Cardiopulmonary Physiotherapy in Trauma: An Evidence-based Approach April 30, 2019

Congratulations to Brenda Morrow and Heleen van Aswegen, two of our physiotherapist members, on the publication of their new textbook giving evidence based guidance on the physiotherapeutic management of trauma victims!

Trauma in its various forms remains a serious public health problem worldwide and is one of the leading causes of death among children between the ages of one and nine years. The Global Burden of Disease Report on Road Safety (2009) stated that 20 – 50 million people worldwide sustain injuries related to motor vehicle accidents annually. The Global Burden of Disease Report on Violence and Disability reported that 1.6 million people worldwide lose their lives due to violence each year and that many more people suffer from a range of physical and mental health problems due to violence.

Physiotherapists are often involved in the management of patients who suffered trauma in the acute care and rehabilitation settings. In the acute care setting (intensive care unit, high care unit, hospital ward) the main roles of the physiotherapist are prevention and management of respiratory (lung) complications or existing respiratory conditions and the prevention of musculoskeletal complications that may develop secondary to injury and immobility.

Description of the textbook

Cardiopulmonary Physiotherapy in Trauma: An Evidence-based Approach (2015), edited and co-authored by Associate Professors Brenda Morrow (University of Cape Town, Department of Paediatrics) and Heleen van Aswegen (University of the Witwatersrand, Department of Physiotherapy) and published by Imperial College Press, London, is unique in its scope. It is the first textbook devoted to the acute physiotherapy management of trauma victims, both adult and paediatric. This is an important component of acute physiotherapy care, as the outcomes of traumatic injuries are largely dependent on the quality of initial management. The textbook aims to have a global audience, including issues specific to developing, emerging and developed economies.

The elements of evidence-based clinical practice are often described as a combination of a) best available research evidence, b) professional expertise and judgement, and c) the needs and preferences of the patient. In this book information obtained from published research is shared with the reader as well as the clinical expertise of the writers in cases where evidence to support the use of certain treatment techniques in the management of patients with trauma is still lacking.

This book provides information on physiological responses to trauma to provide the physiotherapist with a better understanding of the mechanisms behind muscle protein breakdown and weakness and delayed recovery often observed in patients who suffer critical illness due to trauma-related injuries.

A chapter that describes the anatomical differences between children and adults is included to demonstrate that children are not just small adults and illustrates how their management may differ. Immunosuppressive diseases such as human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) are prevalent worldwide, particularly in South Africa. A chapter is devoted to immunosuppressive diseases and trauma, in which the pulmonary and extra- pulmonary complications associated with HIV and AIDS and antiretroviral therapy is described, and important points to be considered in the management of patients with HIV or AIDS who are involved in trauma are considered. A chapter is also devoted to an in-depth description of physiotherapy treatment techniques, their indications, application and contraindications.

These are followed by chapters dedicated to specific types of life- threatening trauma commonly encountered in clinical practice. Chapters are structured in a similar format and include: an overview of causes and mechanisms of injury; medical and surgical management; physiotherapy treatment aims; suggested treatment techniques; contraindications and precautions to physiotherapy interventions; outcome measures to use to assess the effectiveness of physiotherapy interventions and clinical case scenarios. Differences in management between adults and children involved in trauma are highlighted.

Towards the end of the book, quality of life of patients who survived trauma is discussed as well as the role of exercise therapy to aid such survivor’s recovery.

Launch and distribution

The textbook is being launched on 23 September 2015 at WITS. Further information is available at and the hardcopy of the book can be purchased through the local distributor, Juta. More information can be obtained from Janine Gentle (

Click here download more Information and the Order Form.

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