Clinical Exercise Physiology, 4th Edition PDF by Jonathan K. Ehrman, Paul M. Gordon, Paul S. Visich and Steven J. Keteyian

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Clinical Exercise Physiology, Fourth Edition

By Jonathan K. Ehrman, Paul M. Gordon, Paul S. Visich and Steven J. Keteyian

Clinical Exercise Physiology Fourth Edition

Contents:

Preface

Instructor Resources

Student Resources

Acknowledgments

Part I: Introduction to Clinical Exercise Physiology

Chapter 1: The Profession of Clinical Exercise Physiology

Jonathan K. Ehrman, PhD

Paul M. Gordon, PhD, MPH

Paul S. Visich, PhD, MPH

Steven J. Keteyian, PhD

The Past, Present, and Future of Clinical Exercise Physiology

Professional Organizations and Certifications Throughout the World

Professionalization of Clinical Exercise Physiology

Conclusion

Chapter 2: Promoting a Physically Active Lifestyle

Gregory W. Heath, DHSc, MPH

Josh M. Johann, MS

Benefits of Physical Activity

Participation in Regular Physical Activity

Conclusion

Chapter 3: General Principles of Pharmacology

Steven J. Keteyian, PhD

General Properties of Drugs

Routes of Administration

Phases of Drug Effect

Mechanism of Action

Pharmacotherapy

Conclusion

Chapter 4: General Interview and Examination Skills

Quinn R. Pack, MD, MSc, FACC

Hayden Riley, MS

General Interview

Physical Examination

Conclusion

Chapter 5: Graded Exercise Testing

Steven J. Keteyian, PhD

Micah Zuhl, PhD

Indications

Contraindications

Procedures for Preparing, Conducting, and Interpreting a Graded

Exercise Test

Graded Exercise Testing With Diagnostic Imaging

Conclusion

Chapter 6: Exercise Prescription

Steven J. Keteyian, PhD

Exercise Training Sequence

Goal Setting

Principles of Exercise Prescription

Cardiorespiratory Endurance

Skeletal Muscle Strength and Endurance

Flexibility Training

Conclusion

Part II: Endocrinology and Metabolic Disorders

Chapter 7: Diabetes

Sheri R. Colberg, PhD, FACSM

Mechanism of Action

Pharmacotherapy

Conclusion

Chapter 4: General Interview and Examination Skills

Quinn R. Pack, MD, MSc, FACC

Hayden Riley, MS

General Interview

Physical Examination

Conclusion

Chapter 5: Graded Exercise Testing

Steven J. Keteyian, PhD

Micah Zuhl, PhD

Indications

Contraindications

Procedures for Preparing, Conducting, and Interpreting a Graded

Exercise Test

Graded Exercise Testing With Diagnostic Imaging

Conclusion

Chapter 6: Exercise Prescription

Steven J. Keteyian, PhD

Exercise Training Sequence

Goal Setting

Principles of Exercise Prescription

Cardiorespiratory Endurance

Skeletal Muscle Strength and Endurance

Flexibility Training

Conclusion

Part II: Endocrinology and Metabolic Disorders

Chapter 7: Diabetes

Sheri R. Colberg, PhD, FACSM

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 8: Obesity

David C. Murdy, MD

Jonathan K. Ehrman, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 9: Hypertension

Amanda L. Zaleski, MS

Antonio B. Fernandez, MD

Beth A. Taylor, PhD

Linda S. Pescatello, PhD, FACSM, FAHA

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 10: Hyperlipidemia and Dyslipidemia

Peter W. Grandjean, PhD, FACSM, ACSM–CEP, EIM3

Stephen F. Crouse, PhD, FACSM

Larry Durstine, PhD, FACSM, FAACVPR

Paul G. Davis, PhD, FACSM, RCEP

Benjamin Gordon, PhD, RCEP

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 11: Metabolic Syndrome

Mark D. Peterson, PhD, MS

Paul M. Gordon, PhD, MPH

Flor Elisa Morales, MS

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 12: Chronic Kidney Disease

Samuel Headley, PhD

Sahil Bawa, MBBS

Michael Germain, MD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Part III: Cardiovascular Diseases

Chapter 13: Acute Coronary Syndromes: Unstable Angina Pectoris

and Acute Myocardial Infarction

Ray W. Squires, PhD, MAACVPR, FACSM, FAHA

Pathophysiology

Clinical Assessment

Exercise Training: Inpatient Cardiac Rehabilitation

Exercise Training: Early Outpatient Cardiac Rehabilitation

Exercise Prescription

Conclusion

Chapter 14: Revascularization of the Heart

Neil A. Smart, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription and Training

Conclusion

Chapter 15: Chronic Heart Failure

Steven J. Keteyian, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 16: Peripheral Artery Disease

Ryan J. Mays, PhD, MPH, MS

Ivan P. Casserly, MB, BCh

Judith G. Regensteiner, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 17: Cardiac Electrical Pathophysiology

Kerry J. Stewart, EdD

David D. Spragg, MD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription and Training

Conclusion

Part IV: Diseases of the Respiratory System

Chapter 18: Chronic Obstructive Pulmonary Disease

Satvir S. Dhillon, MSc

Dennis Jensen, PhD

Jordan A. Guenette, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 19: Asthma

Brian W. Carlin, MD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 20: Cystic Fibrosis

Michael J. Danduran, MS

Lauren Camarda, MD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Part V: The Immune System

Chapter 21: Cancer

Dennis J. Kerrigan, PhD

John R. Schairer, DO

Kerry S. Courneya, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 22: Human Immunodeficiency Virus

Mansueto Neto, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Part VI: Disorders of the Bones and Joints

Chapter 23: Arthritis

Andrew B. Lemmey, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 24: Osteoporosis

Lora M. Giangregorio, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 25: Nonspecific Low Back Pain

Jan Perkins, PT, PhD

Tim Zipple, PT, DSc

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription and Training

Conclusion

Part VII: Neuromuscular Disorders

Chapter 26: Spinal Cord Injury

Mary P. Galea, PhD

Eduardo Cofré Lizama, PhD

Andisheh Bastani, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 27: Multiple Sclerosis

Linda H. Chung, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 28: Cerebral Palsy

Désirée B. Maltais, PT, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 29: Stroke

Christopher J. Womack, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 30: Parkinson’s Disease

Angela L. Ridgel, PhD

Brandon S. Pollock, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Part VIII: Special Populations

Chapter 31: Children

Timothy J. Michael, PhD

William A. Saltarelli, PhD

Definition

Scope

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Chapter 32: Older Adults

Jerome L. Fleg, MD

Daniel E. Forman, MD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription and Training

Conclusion

Chapter 33: Depression

Benson M. Hoffman, PhD

Krista A. Barbour, PhD

James A. Blumenthal, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription and Training

Conclusion

Chapter 34: Intellectual Disability

Bo Fernhall, PhD

Tracy Baynard, PhD

Definition

Scope

Pathophysiology

Clinical Considerations

Exercise Prescription

Exercise Training

Conclusion

Glossary

References

About the Editors

Contributors

Preface:

The profession of clinical exercise physiology continues to evolve.

Likewise, the role of the clinical exercise physiologist in health care

continues to grow. Most cardiac rehabilitation programs employ at least

one clinical exercise physiologist, because it is recognized that they are

uniquely trained to appreciate normal and abnormal cardiorespiratory

responses to exercise as well as prescribe exercise in patients across a

variety of clinical conditions. And although it is still true that the day-today

duties of many clinical exercise physiologists primarily involve

patients with cardiovascular disease, clinical exercise physiologists

continue to expand their role, working with other patient populations,

including those with cancer, musculoskeletal disorders, and metabolic

diseases such as chronic kidney disease and diabetes. The clinical exercise

physiology profession includes an ever increasing amount of research—

and the incorporation of the results from such research into evidence-based

guidelines for the treatment of patients with a variety of diseases. Since the

third edition of this text, the number of PubMed-referenced articles that

include the key words “clinical exercise physiologist” has nearly doubled.

Another example of the development of the profession is the continued

growth of the Clinical Exercise Physiology Association (CEPA) in the

United States. The CEPA was established in 2008 to serve practitioners in

the field through advocacy and education. Importantly, the CEPA has

published its official journal, the Journal of Clinical Exercise Physiology

(JCEP), since 2012. And beginning in 2018, JCEP is also the official

journal of the Exercise and Sports Science Australia (ESSA), the leading

clinical exercise physiology association serving Australia and New

Zealand. This exemplifies the advancement of the clinical exercise

physiology profession around the world. Each of these professional

organizations offers continuing education and credits, which are vitally

important to maintaining clinical exercise physiology–related

certifications. Organizations such as ESSA, the American College of

Sports Medicine (ACSM), the American Council on Exercise (ACE), and

the Canadian Society for Exercise Physiology (CSEP) offer clinical

certifications that identify individuals as having the required knowledge as

defined by each organization. And the number of clinical exercise

physiology programs recognized by the Commission on Accreditation of

Allied Health Education Programs (CAAHEP) continues to grow.

The first edition of Clinical Exercise Physiology, published in 2003, has

developed into a cornerstone textbook for the field, quickly becoming a

primary textbook for both upper-level undergraduate students and graduate

students preparing to work as clinical exercise physiologists. The two

original purposes for developing this book remain today in the book’s

fourth edition: (1) to provide a contemporary review of a variety of chronic

diseases and conditions for the clinical exercise physiologist in training,

and (2) to provide a comprehensive resource for people working in the

field. Another use of this text is as a resource for those preparing for the

ACSM clinical examinations. At the time of publication the ACSM still

offers two clinical certifications: Registered Clinical Exercise Physiologist

(ACSM-RCEP) and Clinical Exercise Physiologist (ACSM-CEP; note that

this name changed from Clinical Exercise Specialist in 2015). The ACSM

plans to combine these certifications into a single clinical certification

(ACSM-CEP) in early 2019. This is seen as a natural part of the evolution

of clinical exercise physiology as a profession.

This fourth edition of Clinical Exercise Physiology is fully revised. The

initial section of the book presents six foundational chapters, including an

excellent review of the history of clinical exercise physiology, a

description of the essentials of the physical examination, and a review of

the general properties of drugs and pharmacotherapy. The remaining

chapters, the core of the book, are specific to particular conditions and

populations of patients. These chapters are organized into seven parts:

endocrinology, cardiovascular diseases, respiratory diseases, immunology,

orthopedic and musculoskeletal conditions, neuromuscular disorders, and

special populations.

As with the previous editions, a general format was used for each of the

chapters in parts II through VIII of this fourth edition of Clinical Exercise

Physiology. Each of the chapters in these sections begins with an

introduction to the specific disease that includes the definition and scope

of the condition and a discussion of the relevant pathophysiology. This is

followed by a look at the medical and clinical considerations, including

signs and symptoms, diagnosis, exercise testing, and evidence-based

treatment. Each chapter concludes with an overview of the exercise

prescription for the disorder being discussed, with special emphasis placed

on any disease-specific issues that might alter the exercise prescription.

Each chapter also contains several practical application boxes. In each of

the disease-specific chapters, two of these practical application boxes

focus on the exercise prescription and on information to consider when

interacting with the patient. A third practical application box reviews the

relevant literature and discusses the physiological adaptations to exercise

training, including the potential mechanisms by which exercise can

influence primary and secondary disease prevention.

Each clinical chapter (parts II thru VIII) also has a companion case study

that can be accessed via the web resource. Each of these cases focuses on

an actual patient, progressing from initial presentation and diagnosis to

therapy and exercise treatment. Each case study concludes with several

questions that can be used for facilitating group discussion in the

classroom or for the individual learner to consider when preparing for a

clinical exercise physiology certification examination.

To keep abreast of trends and new research in the field, the chapters on

metabolic syndrome, graded exercise testing, exercise prescription, chronic

kidney disease, and heart failure have undergone major revision.

Additionally, all of the remaining chapters have undergone a thorough

revision to ensure that the material is consistent with current science and

evidence-based practice guidelines. Finally, a new chapter has been added

to address Parkinson’s disease.

Few, if any, upper-level undergraduate courses or graduate-level clinical

exercise physiology programs currently provide students with the breadth

of information required to sit for the ACSM clinical examination. Those

who plan to study for this or any similar certification examination should

understand that no single text provides in-depth coverage of all the clinical

populations that benefit from physical activity and exercise. But this text

may be as close as one can come. In all, Clinical Exercise Physiology

addresses 28 different diseases and populations.

Besides serving as a textbook for students, Clinical Exercise Physiology is

an excellent resource guide for exercise professionals to have in their

office. Its consistent organization, case studies, discussion questions, upto-

date references, and feature boxes are designed to provide the

information required for effective study. In fact, the content was developed

based on the knowledge and skills assessed in the ACSM clinical exercise

physiologist examination (and the previous registered clinical exercise

physiologist examination).

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