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Facilitated stretching.
  1. Ian Horsley
  1. Lecturer in rehabilitation studies University of Salford

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    2nd ed. Robert E McAtee, Jeff Charland. (Pp 143; soft cover; £13.95.) Leeds: Human Kinetics Europe Ltd, 1999. ISBN 0-7360-0066-6.

    This is the second edition of a book previously published in 1996 which has been reorganised to make it easier to use and broaden the scope of stretches presented.

    Chapter 1 begins with the historical basis of PNF, discussing the work of Kabat and later Knott and Voss. It then goes on to explain the myotactic stretch reflex and the role of muscle spindles, together with the role of the Golgi tendon organ in the inverse stretch reflex (autogenic inhibition) and its function in Chaitow's muscle energy technique, where muscle elongation takes place during “post-isometric relaxation”.

    Chapter 2, “Stretching basics”, skims over the subject of whether it is necessary to stretch. Although it is admitted that there is no clear agreement of the value of stretching, personally I would have liked to have seen quoted some references both for and against stretching. Again in this chapter the ideal scenario is stated “stretch after warming up, exercise, then stretch again after exercise as part of the cool-down process” but then this is followed by “If time is a factor . . . we recommend skipping the pre-exercise stretching and concentrate on the post-exercise stretching.” As a physiotherapist, I would advise the opposite—that is, stretch before exercise—as I feel this helps to reduce injury. This apart, the rest of the chapter is well written and briefly considers several different types of stretching, concluding with a detailed description of how to carry out the techniques for both therapist and subject, emphasising the importance of positioning to minimise the risk of injury to both, and how to isolate individual muscles.

    The final section of part I describes patterns of movements for both upper and lower limbs with useful black and white photographs to assist with understanding.

    Part II of the book contains the stretches and is divided into chapters on stretches for the lower extremity, upper extremity, torso, and neck. The general layout begins with the anatomy of the muscle group, accompanied by a line drawing, a table that shows origin, insertion and action, and functional assessment, showing normal ranges of movement. The stretches are then described with relevant photographs showing the positions of subject and partner. Finally there is a “self stretch,” with description and black and white photograph.

    The final chapter in part II is entitled “PNF in physical therapy” and differs from the previous section of the book, as it deals with treatment of injury and the role of PNF in rehabilitation, providing case presentations and treatment programme.

    In a literature review in the appendix it states that “eight of the fourteen studies reviewed (57%) found that PNF stretching is significantly more effective for increasing ROM and flexibility than static, ballistic or passive stretching” but does not provide sufficient information for one to read these studies and compare the protocols used. Furthermore the number of references used throughout the book is comparatively small considering the wealth of studies now being published on the subject of flexibility.

    Overall I feel the book is well written and informative supported by good drawings and photographs. My only reservation is the cover of the book. Although the second edition has been published this year, the colours, style of presentation, and photographs give the impression that the book belongs in the 1970s! Notwithstanding this, I feel the book will be of great value to everyone working within the field of rehabilitation and sports injury.

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