ACSMs guidelines for exercise testing and prescription

The single most internationally read and referenced text in sports medicine, exercise science, and health and fitness, this manual succinctly summarizes recommended procedures for exercise testing and exercise prescription in healthy and diseased individuals. The Seventh Edition contains the most current public health and clinical information and state-of-the-art, research-based recommendations.

Coverage represents the fundamental knowledge, skills, and abilities (KSAs) that must be mastered by candidates for all ACSM certifications. Written by international experts in numerous fields, the Seventh Edition covers additional topics including arthritis, osteoporosis, dyslipidemia, immunology, and metabolic syndrome.

Preface	p. vii
Nota Bene	p. x
Contributors	p. xi
Abbreviations	p. xix
Section I Health Appraisal, Risk Assessment, and Safety of Exercise
1 Benefits and Risks Associated With Physical Activity	p. 3
Physical Activity and Fitness Terminology	p. 3
Public Health Perspective for Current Recommendations	p. 5
Divergent Physical Activity Recommendations	p. 6
Benefits of Regular Physical Activity and/or Exercise	p. 7
Dose-Response Relationship	p. 7
Risks Associated With Exercise	p. 10
Sudden Death Among Young Individuals	p. 11
Exercise Events in Those With Sickle Cell Trait	p. 12
Exercise-Related Cardiac Events in Adults	p. 12
Risks of Cardiac Events During Exercise Testing	p. 12
Risks of Cardiac Events During Cardiac Rehabilitation	p. 13
Prevention of Exercise-Related Cardiac Events	p. 13
2 Preparticipation Health Screening and Risk Stratification	p. 19
Preparticipation Screening Algorithm	p. 19
Risk Stratification and Medical Clearance	p. 21
Additional Preparticipation Assessments	p. 28
Exercise Testing and Testing Supervision Recommendations	p. 29
Risk Stratification for Cardiac Patients	p. 30
Section II Exercise Testing
3 Pre-Exercise Evaluations	p. 39
Medical History, Physical Examination, and Laboratory Tests	p. 39
Blood Pressure	p. 43
Lipids and Lipoproteins	p. 45
Blood Profile Analyses	p. 46
Pulmonary Function	p. 47
Contraindications to Exercise Testing	p. 49
Informed Consent	p. 49
Participant Instructions	p. 51
4 Health-Related Physical Fitness Testing and Interpretation	p. 55
Purposes of Health-Related Fitness Testing	p. 55
Basic Principles and Guidelines	p. 56
Pretest Instructions	p. 56
Test Order	p. 56
Test Environment	p. 56
Body Composition	p. 57
Anthropometric Methods	p. 57
Densitometry	p. 64
Other Techniques	p. 65
Body Composition Norms	p. 66
Cardiorespiratory Fitness	p. 66
The Concept of Maximal Oxygen Uptake	p. 66
Maximal versus Submaximal Exercise Testing	p. 67
Modes of Testing	p. 68
Cardiorespiratory Test Sequence and Measures	p. 76
Test Termination Criteria	p. 78
Interpretation of Results	p. 79
Muscular Strength and Muscular Endurance	p. 80
Muscular Strength	p. 81
Muscular Endurance	p. 83
Flexibility	p. 85
A Comprehensive Health Fitness Evaluation	p. 89
5 Clinical Exercise Testing	p. 93
Indications and Applications	p. 93
Diagnostic Exercise Testing	p. 93
Exercise Testing for Disease Severity and Prognosis	p. 94
Exercise Testing After Myocardial Infarction	p. 94
Functional Exercise Testing	p. 95
Exercise Test Modalities	p. 96
Exercise Protocols	p. 99
Upper Body Exercise Testing	p. 102
Testing for Return to Work	p. 102
Measurements During Exercise Testing	p. 103
Heart Rate and Blood Pressure	p. 103
Electrocardiographic Monitoring	p. 105
Subjective Ratings and Symptoms	p. 106
Gas Exchange and Ventilatory Responses	p. 107
Blood Gases	p. 108
Indications for Exercise Test Termination	p. 108
Postexercise Period	p. 108
Exercise Testing With Imaging Modalities	p. 110
Exercise Echocardiography	p. 110
Exercise Nuclear Imaging	p. 110
Pharmacologic Stress Testing	p. 111
Electron Beam Computed Tomography	p. 111
Supervision of Exercise Testing	p. 112
6 Interpretation of Clinical Exercise Test Data	p. 115
Exercise Testing As a Screening Tool for Coronary Artery Disease	p. 115
Interpretation of Responses to Graded Exercise Testing	p. 116
Heart Rate Response	p. 116
Blood Pressure Response	p. 119
Electrocardiographic Waveforms	p. 119
Limiting Signs and Symptoms	p. 123
Gas Exchange and Ventilatory Responses	p. 123
Diagnostic Value of Exercise Testing	p. 124
Sensitivity	p. 124
Specificity	p. 125
Predictive Value	p. 125
Comparison With Imaging Stress Tests	p. 126
Prognostic Applications of the Exercise Test	p. 126
Section III Exercise Prescription
7 General Principles of Exercise Prescription	p. 133
Principles of Training	p. 134
Overview of the Exercise Prescription	p. 135
The Art of Exercise Prescription	p. 136
Components of the Training Session	p. 136
Warm-up	p. 137
Stimulus or Conditioning Phase	p. 138
Recreational Activities	p. 138
Cool-Down	p. 138
Cardiorespiratory Exercise Prescription	p. 139
Mode of Exercise	p. 139
Exercise Intensity	p. 141
Exercise Duration	p. 146
Energy Expenditure Goals	p. 148
Rate of Progression	p. 149
Initial Conditioning Stage	p. 150
Improvement Stage	p. 150
Maintenance Stage	p. 151
Training Specificity	p. 151
Summary of Guidelines for Cardiovascular Stimulus Phase	p. 153
Resistance Exercise Prescription	p. 154
Flexibility Exercise Prescription	p. 158
Maintenance of the Training Effect	p. 160
Program Supervision	p. 161
Methods for Changing Exercise Behaviors	p. 163
Strategies for Increasing Exercise Adherence	p. 165
Encourage Lifestyle Physical Activity	p. 165
8 Exercise Prescription Modifications for Cardiac Patients	p. 174
Inpatient Rehabilitation Programs	p. 174
Outpatient Exercise Programs	p. 177
Exercise Intensity for the Cardiac Patient	p. 178
Modes of Exercise for Cardiac Patients	p. 181
Progression of Exercise for the Cardiac Patient	p. 182
Recommended Total Dose or Volume of Exercise for Cardiac Patients	p. 183
Exercise Prescription Without a Preliminary Exercise Test	p. 184
Types of Outpatient Programs	p. 186
Benefits of Endurance Training in Cardiac Patients	p. 188
Resistance Training for Cardiac Patients	p. 189
Eligibility and Exclusion Criteria for Resistance Training	p. 189
Time Course for Resistance Training	p. 190
Resistance Training Prescription for Cardiac Patients	p. 190
Exercise Training for Return to Work	p. 191
Special Cardiac Patient Populations	p. 191
Myocardial Ischemia	p. 191
Congestive Heart Failure	p. 193
Pacemakers and Implantable Cardioverter Defibrillators	p. 194
Cardiac Transplant Recipient	p. 197
Cardiac Surgery and Percutaneous Transluminal Coronary Intervention	p. 199
9 Other Clinical Conditions Influencing Exercise Prescription	p. 205
Arthritis	p. 205
Exercise Testing	p. 206
Exercise Prescription	p. 206
Special Considerations	p. 207
Diabetes Mellitus	p. 207
Exercise Testing	p. 208
Exercise Prescription	p. 208
Special Considerations	p. 210
Dyslipidemia	p. 211
Exercise Testing	p. 212
Exercise Prescription	p. 212
Special Considerations	p. 212
Hypertension	p. 213
Exercise Testing	p. 214
Exercise Prescription	p. 215
Special Considerations	p. 215
Obesity	p. 216
Exercise Testing	p. 217
Exercise Prescription	p. 217
Special Considerations	p. 218
Recommended Weight Loss Programs	p. 218
Metabolic Syndrome	p. 219
Exercise Testing and Prescription	p. 220
Immunology	p. 221
Exercise and Upper Respiratory Tract Infections	p. 221
Immune Responses to Exercise	p. 222
Exercise Testing	p. 222
Exercise Prescription	p. 223
Special Considerations	p. 223
Osteoporosis	p. 223
Exercise Testing	p. 224
Exercise Prescription	p. 224
Special Considerations	p. 225
Peripheral Arterial Disease	p. 225
Exercise Testing	p. 226
Exercise Prescription	p. 226
Special Considerations	p. 226
Pulmonary Diseases	p. 227
Exercise Testing	p. 227
Exercise Prescription	p. 228
Special Considerations	p. 229
Pregnancy	p. 229
Exercise Testing	p. 231
Exercise Prescription	p. 231
Special Considerations	p. 231
10 Exercise Testing and Prescription for Children and Elderly People	p. 237
Children	p. 237
Clinical Laboratory Testing	p. 237
Fitness Testing	p. 240
Exercise Prescription	p. 241
Elderly People	p. 246
Exercise Testing	p. 246
Exercise Prescription	p. 247
Section IV Appendices
A Common Medications	p. 255
B Emergency Management	p. 267
C Electrocardiogram (ECG) Interpretation	p. 279
D Metabolic Calculations	p. 286
E Environmental Considerations	p. 300
F American College of Sports Medicine Certifications	p. 309
Index	p. 351

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