Edited by P. Gallagher, D. Desmond, and M. MacLachlan 164 pp, $129.50 London, UK, Springer-Verlag, 2007 ISBN-13: 978-1-8462-8979-8 Amputation is a disability that grabs one's attention. While advances in prosthetic design may promote episodic media attention, the evolution of prosthetic design and engineering is inspiring. However, as a physician who has focused his career on the treatment of persons with limb loss and as a scientist who is trying to develop the next generation of artificial limbs, I am deeply aware that the most important aspect of recovery from amputation is the psychological adjustment of my patients. Figure. The evolution of prosthetic design and utility is being advanced by a more insightful understanding of human morphology as it relates to hydraulic and electrical design. Display of the medical illustration by permission and courtesy of the artist, Jason Glenn Isley. Psychoprosthetics is an important new text for the field of rehabilitation. The editors are leaders in the field of psychology for the rehabilitation of individuals with limb loss and have gathered together an excellent group of contributing authors. In each chapter, the authors present the relevant literature on the emotional adjustment to amputation and build a construct to try and understand the literature. The chapters finish with a discussion of the research needed to advance the field, focusing on a list of key points. This book is not light reading. If a reader is looking for an entertaining book full of descriptive, intriguing, and inspiring stories of how different individuals face the emotional challenge of limb loss, then that reader will be disappointed. This is a scientific textbook, rich with information. However, it is densely written and thick with psychological jargon and language that is challenging for a nonpsychologist (like me) to read. The book has 12 chapters: “Psychoprosthetics: An Introduction”; “Coping With Psychosocial Adjustment to Amputation”; “Limb Loss and Body Image”; “Management of Chronic Pain After Limb Loss”; “Cognition and Mobility Rehabilitation Following Lower Limb Amputation”; “Psychological Adjustment to Lower Limb Amputation: An Evaluation of Outcome Measurement Tools”; “Interventions of Psychological Issues in Amputation: A Team Approach”; “Anthropology and Its Individual, Social, and Cultural Contributions to Psychoprosthetics”; “Embodiment and Prosthetics”; “Osseoperception and Osseointegrated Prosthetic Limbs”; “Virtual and Augmented Reality, Phantom Experience, and Prosthetics”; and “Psychological Fit of a Prosthetic Arm: An Illustrative Case Study Using Repertory Grid Analysis With a User of a High-Tech Upper-Limb Prosthesis.” The editors and authors have integrated these chapters so that there is little repetition and individual chapters frequently build on others. I had several favorite chapters. Bruce Rybarczyk and Jay Behel present an eloquent and thoughtful description on how individuals view themselves after an amputation. This involves integrating 3 self-images: their self-image with a whole body; their perception of self without the lost limb; and, possibly, their self-image including an artificial limb. Seth Messinger frames the issue of limb loss from an anthropologic perspective. This unique perspective addresses the challenge of limb loss from different views within the social organization. He thoughtfully considers how all members in a family, circle of friends, and the general public react to limb loss. Finally, I thoroughly enjoyed the chapter on phantom limb experiences by Jonathan Cole. Phantom limb sensation and pain (feelings in the missing limb) are an intriguing phenomenon. Although clearly they are not psychiatric disorders as once believed, they need to be considered in a rehabilitative framework that incorporates the psychological as well as the physiological. Psychoprosthetics is a reference text that should be embraced by clinicians of varied disciplines and expertise. While it focuses on the emotional and social adjustment to amputation, the lessons learned from such an obvious disability as amputation can shed light on how individuals and society deal with other disabilities and health challenges. This book likewise highlights the great need for further research in this important area of medicine. Back to top Article Information Financial Disclosures: None reported.
JAMA – American Medical Association
Published: Apr 23, 2008
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