Exercise and Disease Management, Second Edition

253 Pages·2011·2.117 MB·English

by  Leutholtz, Brian C.

K11362 Cover 3/25/11 9:27 AM Page 1
C M Y CM MY CY CMY K
EXERCISE & NUTRITION Exercise and Disease Management is designed to help managed
SECOND
care physicians, their patients, other health care professionals, and
EDITION S E C O N D E D I T I O N
interested readers integrate current exercise guidelines into their
practices. This extraordinary book is accompanied by a series of 11
workbooks, each one for a chronic disease, designed specifically for
E EEXXEERRCCIISSEE
physicians to give to their patients. These workbooks make it
X
convenient for physicians to prescribe physical activity to their patients
in a ready-to-use format. Each book chapter and workbook contains E
a section on the background, medical management, and exercise
R aanndd
guidelines, accompanied by self-care instructions for patients,
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encouraging them to take a proactive role in their health and disease
management.
I DDIISSEEAASSEE
S
NEW AND UPDATED IN THE SECOND EDITION: E
• A ready-to-use “Exercise Prescription Page,” which follows each
a
chapter on a specific disease, enables health care professionals,
n MMAANNAAGGEEMMEENNTT
especially physicians in managed care, to prescribe exercise
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quickly to clients with specific medical conditions

D
• The “Rate Pressure Product” method for prescribing exercise helps
health care providers individualize exercise prescriptions for I
patients with heart disease by accounting for the amount of S
oxygen the heart uses E
A
• Individual companion workbooks provide patient health
maintenance information about diabetes, AIDS, obesity, golden S
years (age 65 and older), heart, kidney, peripheral arterial, and
E
lung disease. Workbooks for physical inactivity, osteoporosis,

arthritis, and high blood pressure also are included on the CD.
M
• Common question-and-answer sections help patients understand
A
the diseases from which they suffer and encourages them to take
responsibility for their health N
A
Exercise and Disease Management, Second Edition
G
consolidates the current knowledge base on exercise and chronic
disease, providing a ready-made format for health care providers E
to use when prescribing exercise programs for their clients. Using M
guidelines set forth by the American College of Sports Medicine and
the American Association of Cardiovascular and Pulmonary E
Rehabilitation, this book helps physicians, other health care providers, N
and health enthusiasts respond to the challenge to keep patients
T
healthier and active and reduce recurrent hospitalizations and health
care costs.
Leutholtz
Brian C. Leutholtz
K11362
Ripoll
ISBN: 978-1-4398-2759-8
Ignacio Ripoll
90000
6000 Broken Sound Parkway, NW
Suite 300, Boca Raton, FL 33487
711 Third Avenue 9 781439 827598
an informa business New York, NY 10017
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S E C O N D E D I T I O N
EXERCISE
and
DISEASE
MANAGEMENT

S E C O N D E D I T I O N
EXERCISE
and
DISEASE
MANAGEMENT
Brian C. Leutholtz
Ignacio Ripoll
Boca Raton London New York
CRC Press is an imprint of the
Taylor & Francis Group, an informa business
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2011 by Taylor and Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Printed in the United States of America on acid-free paper
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International Standard Book Number-13: 978-1-4398-2760-4 (Ebook-PDF)
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Contents
Preface......................................................................................................................xv
Acknowledgment ....................................................................................................xxi
The Authors .........................................................................................................xxiii
Section 1 “Postmodern” Medicine: teaching
Patients to Be Responsible
for their Health
Adherence to Exercise ..........................................................................2
The Exercise Prescription and Adherence ...........................................3
Reference ..............................................................................................4
Recommended Reading .......................................................................4
Section 2 curing, Healing, and Maintaining Health
Chapter 1 High Blood Pressure: The Silent Killer ...............................................9
Background ..........................................................................................9
Classification of Hypertension According to Cause ..........................10
Prevention of HTN ........................................................................11
Evaluation of Individuals with High Blood Pressure .........................11
Complications of Hypertension ..........................................................11
Hypertensive Cardiovascular Disease ...........................................12
Hypertensive Cerebrovascular Disease .........................................12
Hypertensive Renal Disease ..........................................................12
Peripheral Vascular Disease and Coronary Artery Disease .........12
Management .......................................................................................12
Pharmacological Therapy of Hypertension ...................................13
Target Blood Pressure ....................................................................16
Follow-Up of Persons with Hypertension ..........................................16
Nonpharmacological Treatment of Hypertension ..............................16
Exercise Issues ...................................................................................17
Exercise Prescription for Patients with High Blood Pressure ............18
Weight Training Guidelines for High Blood Pressure .......................19
Recommended Reading .....................................................................20
Exercise Prescription for High Blood Pressure ..................................21
Other Instructions ..........................................................................21
Common Questions on High Blood Pressure (a Patient’s
Perspective).........................................................................................22
v
© 2011 by Taylor & Francis Group, LLC
vi Contents
Chapter 2: Diabetes ...............................................................................................25
Background ........................................................................................25
Classification of Diabetes ...................................................................25
Insulin-Dependent Diabetes Mellitus or Type 1 Diabetes ............25
Non-Insulin-Dependent Diabetes Mellitus or Type 2 Diabetes ....26
Impaired Glucose Tolerance ..........................................................27
Gestational Diabetes Mellitus .......................................................27
Management .......................................................................................28
Symptoms of Diabetes ...................................................................28
Diagnosis .......................................................................................28
Complications of Diabetes.............................................................28
Diabetes and Heart Disease and Strokes ..................................28
Diabetes and Kidney Disease ...................................................28
Diabetes and the Eye ................................................................29
Diabetes and the Nerves ...........................................................29
Diabetes and the Mouth ............................................................30
Diabetes and the Feet ................................................................30
How to Prevent Complications ......................................................30
Goals and Recommendations for the Management of
Diabetes Mellitus ......................................................................30
Diet Therapy ..................................................................................31
Cholesterol ................................................................................32
Pharmacological Therapy ..............................................................32
A Brief History of Treatment Strategies for Patients with Type 2
Diabetes ..............................................................................................33
Initiation of Treatment ........................................................................36
Hypoglycemia ................................................................................39
Sites of Administration ..................................................................40
Exercise Issues ...................................................................................40
Issues Regarding Exercise Prescription in Patients with Diabetes .....41
Exercise and the Type 1 Diabetic .............................................42
Exercise and the Type 2 Diabetic .............................................42
Glucose Monitoring and Exercise ............................................42
Summary ............................................................................................43
Weight Training Guidelines for Diabetics..........................................44
Recommended Reading .....................................................................45
Exercise Prescription for Diabetes .....................................................46
Other Instructions ..........................................................................46
Common Questions on Diabetes (a Patient’s Perspective) .................47
Chapter 3: Kidney Disease ....................................................................................49
Background ........................................................................................49
Management .......................................................................................51
Exercise Issues ...................................................................................52
© 2011 by Taylor & Francis Group, LLC
Contents vii
Benefits of Exercise ............................................................................53
Weight Training Guidelines in Kidney Disease .................................53
Recommended Reading .....................................................................54
Exercise Prescription for Kidney Disease ..........................................55
Other Instructions ..........................................................................56
Common Questions on Kidney Disease (a Patient’s Perspective) ......56
Chapter 4: Heart Disease ......................................................................................59
Coronary Artery Disease: The Number One Killer ...........................59
Background ....................................................................................59
Management ..................................................................................59
Drug Therapy ............................................................................59
Exercise Issues ...............................................................................60
Weight Training Guidelines for Heart Disease ..................................62
Recommended Reading .....................................................................63
Exercise Prescription for Heart Disease.............................................63
Other Instructions ..........................................................................64
Common Questions on Heart Disease (a Patient’s Perspective) ........64
Congestive Heart Failure ....................................................................66
Background ....................................................................................66
Management ..................................................................................66
Therapy for Patients with Systolic Dysfunction .......................67
Therapy for Patients with Diastolic Dysfunction .....................68
Exercise Issues ...............................................................................68
Recommended Reading .....................................................................69
Exercise Prescription for Congestive Heart Failure ...........................70
Other Instructions ..........................................................................70
Valvular Disease ................................................................................70
Mitral Stenosis ...............................................................................70
Background ...............................................................................70
Management .............................................................................71
Mitral Regurgitation ......................................................................71
Background ...............................................................................71
Management .............................................................................72
Mitral Valve Prolapse ....................................................................72
Background ...............................................................................72
Management .............................................................................72
Aortic Stenosis ...............................................................................72
Background ...............................................................................72
Management .............................................................................73
Aortic Regurgitation ......................................................................73
Background ...............................................................................73
Management .............................................................................74
Multivalvular Disease ....................................................................74
Exercise Issues ...............................................................................74
© 2011 by Taylor & Francis Group, LLC
viii Contents
Recommended Reading .....................................................................75
Exercise Prescription for Valvular Disease ........................................76
Other Instructions ..........................................................................76
Hypertrophic Cardiomyopathy ...........................................................76
Background ....................................................................................76
Management ..................................................................................77
Exercise Issues ...............................................................................77
Recommended Reading .....................................................................78
Exercise Prescription for Hypertrophic Cardiomyopathy ..................78
Other Instructions ..........................................................................79
Cardiac Arrhythmias and Pacemakers ..............................................79
Background ....................................................................................79
Management ..................................................................................79
Exercise Issues ...............................................................................80
Patients with Cardiac Pacemakers ............................................81
Recommended Reading .....................................................................82
Exercise Prescription for Arrhythmias ..............................................82
Other Instructions ..........................................................................83
Exercise Prescription for Patients with Pacemakers ..........................83
Other Instructions ..........................................................................84
Chapter 5: Lung Disease .......................................................................................85
Chronic Lung Disease ........................................................................85
Background ....................................................................................85
Management ..................................................................................85
Restrictive Disease .............................................................................86
COPD .................................................................................................87
Cystic Fibrosis ....................................................................................89
Cor-Pulmonale ...................................................................................90
Exercise Issues ...............................................................................91
Asthma ...............................................................................................93
Background ....................................................................................93
Management ..................................................................................94
Exercise Issues ...............................................................................95
Weight Training Guidelines for Lung Disease ...................................96
Recommended Reading .....................................................................97
Exercise Prescription for Chronic Lung Disease and Asthma ...........98
Other Instructions ..........................................................................99
Common Questions on Lung Disease (a Patient’s Perspective) .........99
Chapter 6: Obesity ...............................................................................................103
Introduction ......................................................................................103
Defining the Metabolic Syndrome ...................................................105
Management ................................................................................108
Exercise Issues .............................................................................113
© 2011 by Taylor & Francis Group, LLC
Contents ix
Weight Training Guidelines for Obesity ..........................................114
Recommended Reading ...................................................................115
Exercise Prescription for Obesity .....................................................116
Other Instructions ........................................................................117
Common Questions on Obesity (a Patient’s Perspective) .................117
Chapter 7: Vascular Disease ...............................................................................119
Background ......................................................................................119
Pathogenesis .....................................................................................120
Pharmacological Treatment ..............................................................123
Diet and Exercise Management ........................................................127
Peripheral Vascular Disease .............................................................128
Exercise Issues .................................................................................128
Weight Training Guidelines for Peripheral Vascular Disease..........130
Recommended Reading ...................................................................131
Exercise Prescription for Peripheral Vascular Disease ....................132
Other Instructions ........................................................................133
Common Questions on Peripheral Vascular Disease (a Patient’s
Perspective).......................................................................................133
Chapter 8: Osteoporosis and Arthritis ..............................................................135
Osteoporosis .....................................................................................135
Background ..................................................................................135
Management ................................................................................135
Exercise Issues .............................................................................137
Arthritis ............................................................................................137
Weight Training Guidelines for Osteoporosis and Arthritis ............138
Recommended Reading ...................................................................139
Exercise Prescription for Osteoporosis and Arthritis ......................140
Other Instructions ........................................................................140
Common Questions on Osteoporosis (a Patient’s Perspective) ........140
Chapter 9: Cancer, the Immune System, and AIDS ........................................143
Cancer ..............................................................................................143
Background ..................................................................................143
AIDS ................................................................................................144
Background ..................................................................................144
Anxiety and Depression in Patients with Cancer and HIV
Infections ..........................................................................................145
Exercise and Cancer .........................................................................146
Colon Cancer ...............................................................................147
Breast Cancer ..............................................................................147
Endometrial Cancer .....................................................................147
© 2011 by Taylor & Francis Group, LLC