1 Benefits and Risks Associated With Physical Activity

Introduction
Physical Activity and Fitness Terminology
Public Health Perspective for Current Recommendations
Sedentary Behavior and Health
Health Benefits of Regular Physical Activity and Exercise
Health Benefits of Improving Muscular Fitness
Risks Associated With Physical Activity and Exercise

Exercise-Related Musculoskeletal Injury
Sudden Cardiac Death Among Young Individuals
Exercise-Related Cardiac Events in Adults
Exercise Testing and the Risk of Cardiac Events
Risks of Cardiac Events During Cardiac Rehabilitation
Prevention of Exercise-Related Cardiac Events
Online Resources

References
2 Preparticipation Evaluation
Introduction
Informed Consent
Exercise Preparticipation Health Screening
American College of Sports Medicine Preparticipation
Screening Process
American College of Sports Medicine Preparticipation
Screening Algorithm

Algorithm Components
Using the Algorithm
Alternative Self-Guided Method
Exercise Testing
Risk Stratification for Individuals With Clinical Conditions
and Medical Fitness Facilities
Medical History and Cardiovascular Disease Risk Factor
Assessment

Additional Recommendations
Online Resources
References

3 Health-Related Physical Fitness Testing and Interpretation

Introduction
Purposes of Health-Related Physical Fitness Testing
Basic Principles and Guidelines
Pretest Instructions for Fitness Testing
Organizing the Fitness Test
Test Environment
A Comprehensive Health Fitness Evaluation
Measurement of Resting Heart Rate and Blood Pressure
Body Composition
Anthropometric Methods
Densitometry
Other Techniques
Body Composition Norms
Cardiorespiratory Fitness
The Concept of Maximal Oxygen Uptake
Maximal Versus Submaximal Exercise Testing
Cardiorespiratory Fitness Test Sequence and Measures
Test Termination Criteria
Modes of Testing
81
Submaximal Exercise Tests
Interpretation of Results


Muscular Fitness
Rationale
Principles
Muscular Strength
Muscular Endurance
Muscular Power
Flexibility

Balance
Online Resources
References
110
4 Clinical Exercise Testing and Interpretation

Introduction
Indications for a Clinical Exercise Test
Conducting the Clinical Exercise Test
Testing Staff
Testing Mode and Protocol
Monitoring and Test Termination
Postexercise
Safety
Interpreting the Clinical Exercise Test
Heart Rate Response
Blood Pressure Response
Rate-Pressure Product
Electrocardiogram
Dysrhythmias

Symptoms

Exercise Capacity
Cardiopulmonary Exercise Testing
Gas Exchange Data Sampling
Maximal Versus Peak Cardiorespiratory Stress
Diagnostic Value of Exercise Testing for the Detection
of Ischemic Heart Disease

Sensitivity, Specificity, and Predictive Value
Clinical Exercise Test Data and Prognosis

Clinical Exercise Tests With Imaging
Field Walking Tests
Online Resources
References
5 General Principles of Exercise Prescription
An Introduction to the Principles of Exercise
Prescription
General Considerations for Exercise Prescription
Components of the Exercise Training Session
Sex Difference Considerations for Exercise Prescription
and Training
Sex Differences in Exercise Performance
Sex Differences in Response to Exercise Training
Resistance Strength Training and High-Intensity Interval
Training
Cardiovascular and Aerobic Endurance Training
Sex Differences in Body Weight Responses to Aerobic
Exercise Training

Other Sex-Based Special Considerations
Cardiorespiratory Fitness
Frequency of Aerobic Exercise
Intensity of Aerobic Exercise
Time (Duration) of Aerobic Exercise
Type (Mode)
Volume (Quantity) of Aerobic Exercise
Progression of Aerobic Exercise
Resistance Training
Frequency of Resistance Training Exercise
Intensity of Resistance Training Exercise
Time (Rest Periods of Resistance Training Exercises)
Types of Resistance Training Exercises
Volume of Resistance Training Exercise
Progression of Resistance Training Exercise
Flexibility
Types of Flexibility Exercises
Volume of Flexibility Exercise (Time, Repetitions,
and Frequency)
Alternatives to Stretching to Increase ROM
 

Future Directions

References
6 Exercise Prescription for Healthy Populations With Special
Considerations
Children and Adolescents
Exercise Testing
Exercise Prescription
Special Considerations
Online Resources
Pregnancy
Health Screening
Exercise Testing
Exercise Prescription
Special Considerations
Online Resources
Low Back Pain
Exercise Testing
Exercise Prescription
Special Considerations
Online Resources
Older Adults
Exercise Testing
Exercise Prescription
Special Considerations for Exercise Programming
Online Resources
Transgender and Gender Diverse Individuals
Medical Interventions
Exercise Testing
Exercise Prescription
Special Considerations
Online Resources
References
7 Environmental Considerations for Exercise Prescription
Introduction
Exercise in High-Altitude Environments
Altitude Acclimatization
Rapid Ascent
Assessing Individual Altitude Acclimatization Status
Medical Considerations: Altitude Illnesses and Preexisting
Conditions
Prevention and Treatment of Altitude Sickness
Exercise Prescription
Special Considerations
Organizational Planning
Exercise in Cold Environments
Medical Considerations: Cold Injuries
Cardiac and Respiratory Considerations

Clothing Considerations
Exercise Prescription
Exercise in Hot Environments
Mitigating Risk
Medical Considerations: Exertional Heat Illnesses
Exercise Prescription
Special Considerations
References
8 Exercise Prescription for Individuals With Cardiovascular
and Pulmonary Diseases
Introduction
Coronary Heart Disease
Exercise Testing
Exercise Prescription
Special Considerations
Cardiac Rehabilitation
Inpatient Cardiac Rehabilitation
Outpatient Cardiac Rehabilitation
Continuous Electrocardiographic Monitoring
Individuals With History of Spontaneous Coronary
Artery Dissection
Exercise Testing
Exercise Prescription
Special Considerations
Chronic Heart Failure
Exercise Testing
Exercise Prescription
Special Considerations
Left Ventricular Assist Device
Heart Transplantation
Exercise Testing
Special Considerations
Exercise Prescription
Sternotomy
Special Considerations
Pacemaker and Implantable Cardioverter
Defibrillator
Special Considerations
Peripheral Arterial Disease
Exercise Testing
Exercise Prescription
Special Considerations
Postural Orthostatic Tachycardia Syndrome
Preexercise Assessment
Exercise Prescription
Special Considerations
Pediatric Cardiac Rehabilitation

Individuals With a Cerebrovascular Accident (Stroke)
Exercise Testing
Exercise Prescription
Exercise Training Considerations
Other Considerations
Exercise Training for Return to Work
Pulmonary Diseases
Asthma
Chronic Obstructive Pulmonary Disease
Exercise Training for Pulmonary Diseases Other Than
Chronic Obstructive Pulmonary Disease
Respiratory Muscle Testing and Training
Online Resources
References
9 Exercise Prescription for Individuals With Metabolic
Disease and Cardiovascular Disease Risk Factors
Introduction
Diabetes Mellitus
Benefits of Regular Physical Activity for Diabetes
Exercise Testing
Exercise Prescription
Special Considerations
Online Resources
Dyslipidemia
Exercise Testing
Exercise Prescription
Special Consideration
Online Resources
Hypertension
Exercise Testing
Exercise Prescription
Special Considerations
Online Resources
Overweight and Obesity
Exercise Testing
Exercise Prescription
Special Considerations
Bariatric Surgery
Online Resources
Metabolic Syndrome
Exercise Testing
Exercise Prescription/Special Considerations
Online Resources
Metabolic Dysfunction–Associated Steatotic Liver Disease
Exercise Testing
Exercise Prescription
Special Considerations
References

 Exercise Testing and Prescription for Populations With Other
Chronic Diseases and Health Conditions

Introduction
Arthritis
Exercise Testing
Exercise Prescription
Special Considerations
Online Resources
Cancer 395
Overview of Importance of Physical Activity in Cancer Survivors 395
Preparticipation Evaluation 397
Exercise Prescription 398
Summary 406
Online Resources 406
Fibromyalgia 407
Pharmacological Treatment Options 410
Exercise Testing 410
Exercise Prescription 413
Special Considerations 416
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome 417
Background 417
Diagnosis and Comorbidities 418
Exercise Testing 420
Pacing 421
Exercise Prescription 421
Special Considerations 422
Summary 425
Online Resources 425
Human Immunodeficiency Virus 425
Exercise Testing 426
Exercise Prescription 427
Special Considerations 429
Online Resources 429
Kidney Disease 429
Exercise Testing 431
Exercise Prescription 432
Special Considerations 434
Online Resources 436
Multiple Sclerosis 436
Exercise Testing 439
Exercise Testing Considerations 440
Exercise Prescription 440
Special Considerations 442
Online Resources 443
Osteoporosis 443
Exercise Testing 444
Exercise Prescription 444
Special Considerations 444

Online Resources
Spinal Cord Injury
Exercise Testing
Exercise Prescription
Special Considerations
Online Resources
Multiple Chronic Diseases and Health Conditions
Exercise Testing
Exercise Prescription
Special Considerations
References
11 Neurologic Diseases, Conditions, and Disorders
Introduction
Anxiety and Depression
Exercise Testing
Exercise Prescription
Exercise Considerations
Special Considerations
Future Directions
Online Resources
Anxiety
Depression
Attention-Deficit/Hyperactivity Disorder
Exercise Testing
Exercise Prescription
Future Directions
Online Resources
Autism Spectrum Disorder
Exercise Testing
Exercise Prescription
Exercise Training Considerations
Future Directions
Online Resources
Intellectual Disability and Down Syndrome
Exercise Testing
Exercise Prescription
Special Considerations for Individuals With Intellectual
Disability
Special Considerations for Individuals With Down
Syndrome
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507
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509
512
514
514
Future Directions
Online Resources
Cerebral Palsy
Exercise Testing
Exercise Prescription
Future Directions
Online Resources

Alzheimer’s Disease
Exercise Testing
Exercise Prescription
Future Directions
Online Resources
Parkinson’s Disease
Exercise Testing
Exercise Programming
Special Considerations
Future Directions
Online Resources
References
12 Behavior-Based Strategy to Promote Physical Activity
and Exercise
Introduction
Theoretical Foundations for Understanding Exercise
Behavior
Social Cognitive Theory
Transtheoretical Model
Health Belief Model
Social Ecological Models
Self-Determination Theory
Theory of Planned Behavior
Dual-Processing Theories
Relevant Targets to Promote Physical Activity Behavior
Change
Self-Efficacy
Outcome Expectations and Expectancies
Self-Regulation
Autonomy
Goal Setting
Intention
Barriers and Problem Solving
Social Support
Affect
Motivation and Reinforcement
Relapse Prevention
Population Considerations
Age and Lifespan
Medical Status and Health Conditions
Cultural Diversity
Group Exercise Behavioral Dynamics
Client-Centered Conversations and Motivational Interviewing
The Role of Client-Centered Counseling
Motivational Interviewing
Online Resources
References

APPENDICES
Appendix A Common Medications
Appendix B Electrocardiogram Interpretation
Appendix C Metabolic Calculations and Methods for Prescribing
Aerobic Exercise Intensity
Appendix D Reference List of Commonly Used Equations
Appendix E Editors and Contributing Authors to the Previous
Two Editions

Index