Sleep and Rehabilitation: A Guide for Health Professionals is a concise reference for the health professional looking to further understand sleep and how sleep science may impact particular areas of various rehabilitation disciplines. Dr. Julie M. Hereford and her contributors present Sleep and Rehabilitation: A Guide for Health Professionals in an easy-to-read manner by dividing the text into four main sections. The first section provides a review of the basic scientific understanding of sleep. While there are many other publications that present a basic scientific understanding of sleep, Sleep and Rehabilitation systematically gears this information toward the rehabilitation professional with commonly used terminology, descriptions of sleep architecture, and information concerning sleep hygiene. The final sections of Sleep and Rehabilitation describe disordered sleep and how it pertains to patients seen in the rehabilitation setting. It guides the health professional to recognise the manifestations and consequences of disordered sleep and teaches the rehabilitation professional how to interpret a sleep study in order to provide guidance in clinical decision making. Finally, Sleep and Rehabilitation provides the ever-important practical application of the theoretical principles in sleep rehabilitation. Features include: Discussion on the science of polysomnography Sleep and sleep dysfunction from a rehabilitation perspective Sleep dysfunction as it relates to the clinical needs of a patient undergoing the rehabilitation process Discussion on the particular concerns that sleep and sleep dysfunction can hold for rehabilitation patients and issues to be addressed by the provider Presentation of unique issues that disordered sleep may present in the rehabilitation process such as on pain, pain management, motor learning, and memory and performance enhancement Tools to assess quality and quantity of a patient's sleep Discussion on methods in which sleep may be manipulated in order to optimise a patient's physical performance Sleep and Rehabilitation: A Guide for Health Professionals is a one-of-a-kind reference that will help the health professional incorporate the science of sleep into the rehabilitation process.

The twu-day sympusium held un the campus uf Augustana Cullege, Ruck Island, Illinuis, April 5 and 6, 1967, explured the interrelatiunship between the life sciences and engineering and attempted tu make the scientific cummunity mure aware uf an interdisciplinary appruach tu engineering. The sympusium suught tu stimulate new mechanical engineering cuncepts perhaps nut pussible utilizing data available unly thruugh ideas derived frum the traditiunal physical sciences. Devuted tu clused luup biomechanical systems in which biulugical furces and feedback influence mechanical, physical, and chemical systems, this first Ruck Island Arsenal Biumechanics Sympusium was cuspunsured by Ruck Island Arsenal, u. S. Army Weapuns Cummand, U. S. Army Research Office Durham, and Augustana Cullege. It strived fur academic excellance, and the spunsurs are indebted tu the Advisury Cummittee in pruviding the guidance and participatiun required tu achieve this ubjective as reflected in these pruceedings. Persunal thanks are extended tu Drs. Russ C. Bean, Geurge Bugliarellu, Rubert G. Gesteland, Warren S. MCCulluugh, Lawrence M. Patrick, Ali Seirig, and Heinz Vun Fuerster. The planning cummittee, which included Pruf. Juhn E. Ekblad, Edwin M. Vaughan, Alan G. Galbavy, and the editurs, are also. tu be cummended fur their ef- furts in arranging this successful sympusium.

Triennial the Division of Biomedical Engineering of the Institute of Textile Technology and Chemical Engineering, Denkendorf, is organizing conferences on specific topics in the field of polymeric materials for use in the biomedical areas. The aim is to bring together scientists from allover the world working on this speci fic topic, to present the newest state of the art and to discuss their problems in a more concentrated atmosphere and at last to create and intensivate their cooperation. Following two conferences on "Polyurethanes in Biomedical Engi neering" (1983 and 1986), the Institute of Textile Technology and Chemical Engineering set a theme, which is very closely related to its own task: "Medical Textiles for Implantation". As technical materials, textiles can be classified in two fields of application: - first, textiles used for highly flexible, strong, but only tension load bearing systems, e.g. tows; - second, textiles manufactured to flat shaped devices to separate two regions more or less semipermeable, e.g. clothing; - a combination of both are reinforced systems like tubular fabrics e.g.; here pressure load will be transformed to tensile load, the separation may be performed by a coating. In the biological systems the classification can be used in the same manner: - Tension load bearing structures are ligaments and tendons, semipermeable separation is realized by cell membranes as well as by cell layers, for example the skin. - The combination of both of the principles can be found for example in arteries and the trachea.

During the past five years there has been a reawakening of interest in the psychotherapy of patients with medical disorders characterized as psychosomatic. For three decades, psychoanalysis and psychoanalytic psychotherapy were used extensively to treat and study psychosomatic disorders. Early in the 1960s, interest in this approach to these conditions faded, and the .Psychosomatic Service. in most hospitals became the .Consultation Liaison Service. (Lipowski, 1967). The recent focus of biofeedback on psychosomatic conditions provides a new technique with which the physician or psychiatrist may treat these patients (Rickles, 1981). In addition, the successful application of biofeedback training to a variety of complaints such as those presented in this volume has heralded the addition of biofeedback to the treatment modalities used for medical complaints. Frequently, psychological factors can still be seen; for example, when biofeedback treatment may require lifestyle changes on the part of the patient, the exploration of secondary gains or resistances before the disorder can be success fully treated, and the establishment of rapport and empathy which is so important for truly effective biofeedback training. Aside from certain psychological dimensions that are always present in biofeed back training, in this case biofeedback is being used in a primarily medical setting for primarily medical complaints."

While emphysema and chronic bronchitis are primarily lung di seases, one of their major consequences is to deeply affect the function of the respiratory muscles. Lung hyperinflation shortens the inspiratory muscles due to increased airways resistance, more of their effort is demanded and changes in nutritional status wea ken them further. Their malfunction can lead to severe dyspnea and to failure of the ventilatory pump. Over the last 10 years we have witnessed an explosion of information of how respiratory muscles function in health and disease, new techniques for their evaluation have been created, the concept of fatigue, weakness, and failure was developed, and their rest or training was attemp ted. The implication of respiratory muscles malfunction in respi ratory medicine has reached a prominent place. It seems remarkable that while some aspect of skeletal muscles function requires molecular biology techniques to find new an swers, we still know little on respiratory muscles interaction, stra tegies of coordination, their role in dyspnea, chronic hypercapnia or how to effectively improve their function in patients. This workshop was organized and held at the Medical Center of Rehabilitation in Montescano and represents an attempt to focus on how the newly adquired wealth of information can eventually be trasformed into medical care. The particpants in this workshop brought forward challenging thoughts and we are most grateful for their participation. This book represents a report of the proceedings and also provides the most updated information in this field.

G. MATHE and R. K. OLDHAM' Institut de Cancerologie et d'Immunogem tique, Hopital Paul Brousse, Villejuif Since the last war, cancer chemotherapy has been the object of very intensive and expensive research. Nevertheless, its development has been very slow, and its ultimate potential is today somewhat in doubt. In doubt because it does not cure any cancer patients except a) females carrying placental choriocarcinoma, a semi-allogenic tumor, in which case, cure may be in fluenced by immune rejection, and b) children suffering from Burkitt's tumor, where the probable reason for the cure is that all the neoplastic cells are in the cycle, which is a unique condition among all the human tumor varieties. Whether the long term survivors in acute leukemia, lymphomas, certain sarcomas and certain testicular tumors are "cures" will require longer follow-up. The idea that chemotherapy does not cure most cancer patients because all their neoplastic cells are not in cycle has led to the use of drug combinations. Whatever they are, "cocktail combinations" which are made up of drugs given according to any timing, or scientific combinations, based on pharmacodynamics, pharmaco kinetics or cell kinetics data, are more toxic than single drugs, and are all the more toxic as the number of drugs in the combination is increased."

The human personality is inextricably bound up with, among other things, the function of the central nervous system. Diseases and malfunctions of the brain, head injuries and neurosurgical operations can all result in permanently altered behaviour patterns. This interrelation between brain and behaviour is most clearly demonstrated in cases involving functional neurosurgery and severe traumatic lesions. Despite the fact that this interrelation represents an everyday challenge to the neurosurgeon, it is a question which receives less attention than it deserves in neurosurgical meetings. Given the scope and complexity of this topic, it is not possible to cover every aspect of it here: hence, discussion is limited to the impact on personality of injuries, language, epilepsy and psychosurgery. However, before considering the medical aspects, it was deemed necessary to try and arrive at a definition of "personality." This question was discussed by a number of philosophers representing various perspectives. Their diversity of viewpoints and conceptions greatly enriched the discussions.

Over the past 10-20 years there has been an explosion of work on the disturbance of motor control that is manifested as "spasticity." This work has been based on new insights from animal experiments into the basis of normal motor control and the development of experimental techniques that could be used in patients with neurological disturbances. For this reason, on the initiative of Alfred Thilmann, the editors of this volume organized a workshop on spasticity, held in Essen, Germany, in November, 1992. The intention of the meeting was to bring together leading scientists in an atmosphere that would generate discussion and hopefully consensus and ideas for future work. The attendance was restricted and deliberately selective, with a mix of basic scientists, clinical scientists and practicing clinicians. The product of their presentations and deliberations is this volume. The book is organized in the same sequence as the workshop, so that the discussion sessions could be summarized by the appropriate chairman.

Up until two decades ago, clinical interest in the etiopathogenetic interpretation of lumbo-radicular syndromes was prevalently concentrated on the pathology of the inter vertebral disc. This vision gradually changed and grew as a result of the affirmation of the concept of pathological narrowing of the osteoligamentous vertebral canal as a cause of compression of the lumbar nervous structures. Finally, in the last ten years, lumbar stenosis has become more and more a subject of current interest not only as a result of problems related to nosography, diagnosis, and therapy, but also as a result of the increasing frequency with which vertebral canal or nerve root canal stenosis syndromes are recognized and treated. At the same time there was a tendency to include in stenotic pathology other pathological conditions responsible for lumbo-radicular syndromes. This led to dilation of the concept of stenosis, which perhaps no longer responded to reality, and which was not useful from a practical point of view. The need to define stenotic pathology and to correctly locate it within the vast field of lumbar pathology inspired the writing of this volume. This monograph gathers many diagnostic and therapeutic concepts matured at our In stitution over the years. Some of these concepts have already been defined in scientific meet ings or in publications."

The volume contains papers presented at a workshop of held from September 28 - October 1st in Eibsee near Munich, Germany.
The aim of the workshop was to present results of interdisciplinary research which aims to help handicapped persons suffering from paraplegia or hemiplegia to regain the capability to stand or walk. The contributions cover both fundamental research and clinical applications.

In-patient treatment for alcoholism going beyond physical withdrawal from the drug has been available in Germany for more than 130 years. Particularly since the Second World War, treatment has broadened and changed in various ways. There are several reasons for this development. The recognition of alcoholism as a disease by the Supreme Court had widespread financial and administrative consequences. Since then in patient treatment has been funded mainly by the pension insurance institutions. Another reason is the strengthened influence of different psychotherapeutic schools on practice in treatment. At the present time in the Federal Republic of Germany there are about 250 treatment facilities (Suchtfachkliniken, or addiction centres), where around 25000 patients a year receive in-patient treatment. In addition to these, there are the addiction units in psychiatric and general hospitals, of which some offer withdrawal treatment, while others also offer rehabilit ation treatment. For out-patient treatment there are about 450 special addiction counselling and treatment centres, out-patient facilities available at local health authorities and university hospitals and, further to all this, there are thousands of self-help groups of various kinds. This system of interlocking treatment facilities of various kinds, from the first contact to the after-care stage, is called a treatment network or chain.

The management of and attitudes toward children and adults with Down syndrome have undergone considerable changes in the course of the condi tion's long history (Zellweger, 1977, 1981, Zellweger & Patil, 1987). J. E. D. Esquirol (1838) and E. Seguin (1846) were probably the first physicians to witness the condition without using currently accepted diagnostic designa tions. Seguin coined the terms furfuraceus or lowland cretinism in contradis tinction to the goiterous cretinism endemic at that time in the Swiss Alps. Esquirol, as well as Seguin, had a positive attitude toward persons who were mentally ill or mentally subnormal. Esquirol pioneered a more humane treatment in mental institutions and Seguin created the first homes in France, and later in the United States, aimed at educating persons who were mentally subnormal. The term mongolian idiocy was coined by J. H. L. Down in England (1866). The term is misleading in several respects: (1) Down identified the epicanthic folds seen in many children with Down syndrome with the additional skin fold in the upper lid occurring particularly in people of Oriental (Mongolian) descent; and (2) Down also erred by assuming that Down syndrome represented regression to an ethnic variant of lower cultural standing. Such an interpretation might have been understandable at a time when the myth of Anglo-Saxon superiority was widely accepted by the British. Charles Darwin's then highly acclaimed theory of origin of the species may have contributed to such a concept."

The spinal cord has a characteristic structure and functions that are distinct from those of the brain. Its functions are tremendously important since it modulates the peripheral sensory inputs to the dorsal horn, and it gives rise to the ascending pathways transmitting peripheral afferent inputs to the brain, and conveys the descending pathways from the brain both to the lower motor neurons, the final common pathway, and to dorsal horn sensory neurons. In spite of these vital functions, the spinal cord constitutes only a small percent age of the mass of the human central nervous system and is located far from the skin surface, which has obstructed the recording of its electrical activity. Recently, however, important advances have been made in several recording techniques, including epidural recording or averaging methods, allowing both sensory and motor evoked spinal cord potentials in man to be recorded. This volume is based on the papers presented at the Fourth International Symposium on Spinal Cord Monitoring and Electrodiagnosis. Each of these international symposia has brought together many of the specialists involved in this research, with an important increase in the number of participants since the first symposium was held in Toyko in 1981. At the past symposia several attempts were made to standardize data, techniques, and clinical applications and to integrate the new findings into patient care."

In summary, considerable controversy and research have been generated from the automatic/effortful distinction. Hasher and Zacks (1979) initially stated that all manipulations (e. g. , practice, individual differences such as age, orienting instructions) must produce null effects in order to satisfy the criteria that a process is "automatic. " However, Zacks et al. (1984) have more recently noted that automatic processes may range in degree from relative insensitivity to task and subject variables (e. g. , frequency processing) to those that are more vulnera- ble to disruptive effects (e. g. , temporal processing). A review of the literature reveals that individuals are sensitive to frequency information even if manipUla- tions alter the slope of the judgments. Perhaps the application of dual-task metho- dology to the measurement of capacity demands will be useful in classifying processes along an attentional continuum. Moreover, there has been a tendency to dichotomize automatic/effortful processes rather than to characterize them as ranging from low to high attentional demands. Recent evidence (Maki & Ostby, 1987) suggests that attention may be important only in the initial (early) stages of processing frequency information. Therefore, a major difference that may emerge between automatic and effortful processing could be the degree of sus- tained attention required from individuals. In the following section, we review the findings obtained in the application of the automatic/effortful framework to the elderly and neurological/psychiatric populations.

At the beginning of the century the average life span in developed societies was less than 50 years. It is now more than 70 years and will continue to increase in the near future. Aging is a challenge to science and society. There are several theories of aging. The programmed aging hypothesis suggests that aging cannot be altered by any external influence, that aging is programmed from the beginning of life until the end of senescence. Another theory is based on genetic instability, with repair processes correcting errors in the cells that cause aging. Aging processes manifest themselves at the molecular and cellular level, in different organs, and in the whole organism. Most older persons acquire multiple diseases, primarily chronic ones. The multimorbidity of the elderly raises many questions as to nutrition, metabolism, immunity, drug therapy, and rehabilitation. Nutrition may be able to intervene in the aging process. Aging is associated with dec lining immunity and reduced resistance to many diseases, and it is pos sible that nutritional changes in old age contribute to the declining immunity in the elderly. The elderly take 40% of the prescription drugs in Germany and adverse drug reactions are more frequent in geriatric patients. There are not only problems in drug therapy for elderly pa tients, but also in their rehabilitation. The aim of rehabilitation is the restoration of geriatric patients to their former functional and environ mental status."

As a graduate student a decade ago, I recall vividly reading the inaugural issue of the Journal of Behavioral Medicine when it appeared in 1978. Its purpose was described as "a broadly conceived interdisciplinary publication devoted to fur thering our understanding of physical health and illness through knowledge and techniques of behavioral science: ' The articles in that first issue addressed such topics as the biofeedback treatment of neuromuscular disorders, anxiety manage ment of Type A behavior, and premorbid psychological factors related to cancer incidence. At that time, coursework in behavioral medicine was in its infancy at my university, and I, along with many classmates, was eager to learn more of this "new and emerging field: ' Thinking back to those times, it is astonishing for one to reflect on the rapid evolution of behavioral medicine and its current status as a clinical and scientific discipline. Organizations such as the Society of Behavioral Medicine now include a broad-based membership that is convened yeady at a major convention. In addition to the Journal of Behavioral Medicine, professionals can avail them selves of several other specialty journals (Annals of Behavioral Medicine, Behavioral Medicine Abstracts, Journal of Developmental and Behavioral Pedi atrics) as well as the numerous articles on behavioral medicine that appear regu larly in the clinical psychology, psychiatry, rehabilitation, and behavior therapy literature. And behavioral medicine services and training programs are encoun tered with increasing frequency within clinic, hospital, and academic settings."

Here is a book for clinicians, clinical investigators, trainees, and graduates who wish to develop their proficiency in the planning, execution, and interpretation of clinical and epidemiological research. Emphasis is placed on the design and analysis of research studies involving human subjects where the primary interest concerns principles of analytic (cause-and- effect) inference. The topic is presented from the standpoint of the clinician and assumes no previous knowledge of epidemiology, research design or statistics. Extensive use is made of illustrative examples from a variety of clinical specialties and subspecialties. The book is divided into three parts. Part I deals with epidemiological research design and analytic inference, including such issues as measurement, rates, analytic bias, and the main forms of observational and experimental epidemiological studies. Part II presents the principles and applications of biostatistics, with emphasis on statistical inference. Part III comprises four chapters covering such topics as diagnostic tests, decision analysis, survival (life-table) analysis, and causality.

On one of my returns to California, I attended the "Disabilities Expo 88" at the Los Angeles Convention Center. Among the various marvels oftech nology for the wheelchair disabled were stair-climbing wheelchairs, self raising and lowering kitchen cabinetry, and even a completely accessible "dude ranch" experience. At the same time, as a guest of the Southern California Chapter of the National Spinal Cord Injury Association, I was part of a small booth (among the more than two hundred exhibitors) in which we had spinal cord injured people up and walking with a lower extremity bracing system (the reciprocating gait orthosis) used at the PEERS Spinal Injury Program in Los Angeles. I had a young man, a C6/7 level quadriplegic, walking with electrical muscle stimulation and lower extremity bracing. The system is reviewed in Chapter 8 of this book. As these "disabled" persons walked erect and upright among their wheel chair bound colleagues and took long, confident strides past exhibits extol ling the latest technological virtues of yet another "new" wheelchair (Fig. 1), I reflected on the paradox of it all. What a majority of these paralyzed people W0re really looking for was an alteration oftheir disability so that they could more normally function (in an unaltered environment). What the great majority of the exhibitors were offering was an alteration of the environment so that they could more normally function (with an unaltered disability)."

For some time now, the study of cognitive development has been far and away the most active discipline within developmental psychology. Although there would be much disagreement as to the exact proportion of papers published in develop mental journals that could be considered cognitive, 50% seems like a conservative estimate. Hence, a series of scholarly books devoted to work in cognitive devel opment is especially appropriate at this time. The Springer Series in Cognitive Development contains two basic types of books, namely, edited collections of original chapters by several authors, and original volumes written by one author or a small group of authors. The flagship for the Springer Series is a serial publication of the "advances" type, carrying the subtitle Progress in Cognitive Development Research. Each volume in the Progress sequence is strongly thematic, in that it is limited to some well-defined domain of cognitive developmental research (e.g., logical and mathematical development, development of learning). All Progress volumes will be edited collections. Editors of such collections, upon consultation with the Series Editor, may elect to have their books published either as contributions to the Progress sequence or as separate volumes. All books written by one author or a small group of authors are being published as separate volumes within the series."

Sonography is an ideal real-time imaging technique for the evaluation of muscles and tendons of the extremities, and this book is a useful reference for both the technique of examination and normal ultrasound anatomy. The first part considers technical aspects of the examination such as sonographic equipment, water-path systems, and dynamic maneuvers. The basic sonographic patterns of normal muscles, tendons, and other components of the extremities are then presented. Emphasis has been placed on pitfalls and artifacts. The other available imaging techniques for muscles and tendons are also discussed. The second part comprises an atlas of normal ultrasound scans of shoulder, arm, elbow, forearm, wrist, hand, thigh, knee, leg, ankle, and foot, with accompanying explanatory line drawings.

The Neuropsychology Casebook was developed to fill the existing gap in the cur rent body of literature on clinical neuropsychology. Although texts are available that describe neuropsychological tests and others provide information on syn dromes, this volume provides descriptions of neuropsychological test perform ance for individuals with various syndromes. It was designed to illustrate the process of clinical interpretation of test findings and report writing for the individual case. Our aims are to provide both the student and practicing profes sional with a collection of actual neuropsychological case studies that typify many of the cardinal disorders or syndromes frequently seen by practicing clini cal neuropsychologists. We have not provided an exhaustive survey of case studies representing many of the disorders commonly seen in neuropsychology; rather, we have focused on a few select cases that illustrate some of the more common disorders. This book includes detailed case reports complete with referral questions, historical information, relevant neuroradiological findings, actual neuropsycho logical test data, and clinical interpretations that take into account all available information on the patient. The cases are discussed in the chapter commentaries with reference to how each compares and contrasts with the prototypic case for that disorder or syndrome. Such case studies help to highlight the various types of behavioral and cognitive sequelae associated with common clinical disorders. The case studies, which are examined through an hypothesis-testing approach, are also aimed at demonstrating how neuropsychological principles and methods are applied."

Each year in the United States, an estimated 40,000 persons lose a limb. Of these amputees, approximately 30% lose a hand or an arm. This loss is most frequently related to trauma occurring in the healthy young adult male and is often work related. Approximately 3% of all amputees are born with congenital limb absence. In children, the ratio of congenital to acquired amputation is 2: 1, and the ratio of upper-limb to lower-limb amputees is 1. 2: 1. Therefore, since relatively few amputations result in upper-limb loss, only a small number of health practitioners, even those specializing in amputee rehabilitation, have the opportunity to provide services for a significant number of arm amputees. As a result, clinicians need to share their experiences so that the full range of options for optimum care and rehabilitation of the patient population may be considered. To meet this challenge for wider communication of clinical experience, a group of upper-limb amputee specialists met in Houston, Texas, in 1981 to serve as the core faculty for a course entitled "Contemporary Issues in Upper Extremity Amputation and Prosthetic Function. " This program provided the opportunity for surgeons, physiatrists, engineers, prosthetists, social workers, psychologists, occupational therapists, and physical therapists from the United States and Canada to discuss their extensive experience in working with upper extremity amputees. A second conference continuing the discussion of upper limb amputee rehabilitation was held one year later."

Written by an international board of experts, this comprehensive text provides an in-depth review on the treatment and rehabilitation of the most common sports-related injuries according to the latest scientific developments in functional rehabilitation and the most clinically relevant features of pathophysiology of sports lesions. The management of acute and overuse sports lesions are classified by body area -- spine, upper and lower extremity.

There have been dramatic increases in the financial, emotional, and psychological investment in pets over the past four decades. The increasing importance of animal companions in people's lives has resulted in growing emphasis on the human-animal bond within academic literature. This book introduces practicing and emerging professionals to vital subject matter concerning this growing specialty area by providing an essential framework and information through which to consider the unique contextual backdrop of the human-animal bond. Such contexts include a wide array of themes including: issues of attachment and loss, success and frustration with making and sustaining connections, world views regarding animal ethics, familial history of neglect or abuse, and cultural dynamics that speak to the order of things between mankind and nature. Adopting a contextual stance will aid mental health professionals in appreciating why and how this connection has become a significant part of everyday life for many. As with any other important clinical dynamic, training and preparation are needed to gain competence for professional practice and research. To this end, an ensemble of international experts across the fields of psychology and mental health explore topics that will help both new and established clinicians increase and understanding of the various ways the human-animal bond manifests itself. Perspectives from beyond the scope of psychology and mental health such as anthropology, philosophy, literature, religion, and history are included to provide a sampling of the significant contexts in which the human-animal bond is established. What brings these divergent topics together in a meaningful way is their relevance and centrality to the contextual bonds that underlie the human-animal connection. This text will be a valuable resource that provides opportunities to deepen one's expertise in understanding the psychology of the human-animal bond.

In his review of the Proceedings of the First International Workshop on Respiratory Muscles in Chronic Obstructive Pulmonary Disease, organized in Montescano in 1986, Thomas K. Aldrich stated that "there is little information on nutrition". We felt that the need to supplement the evaluation of respiratory muscles by studying nutritional problems was an important enough matter to justify producing a specific study on the subject. This book is the result of the efforts made in this direction. Since 1986, many of the problems associated with nutrition and ventilatory function have been elucidated, and we hope that the contents of this book may contribute towards spreading interest and knowledge in this sector, particularly among those working in the field of respiratory rehabilitation. The physiological and clinical aspects of nutritional problems and the therapeutic approaches adopted in different disease conditions are dealt with in these pages by some of the best-known researchers in the field, providing abundant evidence, if any should be needed, that rehabilitation is not merely exercise. The picture strongly emerging over these last few years is that rehabilitation is not merely a matter of knowledge of lung or respiratory muscles, but also of heart-lung interaction, metabolic equilibrium and nutrition. So much for recent developments, but what does the future hold in store? May 1992 RENATO CORSICO Preface Nutrition and ventilation are inextricably related.