Acsm's Exercise Management for Persons with Chronic Diseases and Disabilities

418 Pages·2016·2.965 MB·English

by  American College of Sports Medicine

ACSM’s

Exercise Management for
Persons With Chronic
Diseases and Disabilities
FOURTH EDITION
Geoffrey E. Moore, MD, FACSM
Healthy Living and Exercise Medicine Associates
J. Larry Durstine, PhD, FACSM
University of South Carolina
Patricia L. Painter, PhD, FACSM
University of Utah
Human Kinetics
Library of Congress Cataloging-in-Publication Data
Names: Moore, Geoffrey E., 1957- , editor. | Durstine, J. Larry, editor. |
Painter, Patricia Lynn, editor. | American College of Sports Medicine.
Title: ACSM’s exercise management for persons with chronic diseases and
disabilities / Geoffrey E. Moore, J. Larry Durstine, Patricia L. Painter,
editors.
Other titles: Exercise management for persons with chronic diseases and
disabilities
Description: Fourth edition. | Champaign, IL : Human Kinetics, [2016] |
Includes bibliographical references and index.
Identifiers: LCCN 2015026995 | ISBN 9781450434140 (print)
Subjects: | MESH: Exercise Therapy--standards--Practice Guideline. | Chronic
Disease--rehabilitation--Practice Guideline. | Disabled
Persons--rehabilitation--Practice Guideline. | Exercise
Test--methods--Practice Guideline.
Classification: LCC RM725 | NLM WB 541 | DDC 615.8/2--dc23 LC record available at http://lccn.loc.
gov/2015026995
ISBN: 978-1-4504-3414-0 (print)
Copyright © 2016, 2009, 2003, 1997 by the American College of Sports Medicine
All rights reserved.Except for use in a review, the reproduction or utilization of this work in any form or

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Contents
Foreword xv
Preface xvii
Acknowledgments xxi
Notice and Disclaimer xxiii
Part I Foundations of Exercise
in Chronic Disease and Disability . . . . . . . . . . . . .1
Geoffrey E. Moore, J. Larry Durstine, and Patricia L. Painter
Chapter 1 Exercise Is Medicine in Chronic Care . . . . . . . . . . . . . . . . . 3
Robert Sallis and Geoffrey E. Moore
Exercise Is Medicine 3
Take-Home Message 12
Suggested Readings 12
Chapter 2 Basic Physical Activity and Exercise Recommendations
for Persons With Chronic Conditions . . . . . . . . . . . . . . . . 15
Benjamin T. Gordon, J. Larry Durstine, Patricia L. Painter, and Geoffrey E. Moore
Definitions Used in This Book 15
Basic CDD4 Recommendations for Physical Activity or Exercise
in Chronic Conditions 18
How to Prescribe Physical Activity or Exercise in Chronic Care 21
Graded Exercise Testing 25
Minimum Exercise Recommendations When an Exercise Test Is Not Available 27
Clinically Supervised Exercise Programming 28
ACSM’s Exercise Personnel Certifications 30
Suggested Readings 31
Chapter 3 Art of Clinical Exercise Programming . . . . . . . . . . . . . . . 33
Patricia L. Painter and Geoffrey E. Moore
Step 1: Assess Current Health Status 33
Step 2: Assess Current Level of Physical Activity 34
Step 3: Identify Exertional Symptoms That Limit Physical Activity 35
Step 4: Evaluate Physical Function and Performance 35
Step 5: Selecting Physical Performance Assessments 37
Activities of Daily Living and Instrumental Activities of Daily Living 37
Commonly Used Tests of Physical Functioning 37
iii
iv Contents
Step 6: Considerations for Formal Exercise Tolerance Testing 41
Step 7: Considerations for Program Referral 43
Step 8: Develop a Strategy for Monitoring Progress 43
Take-Home Message 45
Suggested Readings 46
Additional Resources 46
Chapter 4 Art of Exercise Medicine:
Counseling and Socioecological Factors . . . . . . . . . . . . . 47
Geoffrey E. Moore, Michael Costello, and Patricia L. Painter
Common Behavioral Techniques Used in Exercise Counseling 48
Other Aspects of Exercise Counseling 51
Socioecological Disparities and Exercise in Chronic Conditions 55
Integration Into a Medical Home Model 57
Suggested Readings 57
Additional Resource 59
Part II Common Chronic Conditions
and Comorbidities . . . . . . . . . . . . . . . . . . . . . . .61
Geoffrey E. Moore and J. Larry Durstine
Chapter 5 Approach to the Common Chronic Conditions . . . . . . . . 63
Geoffrey E. Moore, Patricia L. Painter, J. Larry Durstine, and Benjamin T. Gordon
Nature of Multiple Conditions and Related Comorbidities 63
General Recommendations for Exercise 63
Recommendations for Exercise Assessment 64
Recommendations for Exercise Programming 65
CDD4 Alternative Recommendation: The Functional Exercise Trial 65
General Solutions for Common Chronic Conditions 66
Integration Into a Medical Home Model 67
Suggested Readings 68
Chapter 6 Chronic Conditions Strongly Associated
With Physical Inactivity . . . . . . . . . . . . . . . . . . . . . . . . . . 71
J. Larry Durstine, Geoffrey E. Moore, Patricia L. Painter, Richard Macko,
Benjamin T. Gordon, and William E. Kraus
Hypertension and Dyslipidemia 71
Overweight, Obesity, Prediabetes, and Type 2 Diabetes Mellitus 80
Arthritis and Back Pain 85
Osteoporosis 88
Suggested Readings 91
Additional Resources 93
Web Resources 93
Contents v
Chapter 7 Chronic Conditions Very Strongly
Associated With Tobacco . . . . . . . . . . . . . . . . . . . . . . . . . 95
Christopher B. Cooper, Brett A. Dolezal, J. Larry Durstine, Benjamin T. Gordon,
Sherry O. Pinkstaff, Abraham S. Babu, and Shane A. Phillips
Chronic Obstructive Pulmonary Disease 95
Coronary Artery Disease and Atherosclerosis 100
Angina and Silent Ischemia 102
Peripheral Arterial Disease 106
Suggested Readings 110
Additional Resources 112
Chapter 8 Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Kathryn Schmitz
Basic Pathophysiology 115
Management and Medications 116
Effects on the Exercise Response 119
Effects of Exercise Training 119
Recommendations for Exercise Testing 120
Recommendations for Exercise Programming 121
Integration Into a Medical Home Model 122
Suggested Readings 123
Additional Resources 123
Chapter 9 Significant Sequelae Related to Common
Chronic Conditions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Jessica S. Oldham, Patricia L. Painter, Elizabeth J. Protas, Geoffrey E. Moore,
and Richard Macko
Depression as a Comorbidity 125
Lower-Limb Amputation 128
Frailty 130
Suggested Readings 132
Additional Resource 132
Part III Cardiovascular Diseases . . . . . . . . . . . . . . . . . .133
Jonathan N. Myers and Peter H. Brubaker
Chapter 10 Chronic Heart Failure . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Peter H. Brubaker and Jonathan N. Myers
Basic Pathophysiology 135
Management and Medications 136
Effects on the Exercise Response 137
Effects of Exercise Training 137
vi Contents
Recommendations for Exercise Testing 138
Recommendations for Exercise Programming 139
Integration Into a Medical Home Model 140
Take-Home Message 140
Suggested Readings 141
Additional Resources 142
Chapter 11 Atrial Fibrillation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Jonathan N. Myers and J. Edwin Atwood
Basic Pathophysiology 143
Management and Medications 143
Effects on the Exercise Response 144
Effects of Exercise Training 144
Recommendations for Exercise Testing 145
Recommendations for Exercise Programming 145
Integration Into a Medical Home Model 146
Take-Home Message 146
Suggested Readings 146
Additional Resources 147
Chapter 12 Pacemakers and Implantable
Cardioverter-Defibrillators . . . . . . . . . . . . . . . . . . . . . . 149
Clinton A. Brawner and Barry Lewis
Permanent Pacemakers 149
Implantable Cardioverter-Defibrillators 150
Combination Pacemaker–Defibrillator Devices 150
Management and Medications 150
Effects on the Exercise Response 151
Effects of Exercise Training 151
Recommendations for Exercise Testing 151
Recommendations for Exercise Programming 152
Integration Into a Medical Home Model 152
Suggested Readings 152
Additional Resources 153
Chapter 13 Valvular Heart Disease . . . . . . . . . . . . . . . . . . . . . . . . . 155
Matthew W. Parker
Basic Pathophysiology 155
Mitral Valve Disease 155
Aortic Valve Disease 156
Right-Sided Valvular Heart Disease 156
Management and Medications 156
Effects on the Exercise Response 157
Effects of Exercise Training 158
Recommendations for Exercise Testing 158
Contents vii
Recommendations for Exercise Programming 158
Integration Into a Medical Home Model 159
Take-Home Message 160
Suggested Readings 160
Additional Resources 160
Chapter 14 Heart Transplantation . . . . . . . . . . . . . . . . . . . . . . . . . 163
Audrey B. Silva and Gerson Cipriano Jr.
Effects on the Exercise Response 163
Effects of Exercise Training 163
Management and Medications 164
Recommendations for Exercise Testing 165
Recommendations for Exercise Training 165
Integration Into a Medical Home Model 166
Take-Home Message 166
Suggested Readings 166
Additional Resources 167
Chapter 15 Aneurysms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Holly Fonda and Jonathan N. Myers
Management and Medications 170
Effects on the Exercise Response 170
Effects of Exercise Training 171
Recommendations for Exercise Testing 171
Recommendations for Exercise Programming 172
Integration Into a Medical Home Model 172
Take-Home Message 173
Suggested Readings 173
Additional Resources 174
Part IV Pulmonary Diseases . . . . . . . . . . . . . . . . . . . . .175
Tony Babb
Chapter 16 Chronic Restrictive Pulmonary Disease . . . . . . . . . . . . . 177
Connie C. W. Hsia
Basic Pathophysiology 177
Management and Medications 178
Effects on the Exercise Response 179
Effects of Exercise Training 180
Recommendations for Exercise Testing 180
Recommendations for Exercise Programming 181
Integration Into a Medical Home Model 181
Take-Home Message 181
Suggested Readings 181
viii Contents
Chapter 17 Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Kenneth W. Rundell
Basic Pathophysiology 183
Management and Medications 184
Effects on the Exercise Response 185
Effects of Exercise Training 185
Recommendations for Exercise Testing 186
Recommendations for Exercise Programming 187
Integration Into a Medical Home Model 187
Take-Home Message 187
Suggested Readings 188
Additional Resources 188
Chapter 18 Cystic Fibrosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189
Erik Hulzebos, Maarten S. Werkman, Bart C. Bongers, and Tim Takken
Management and Medications 189
Effects on the Exercise Response 189
Effects of Exercise Training 191
Recommendations for Exercise Testing 191
Recommendations for Exercise Programming 191
Integration Into a Medical Home Model 192
Take-Home Message 193
Suggested Readings 193
Additional Resources 193
Chapter 19 Pulmonary Hypertension . . . . . . . . . . . . . . . . . . . . . . . 195
Kelly Chin
Management and Medications 195
Effects on the Exercise Response 195
Effects of Exercise Training 196
Recommendations for Exercise Testing 196
Recommendations for Exercise Programming 196
Integration Into a Medical Home Model 197
Take-Home Message 197
Suggested Readings 197
Additional Resource 198
Part V Immunological, Hematological,
and Organ Failure . . . . . . . . . . . . . . . . . . . . . .199
David C. Nieman
Chapter 20 Chronic Kidney and Liver Disease . . . . . . . . . . . . . . . . . 201
Patricia L. Painter
Renal Disease 201
Liver Disease 202
Management and Medications for Kidney Disease 202