ‘A report on the clinicaleffectiveness of physiotherapy in mental health’, CharteredSociety of Physiotherapy, London.
Cognition in Schizophrenia
Impairments, importance and treatment strategies
