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

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Overview

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.

The book contains predominantly black-and-white illustrations, with some two-color illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: Daniel P. Heil, PhD (Montana State University)
Description: This text is a much needed revision of the 5th edition that was published in 1995. Expansion of topics covered in the fifth edition, an update of terminology and testing guidelines, as well as a vast improvement in content organization and presentation all make this a valuable revision.
Purpose: The purpose is to provide exercise and health practitioners with a single, concise source of information pertaining to health screening, exercise testing, and prescription in a variety of populations. Such a text is absolutely critical to creating uniformity in exercise testing and prescription practices among a diverse group of health professionals, as well as serving to legitimize our presence to those in the medical community.
Audience: The text is intended to serve the needs of an incredibly diverse group of professionals that include health/fitness and clinical exercise professionals, medical physicians, PAs, OTs, PTs, RDs, and even healthcare administrators. I feel that the text is most appropriate for health/fitness and clinical exercise professionals who find themselves within health/fitness centers, corporate fitness environments, and clinical or cardiac rehabilitation centers.
Features: The reader will find this a single source of information with regard to health screening procedures, exercise testing guidelines, and exercise prescription guidelines for professionals working with both "low risk" and "high risk" patient populations (formerly known as "apparently healthy" and "known disease"). Chapter 4 (Physical Fitness Testing and Interpretation) in particular has been vastly improved with more complete descriptions of the background and rationale for common tests, detailed descriptions of tests not discussed in the fifth edition, and the addition of percentile tables following each test description. Other notable changes include the addition of a spiral binding and improved explanations for a diverse readership about metabolic calculations and environmental physiology.
Assessment: Due to enhanced organization and user-friendliness, I feel that this text could easily serve as a sole-source textbook for a university course on exercise testing and prescription guidelines.
Daniel P. Heil
This text is a much needed revision of the 5th edition that was published in 1995. Expansion of topics covered in the fifth edition, an update of terminology and testing guidelines, as well as a vast improvement in content organization and presentation all make this a valuable revision. The purpose is to provide exercise and health practitioners with a single, concise source of information pertaining to health screening, exercise testing, and prescription in a variety of populations. Such a text is absolutely critical to creating uniformity in exercise testing and prescription practices among a diverse group of health professionals, as well as serving to legitimize our presence to those in the medical community. The text is intended to serve the needs of an incredibly diverse group of professionals that include health/fitness and clinical exercise professionals, medical physicians, PAs, OTs, PTs, RDs, and even healthcare administrators. I feel that the text is most appropriate for health/fitness and clinical exercise professionals who find themselves within health/fitness centers, corporate fitness environments, and clinical or cardiac rehabilitation centers. The reader will find this a single source of information with regard to health screening procedures, exercise testing guidelines, and exercise prescription guidelines for professionals working with both ""low risk"" and ""high risk"" patient populations (formerly known as ""apparently healthy"" and ""known disease""). Chapter 4 (Physical Fitness Testing and Interpretation) in particular has been vastly improved with more complete descriptions of the background and rationale for common tests, detailed descriptions of testsnot discussed in the fifth edition, and the addition of percentile tables following each test description. Other notable changes include the addition of a spiral binding and improved explanations for a diverse readership about metabolic calculations and environmental physiology. Due to enhanced organization and user-friendliness, I feel that this text could easily serve as a sole-source textbook for a university course on exercise testing and prescription guidelines.
Booknews
New edition of a one-stop resource for the knowledge, skills, and abilities needed for ACSM certifications and current clinical practices in sports medicine. It emphasizes the value and application of exercise testing and prescription in persons with and without chronic disease. Expert insights cover a broad range of specialties including physiology, fitness, cardiology, pulmonary medicine, epidemiology, law, nursing, physician assisting, and physical therapy. Wire spiral binding. Annotation c. Book News, Inc., Portland, OR (booknews.com)

4 Stars! from Doody
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Product Details

  • ISBN-13: 9780683303551
  • Publisher: Lippincott Williams & Wilkins
  • Publication date: 1/28/2000
  • Series: American College of Sports Medicine
  • Format: Spiral Bound
  • Edition description: Sixth Edition
  • Edition number: 6
  • Pages: 368
  • Product dimensions: 5.84 (w) x 8.38 (h) x 0.84 (d)

Table of Contents

Preface VII
Note Bene X
Contributors XI
Abbreviations XVIII
Section I. Health Appraisal, Risk Assessment, and Safety of Exercise 1
Chapter 1. Benefits and Risks Associated With Exercise 3
Public Health Perspective 3
Benefits of Regular Physical Activity and/or Exercise 5
Risks Associated With Exercise Testing 6
Risks Associated With Vigorous Exercise 10
Incidence of Cardiovascular Complications 12
Issues Regarding Preliminary Screening 13
Recommendations to Reduce the Incidence and Severity of Complications During Exercise 15
Chapter 2. Health Screening and Risk Stratification 22
Preparticipation Health Screening 22
ACSM Risk Stratification 25
Risk Stratification for Cardiac Patients 27
Modifying Coronary Risk Status 29
Section II. Exercise Testing 33
Chapter 3. Pretest Clinical Evaluation 35
Medical History, Physical Examination, and Laboratory Tests 35
Alternative Stress Tests 37
Blood Pressure 39
Cholesterol and Lipoproteins 39
Blood Profile Analyses 41
Pulmonary Function 43
Contraindications to Exercise Testing 50
Informed Consent 51
Patient Instructions 52
Chapter 4. Physical Fitness Testing and Interpretation 57
Purposes of Fitness Testing 57
Basic Principles and Guidelines 58
Test Order 59
Test Environment 59
Body Composition 59
Densitometry 60
Anthropometric Methods 62
Other Techniques 64
Cardiorespiratory Fitness 68
The Concept of Maximal Oxygen Uptake 68
Maximal versus Submaximal Exercise Testing 69
Modes of Testing 70
Cardiorespiratory Test Sequence and Measures 77
Test Termination Criteria 80
Muscular Fitness 80
Flexibility 85
Chapter 5. Clinical Exercise Testing 91
Indications and Applications 91
Diagnostic Exercise Testing 91
Exercise Testing for Disease Severity and Prognosis 93
Exercise Testing After Myocardial Infarction 93
Functional Exercise Testing 93
Exercise Test Modalities 95
Exercise Protocols 97
Upper Body Exercise Testing 98
Testing for Return to Work 99
Weight Carrying Test 100
Repetitive Lifting Test 101
Measurements 101
Heart Rate and Blood Pressure 102
Expired Gases 103
Electrocardiographic Monitoring 105
Subjective Ratings 105
Postexercise Period 106
Indications for Exercise Test Termination 106
Exercise Testing With Imaging Modalities 107
Exercise Echocardiography 107
Exercise Nuclear Imaging 107
Pharmacologic Stress Testing 108
Considerations for Pulmonary Patients 109
Lung Function 109
Exercise Testing of Pulmonary Patients 110
Supervision of Exercise Stress Testing 111
Considerations Regarding Medical Supervision 111
Current Guidelines and Practices 111
Competency Considerations 112
Implications for Cost-Effectiveness 113
Chapter 6. Interpretation of Clinical Test Data 115
Exercise Testing as a Screening Tool for Coronary Artery Disease 115
Interpretation of Responses to Graded Exercise Testing 116
Maximal Oxygen Uptake 117
Heart Rate Response 117
Blood Pressure Response 117
ECG Waveforms 120
Symptoms 124
Diagnostic Value of Exercise Testing 124
Sensitivity 125
Specificity 126
Predictive Value 126
Comparison With Imaging Stress Tests 127
Prognostic Applications of the Exercise Test 129
Interpretation of Exercise Tests in Pulmonary Patients 130
Specific Respiratory Diseases 130
Section III. Exercise Prescription 135
Chapter 7. General Principles of Exercise Prescription 137
Principles of Training 138
Overview of the Exercise Prescription 139
The Art of Exercise Prescription 139
Components of the Training Session 140
Warm-up 141
Endurance Phase 142
Recreational Activities 142
Cool-down 143
Cardiorespiratory Fitness 143
Mode of Exercise 143
Exercise Intensity 145
Exercise Duration 150
Exercise Frequency 151
Energy Expenditure Goals 151
Rate of Progression 154
Initial Conditioning Stage 154
Improvement Stage 155
Maintenance Stage 155
Training Specificity 156
Musculoskeletal Flexibility 156
Muscular Fitness 159
Maintenance of the Training Effect 160
Program Supervision 161
Chapter 8. Exercise Prescription for Cardiac Patients 165
Inpatient Programs 166
Outpatient Programs 169
Intensity 170
Frequency 171
Duration 172
Outpatient Rate of Progression 172
Types of Outpatient Programs 174
Exercise Prescription Without a Preliminary Exercise Test 175
Resistance Training 176
Eligibility and Exclusion Criteria 177
Time Course to Resistance Training 178
Prescriptive Guidelines 178
Arm Exercise Prescription 181
Arm Exercise Training Heart Rate 181
Work Rates for Arm Training 181
Arm Exercise Equipment and Training Modalities 182
Exercise Training for Return to Work 182
Optimal Exercise Dosage? Pathophysiologic Considerations 183
Special Patient Populations 185
Angina or Silent Ischemia 185
Congestive Heart Failure 186
Pacemaker and Implantable Cardioverter Defibrillators 189
Cardiac Transplant 191
Exercise: An Integral Component of a Comprehensive Treatment Approach 193
Chapter 9. Exercise Prescription for Pulmonary Patients 200
Exercise Prescription 200
Mode of Exercise 200
Frequency 200
Intensity 201
Duration 201
Special Considerations 202
Pursed-Lips Breathing 202
Supplemental Oxygen 202
Alternative Modes of Exercise Training 202
Continuous Positive Airway Pressure 203
Upper Body Resistance Training 203
Ventilatory Muscle Training 203
Program Design and Supervision 204
Monitoring Exercise Training Intensity 204
Chapter 10. Other Clinical Conditions Influencing Exercise Prescription 206
Hypertension 206
Lower-Extremity Peripheral Vascular Disease 208
Diabetes Mellitus 212
Obesity 214
Programs for Reducing Body Fatness 214
Chapter 11. Exercise Testing and Prescription for Children, the Elderly, and Pregnant Women 217
Children 217
Fitness Testing 217
Clinical Exercise Testing 218
Exercise Prescription 219
The Elderly 223
Exercise Testing 223
Exercise Prescription 225
Pregnant Women 230
Section IV. Special Considerations 235
Chapter 12. Methods for Changing Exercising Behaviors 237
Exercise Compliance 237
Adult Learning 239
Psychological Components of Successful Behavior Change 241
Strategies to Improve Behavioral Change Outcomes 242
Practical Recommendations to Enhance Exercise Adherence 245
Population-Specific Barriers to Physical Activity 249
Program Models: Group versus Home-Based Exercise Therapy 249
Other Targets for Health Behavior Change 251
Smoking Cessation 252
Weight Management 252
Dietary Modification 253
Stress Management 254
Chapter 13. Legal Issues 258
Contracts, Informed Consent, and Torts 259
Contract Law 259
Informed Consent 260
Torts 261
Negligence and/or Malpractice 261
Defenses to Negligence and/or Malpractice Actions 263
Liability Insurance 264
Standards of Care 264
Policies, Protocols, Forms, and Fulfillment 266
Legal Concerns and the Roles of Licensed and Nonlicensed Exercise Professionals 267
Summary 269
Section V. Appendices 271
Appendix A. Common Medications 273
Appendix B. Emergency Management 283
Appendix C. Electrocardiogram ECG Interpretation 293
Appendix D. Metabolic Calculations 300
Appendix E. Environmental Considerations 313
Appendix F. American College of Sports Medicine Certifications 322
Index 353
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