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Wheelchair Training Resource Pack 1996 College of Occupational Therapists, 6-8 Marshalsea Road, London SEl lHL, 1996. Illus. 175 pages. f25 including postage.

For therapists or rehabilitation engineers who have used the original Wheelchair Training Pack issued by the Department of Health and the Central Office of Information, this updated version will be welcomed. If the new man- ual is used in conjunction with the slides/videos/tapes of the original pack, the training of future ther- apists can only be enhanced.

The wheelchair service has moved a long way since the McColl report in 1986 and it is only right that the therapists and engineers who are being trained increase their expertise and knowledge in the complexity of wheelchair assess- ment along with these service changes. The information provided in the new pack goes a long way in helping that process. It is essential that material used for new teaching purposes is kept updated.

The new version contains some excerpts from the original pack

which have not been revised or amended but this information is still very relevant to the assessment process. It can be used as valuable information handouts and over- heads for students and trainers.

The 1996 training pack contains a wide range of information from assessment, case studies, ideas for training sessions, to equipment, the law, and lists of useful addresses and references.

The depth of information varies; while some is very basic, other sec- tions are of specific interest to wheelchair therapists and rehab- ilitation engineers.

Unlike the original pack the new version is not divided into four separate sections. This is not a problem as each topic follows on logically from the assessment process of the user, to the carers’ needs, the equipment available, aspects of the law, and a useful extended bibliography at the end.

There is more detailed informa- tion on posture, seating, positioning and pressure sores. Particularly welcomed is more information on such topics as the indoorloutdoor eligibility criteria, moving and

handling, and aspects of the law. At a time when litigation is

increasing it is very useful to know and understand how the law relates to the issue of wheelchairs and cushions and the liabilities of prescribers, manufacturers and users.

Wheelchair therapists and rehab- ilitation engineers are responsible for training many different groups of people from fellow therapists, medical and hospital staff to carers and volunteers. The ideas provided for setting up training sessions to include role play and case studies will help health professionals to understand and increase awareness of the complex- ities of wheelchair assessment situations. The reference to care workers studying for vocational qualifications is very relevant in the changing service requirements of the present day.

The new wheelchair pack is good value for money, easy t o read and very relevant t o health profession- als involved in the wheelchair prescription process.

A Pearce MCSP

letters Relaxation and Rest MADAM - It was instructive to have a comDarison of the Mitchell and Jacobson relaxation methods (Salt

Longwave Ultrasound MADAM -We have noted the reply by Dr Robertson and Ms Ward to our comments (‘Letters’, May) on their paper reviewing longwave ultrasound (Robertson and Ward, 1997).

While we are at odds with many of their statements, we must necessarily limit this brief response to dealing with one particular anomaly. Ward and Robertson, instead of withdrawing gracefully over their fundamental error regarding the power rating of the Phys-Assist instrument, still insist on claiming that it delivers a maximum output of 12 watts. This would indeed be remarkable for a machine with a DC input rating of 6 watts and is of course untrue.

The maximum acoustic output is 0.95 watts with a corresponding intensity of 74 mW cm-* based on an effective radiating area of 12.8 cm2.

This is of course compatible with the pressure amplitude quoted in their first reference and would have been easily verified had they fulfilled the basic calibration requirements of any serious research.

We repeat, their approach to the subject is superficial and adds little of value to the debate.

Brian Bradnock

Royal National Orthopaedic Hospital Stanmore

FRCSEd FRCSOrth

M Young MSc PhD Orthosonics Ltd Ashburton Devon

Reference Robertson, V J and Ward, A R (1997). ‘Longwave ultrasound reviewed and reconsidered’, Physiotherapy, 83, 3, 123-1 30.

and Kerr, 1997). 60th types of relaxation come with

good credentials and it was not sur- prising that the effects studied (blood pressure, heart rate and respiratory rate) hardly varied.

However, the Mitchell method has the added strength that it teaches the position of rest of the joints of the body. As a result, tension positions can immediately be recognised and corrected by the necessary reciprocal movement. This can be applied to living and working situations leading to economy of muscle action and prevention of fatigue. Julie McKenna MCSP Royal Free Hospital London

Reference Salt, V L and Kerr, K M (1997).. ‘Mitchell’s simple physiological relaxation and Jacob- son’s progressive relaxation techniques: A comparison’, Physiotherapy, 83, 4, 200-207.

Phvsiotheraov. June 1997. vol 83. no 6