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ACSM's Guidelines for Exercise Testing and Prescription / Edition 6

ACSM's Guidelines for Exercise Testing and Prescription / Edition 6

by American College of Sports Medicine

See All Formats & Editions

ISBN-10: 0683303554

ISBN-13: 9780683303551

Pub. Date: 01/28/2000

Publisher: Lippincott Williams & Wilkins

ACSM's Guidelines for Exercise Testing and Prescription began as a concise summary of recommendations for exercise testing and prescription primarily for cardiac patients; it has now become one of the single most internationally read and referenced texts of its kind. This reference is a virtual pharmacopoeia of exercise guidelines in a broad spectrum of patients.


ACSM's Guidelines for Exercise Testing and Prescription began as a concise summary of recommendations for exercise testing and prescription primarily for cardiac patients; it has now become one of the single most internationally read and referenced texts of its kind. This reference is a virtual pharmacopoeia of exercise guidelines in a broad spectrum of patients. In this new edition there is heightened emphasis on preventing illness in apparently healthy persons and those "at risk", as well as treating patients with chronic disease. There are also two new chapters on methods for changing exercise behavior and legal issues.

Product Details

Lippincott Williams & Wilkins
Publication date:
American College of Sports Medicine
Edition description:
Sixth Edition
Product dimensions:
5.84(w) x 8.38(h) x 0.84(d)

Table of Contents

Note BeneX
Section I.Health Appraisal, Risk Assessment, and Safety of Exercise1
Chapter 1.Benefits and Risks Associated With Exercise3
Public Health Perspective3
Benefits of Regular Physical Activity and/or Exercise5
Risks Associated With Exercise Testing6
Risks Associated With Vigorous Exercise10
Incidence of Cardiovascular Complications12
Issues Regarding Preliminary Screening13
Recommendations to Reduce the Incidence and Severity of Complications During Exercise15
Chapter 2.Health Screening and Risk Stratification22
Preparticipation Health Screening22
ACSM Risk Stratification25
Risk Stratification for Cardiac Patients27
Modifying Coronary Risk Status29
Section II.Exercise Testing33
Chapter 3.Pretest Clinical Evaluation35
Medical History, Physical Examination, and Laboratory Tests35
Alternative Stress Tests37
Blood Pressure39
Cholesterol and Lipoproteins39
Blood Profile Analyses41
Pulmonary Function43
Contraindications to Exercise Testing50
Informed Consent51
Patient Instructions52
Chapter 4.Physical Fitness Testing and Interpretation57
Purposes of Fitness Testing57
Basic Principles and Guidelines58
Test Order59
Test Environment59
Body Composition59
Anthropometric Methods62
Other Techniques64
Cardiorespiratory Fitness68
The Concept of Maximal Oxygen Uptake68
Maximal versus Submaximal Exercise Testing69
Modes of Testing70
Cardiorespiratory Test Sequence and Measures77
Test Termination Criteria80
Muscular Fitness80
Chapter 5.Clinical Exercise Testing91
Indications and Applications91
Diagnostic Exercise Testing91
Exercise Testing for Disease Severity and Prognosis93
Exercise Testing After Myocardial Infarction93
Functional Exercise Testing93
Exercise Test Modalities95
Exercise Protocols97
Upper Body Exercise Testing98
Testing for Return to Work99
Weight Carrying Test100
Repetitive Lifting Test101
Heart Rate and Blood Pressure102
Expired Gases103
Electrocardiographic Monitoring105
Subjective Ratings105
Postexercise Period106
Indications for Exercise Test Termination106
Exercise Testing With Imaging Modalities107
Exercise Echocardiography107
Exercise Nuclear Imaging107
Pharmacologic Stress Testing108
Considerations for Pulmonary Patients109
Lung Function109
Exercise Testing of Pulmonary Patients110
Supervision of Exercise Stress Testing111
Considerations Regarding Medical Supervision111
Current Guidelines and Practices111
Competency Considerations112
Implications for Cost-Effectiveness113
Chapter 6.Interpretation of Clinical Test Data115
Exercise Testing as a Screening Tool for Coronary Artery Disease115
Interpretation of Responses to Graded Exercise Testing116
Maximal Oxygen Uptake117
Heart Rate Response117
Blood Pressure Response117
ECG Waveforms120
Diagnostic Value of Exercise Testing124
Predictive Value126
Comparison With Imaging Stress Tests127
Prognostic Applications of the Exercise Test129
Interpretation of Exercise Tests in Pulmonary Patients130
Specific Respiratory Diseases130
Section III.Exercise Prescription135
Chapter 7.General Principles of Exercise Prescription137
Principles of Training138
Overview of the Exercise Prescription139
The Art of Exercise Prescription139
Components of the Training Session140
Endurance Phase142
Recreational Activities142
Cardiorespiratory Fitness143
Mode of Exercise143
Exercise Intensity145
Exercise Duration150
Exercise Frequency151
Energy Expenditure Goals151
Rate of Progression154
Initial Conditioning Stage154
Improvement Stage155
Maintenance Stage155
Training Specificity156
Musculoskeletal Flexibility156
Muscular Fitness159
Maintenance of the Training Effect160
Program Supervision161
Chapter 8.Exercise Prescription for Cardiac Patients165
Inpatient Programs166
Outpatient Programs169
Outpatient Rate of Progression172
Types of Outpatient Programs174
Exercise Prescription Without a Preliminary Exercise Test175
Resistance Training176
Eligibility and Exclusion Criteria177
Time Course to Resistance Training178
Prescriptive Guidelines178
Arm Exercise Prescription181
Arm Exercise Training Heart Rate181
Work Rates for Arm Training181
Arm Exercise Equipment and Training Modalities182
Exercise Training for Return to Work182
Optimal Exercise Dosage? Pathophysiologic Considerations183
Special Patient Populations185
Angina or Silent Ischemia185
Congestive Heart Failure186
Pacemaker and Implantable Cardioverter Defibrillators189
Cardiac Transplant191
Exercise: An Integral Component of a Comprehensive Treatment Approach193
Chapter 9.Exercise Prescription for Pulmonary Patients200
Exercise Prescription200
Mode of Exercise200
Special Considerations202
Pursed-Lips Breathing202
Supplemental Oxygen202
Alternative Modes of Exercise Training202
Continuous Positive Airway Pressure203
Upper Body Resistance Training203
Ventilatory Muscle Training203
Program Design and Supervision204
Monitoring Exercise Training Intensity204
Chapter 10.Other Clinical Conditions Influencing Exercise Prescription206
Lower-Extremity Peripheral Vascular Disease208
Diabetes Mellitus212
Programs for Reducing Body Fatness214
Chapter 11.Exercise Testing and Prescription for Children, the Elderly, and Pregnant Women217
Fitness Testing217
Clinical Exercise Testing218
Exercise Prescription219
The Elderly223
Exercise Testing223
Exercise Prescription225
Pregnant Women230
Section IV.Special Considerations235
Chapter 12.Methods for Changing Exercising Behaviors237
Exercise Compliance237
Adult Learning239
Psychological Components of Successful Behavior Change241
Strategies to Improve Behavioral Change Outcomes242
Practical Recommendations to Enhance Exercise Adherence245
Population-Specific Barriers to Physical Activity249
Program Models: Group versus Home-Based Exercise Therapy249
Other Targets for Health Behavior Change251
Smoking Cessation252
Weight Management252
Dietary Modification253
Stress Management254
Chapter 13.Legal Issues258
Contracts, Informed Consent, and Torts259
Contract Law259
Informed Consent260
Negligence and/or Malpractice261
Defenses to Negligence and/or Malpractice Actions263
Liability Insurance264
Standards of Care264
Policies, Protocols, Forms, and Fulfillment266
Legal Concerns and the Roles of Licensed and Nonlicensed Exercise Professionals267
Section V.Appendices271
Appendix A.Common Medications273
Appendix B.Emergency Management283
Appendix C.Electrocardiogram (ECG) Interpretation293
Appendix D.Metabolic Calculations300
Appendix E.Environmental Considerations313
Appendix F.American College of Sports Medicine Certifications322

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