Fitness Professional's Handbook-6th Edition

610 Pages·2012·31.15 MB·English

by  Edward Howley

Fitness Professional’s
Handbook
Sixth Edition
Edward T. Howley, PhD
Dixie L. Thompson, PhD
University of Tennessee at Knoxville
Human Kinetics
Library of Congress Cataloging-in-Publication Data
Howley, Edward T., 1943-
Fitness professional’s handbook / Edward T. Howley and Dixie L. Thompson. -- 6th ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4504-1117-2 (print) -- ISBN 1-4504-1117-7 (print)
I. Thompson, Dixie L., 1960- II. Title.
[DNLM: 1. Exercise--physiology. 2. Physical Fitness--physiology. 3. Health Behavior. 4. Nutritional Physiological
Phenomena. QT 255]

613.7--dc23
2011043137
ISBN-10: 1-4504-1117-7 (print)
ISBN-13: 978-1-4504-1117-2 (print)
Copyright © 2012 by Edward T. Howley and Dixie L. Thompson
Copyright © 2007, 2003, 1997, 1992, 1986 by Edward T. Howley and B. Don Franks
All rights reserved. Except for use in a review, the reproduction or utilization of this work in any form or by any electronic,
mechanical, or other means, now known or hereafter invented, including xerography, photocopying, and recording, and
in any information storage and retrieval system, is forbidden without the written permission of the publisher.
Notice: Permission to reproduce the following material is granted to instructors and agencies who have purchased Fitness
Professional’s Handbook, Sixth Edition: pp. 19-20, 22-23, 32, 99, 147, 160, 408, 410. The reproduction of other parts
of this book is expressly forbidden by the above copyright notice. Persons or agencies who have not purchased Fitness
Professional’s Handbook, Sixth Edition may not reproduce any material.
The web addresses cited in this text were current as of August 2011, unless otherwise noted.
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To Ann, for her love and support.
Ed Howley
To my parents, Jean and Felton Thompson. Thank you
for your unwavering love and support. To Penny. Thank
you for helping make the journey one full of adventure.
Dixie Thompson
ConTenTs
Preface  viii
Acknowledgment to Don Franks  xi
ParT I activity, Health, and Fitness
1 Health, Fitness, and Performance 3
Health and Avoidance of Disease 4 • Physical Activity and Health 7 • Physical Activity 
Guidelines 7 • Fitness 11 • Performance 12 • Pulling It All Together 13 • Study  
Questions 14 • Case Studies 15 • References 15
2 Health appraisal 17
Evaluating Health Status 18 • Preactivity Screening 18 • Fitness Program  
Decisions 30 • Study Questions 33 • Case Studies 34 • References 34
ParT II Scientific Foundations
3 Functional anatomy and Biomechanics 39
Skeletal Anatomy 40 • Planes and Axes of Movement 42 • Structure and Function of 
Joints 42 • Specific Joint Movements 43 • Skeletal Muscle 48 • Tips for Exercising 
Muscle Groups and Common Exercise Mistakes 52 • Basic Biomechanical Concepts for 
Human Movement 55 • Muscle-Group Involvement in Selected Activities 59 • Common 
Mechanical Errors in Walking and Running, Throwing, and Striking 63 • Study  
Questions 63 • Case Studies 64 • References 64
4 Exercise Physiology 65
Energy and Work 66 • Understanding Muscle Structure and Function 67 •  
Metabolic, Cardiovascular, and Respiratory Responses to Exercise 71 • Graded  
Exercise Test 75 • Cardiac Output 78 • Effects of Endurance Training and Detraining 
on Physiological Responses 81 • Cardiovascular Responses to Exercise for Females 
and Males 83 • Cardiovascular Responses to Isometric Exercise and Weightlifting 85 • 
Regulating Body Temperature 85 • Study Questions 87 • Case Studies 88 •  
References 88
5 Nutrition 91
Essential Nutrients 92 • Assessing Dietary Intake 98 • Recommendations for Dietary 
Intake 100 • Diet, Exercise, and the Blood Lipid Profile 101 • Nutrition for Physically 
Active People 104 • Study Questions 107 • Case Studies 107 • References 107
6 Energy Costs of Physical activity 109
Measuring Physical Activity 110 • Measuring Energy Expenditure 111 •  
Expressing Energy Expenditure 112 • Equations for Estimating the Energy Cost  
of Activities 114 • Energy Requirements of Walking, Running, Cycle Ergometry,  
and Stepping 115 • Energy Requirements of Other Activities 125 • Study
Questions 129 • Case Studies 129 • References 129
iv
Contents
ParT III Fitness assessment
7 assessment of Cardiorespiratory Fitness 133
Why Test Cardiorespiratory Fitness? 134 • Risks of Cardiorespiratory Fitness  
Testing 134 • Testing Sequence 134 • Field Tests 137 • Graded Exercise Tests 143 •  
Common Variables Measured During a Graded Exercise Test 145 • Procedures for 
Graded Exercise Tests 146 • When to Use Submaximal and Maximal Tests 147 • Study 
Questions 157 • Case Studies 157 • References 158 • Appendix 160
8 assessment of Body Composition 165
Health and Body Composition 166 • Methods for Assessing Body Composition 167 •  
Other Body Composition Techniques 175 • Calculating Target Body Weight 177 •  
Study Questions 178 • Case Studies 178 • References 179
9 assessment of Muscular Fitness 181
Preliminary Considerations 182 • Muscular Strength 183 • Muscular Endurance 185 •  
Testing Older Adults 190 • Testing Clients With Cardiovascular Disease 190 • Testing 
Children and Adolescents 193 • Study Questions 194 • Case Studies 194 •  
References 195
10 assessment of Flexibility and Low-Back Function 197
Factors Affecting Range of Motion 198 • Range of Motion and Low-Back  
Function 200 • Measuring Spinal and Hip Range of Motion 202 • Study  
Questions 212 • Case Studies 212 • References 212
ParT IV Exercise Prescription for Health and Fitness
11 Exercise Prescription for Cardiorespiratory Fitness 217
Prescribing Exercise 218 • Short- and Long-Term Responses to Exercise 220 • Public 
Health Recommendations for Physical Activity 220 • General Guidelines for 
Cardiorespiratory  Fitness Programs 222 • Formulating the Exercise Prescription 223 •  
Determining Intensity 226 • Exercise Recommendations for the Untested Masses 230 •  
Exercise Programming for the Fit Population 231 • Exercise Prescriptions Using  
Complete Graded Exercise Test Results 232 • Program Selection 232 • Exercise and 
Cold Exposure 237 • Effect of Air Pollution 239 • Effect of Altitude 240 • Study  
Questions 241 • Case Studies 241 • References 242
12 Exercise Prescription for Weight Management 245
Increasing Prevalence of Obesity in the United States 246 • Etiology of Obesity 246 •  
Maintaining a Healthy Weight 248 • Behavior Modification for Weight Loss and  
Maintenance 250 • Gimmicks and Gadgets for Weight Loss 253 • Disordered Eating  
Patterns 254 • Strategies for Gaining Weight 254 • Study Questions 256 • Case  
Studies 256 • References 256
13 Exercise Prescription for Muscular Fitness 259
Principles of Training 261 • Program Design Considerations 262 • Types of Resistance 
Training 262 • Modes of Resistance Training 265 • Safety Issues 269 • Resistance 
Training Guidelines 271 • Resistance Training Models for Healthy Adults 278 •  
Overreaching and Overtraining 278 • Resistance Training Systems 279 • Resistance  
Training for Special Populations 280 • Study Questions 285 • Case Studies 285 •  
References 285 • Appendix 289
v
Contents
14 Exercise Prescription for Flexibility and Low-Back Function 299
Anatomy of the Spine 300 • Spinal Movement 302 • Mechanics of the Spine  
and the Hip Joint 303 • Low-Back Pain: A Repetitive Motion Injury 304 • Exercise  
Considerations: Preventive and Therapeutic 305 • Exercises Involving Core  
Muscles 307 • Exercises Involving the Abdominal Wall 309 • Prophylactic Exercises  
for Enhancing Low-Back Function 310 • Study Questions 311 • Case Studies 311 •  
References 311 • Appendix 313
ParT V Special Considerations
15 Exercise and Children and Youth 331
Response to Exercise 332 • Special Considerations 333 • Testing 333 •  
Recommendations for Physical Activity 336 • Transition From Childhood to  
Adolescence 338 • Study Questions 339 • Case Studies 340 • References 340
16 Exercise and Older adults 343
Overview 344 • Effects of Aging on Fitness 345 • Special Considerations Regarding  
Exercise Testing 348 • Exercise Prescription 348 • Aerobic Activity for Health and  
Cardiorespiratory Fitness 349 • Psychological Health and Well-Being 351 • Study  
Questions 352 • Case Studies 352 • References 353
17 Exercise and Women’s Health 355
Pregnancy and Exercise 356 • Osteoporosis 358 • Exercise in Prevention  
and Treatment of Osteoporosis 359 • Female Athlete Triad 361 • Study  
Questions 362 • Case Studies 363 • References 363
18 Exercise and Heart Disease 365
Atherosclerosis 366 • Populations in Cardiac Rehabilitation Programs 367 • Evidence 
for Exercise Training 368 • Special Diagnostic Tests to Detect Coronary Heart  
Disease 369 • Typical Exercise Prescription 370 • Study Questions 372 • Case  
Studies 372 • References 373
19 Exercise and Obesity 375
Potential Causes 376 • Physical Activity in Prevention and Treatment of  
Obesity 377 • Special Medical Screening 378 • Exercise Prescription 379 •  
Study Questions 380 • Case Studies 380 • References 381
20 Exercise and Diabetes 383
Comparison of Type 1 and Type 2 Diabetes 384 • Exercise for Clients With  
Diabetes 386 • Screening and Testing Clients With Diabetes 386 • Exercise  
Prescription 387 • Study Questions 390 • Case Studies 390 • References 391
21 Exercise and Pulmonary Disease 393
Chronic Obstructive Pulmonary Diseases 394 • Restrictive Lung Diseases 395 •  
Evidence for Exercise 396 • Testing and Evaluation 396 • Typical Exercise  
Prescription 399 • Medications for Pulmonary Diseases 400 • Study Questions 401 •  
Case Studies 401 • References 401
vi
Contents
ParT VI Exercise Programming
22 Exercise Programming for Health and Fitness 405
Professional Competency and Exercise Programming 406 • Progression of  
Activities 407 • Walk, Jog, Run Programs 409 • Cycling 413 • Games 413 • Aquatic  
Activities 415 • Group Exercise Classes 417 • Exercise Equipment 418 • Circuit  
Training 419 • Study Questions 419 • Case Studies 420 • References 420
23 Behavior Change 421
Transtheoretical Model of Behavior Change 422 • Promoting Exercise: Targeting  
Participants in Early Stages of Change 424 • Enhancing Adherence: Methods of  
Behavior Change for Participants in the Action and Maintenance Stages 428 • 
Health and Fitness Counseling 434 • Study Questions 436 • Case Studies 437 •  
References 437
24 Mindful Exercise for Fitness Professionals 439
Origins 441 • Yoga 442 • Qigong Exercise and Tai Chi 450 • Modern Mindful  
Exercise Programs 452 • Mindful Exercise Outcomes 455 • Study Questions 457 •  
Case Studies 457 • References 458
25 Exercise related to ECG and Medications 459
Structure of the Heart 460 • Oxygen Use by the Heart 460 • Electrophysiology  
of the Heart 461 • Conduction System of the Heart 461 • Interpreting the 
ECG 462 • Cardiovascular  Medications 470 • Study Questions 474 • Case  
Studies 475 • References 476
26 Injury Prevention and Treatment 479
Preventing Injuries 480 • Injury Treatment 482 • Environmental Concerns 486 •  
Medical Concerns 490 • Common Orthopedic Problems 493 • Cardiopulmonary 
Resuscitation and Emergency Procedures 497 • Rescue Breathing, Cardiopulmonary  
Resuscitation, and Automated External Defibrillators 499 • Study Questions 500 •  
Case Studies 501 • References 501
27 Legal Considerations 503
Causes of Injuries and Negligence 504 • The Law and Legal System 505 •  
Federal Laws Applicable to the Fitness Profession 510 • Determining Duty in  
Negligence Cases 511 • Special Relationship: Person on Land and Landowner or  
Occupier 513 • Risk Management 514 • Conclusion 524 • Study Questions 529 •  
Case Studies 529 • References 530
Appendix A  Case Study Answers  533
Appendix B  Calculation of Oxygen Uptake and Carbon Dioxide Production  547
Appendix C  Compendium of Physical Activities  551
Appendix D  Common Medications  553
Appendix E  Fitness Assessment  563
Glossary  567
Index  580
About the Authors  593
About the Contributors  595
vii
PrefaCe
You are different from most people. In all likelihood injury prevention. As you
you are physically active, exercise each week, and are might expect, some chap-
concerned about your fitness. In contrast, more than 60% ters have required more
of American adults do not engage in the recommended updates than others. The
amounts of physical activity and are overweight. Further, chapters that received the
the epidemic of obesity reaches right into the elementary most significant updates
classroom. are the following:
Your timing is perfect if you are interested in helping
• Chapter 1, Health, Fitness, and Performance, links
children, adults, or older citizens become more active and
physical activity to health, fitness, and performance
improve fitness, health, and quality of life. Support is grow-
as a logical continuum of outcomes. It clarifies
ing in the government and private sector to do something
the distinction between moderate and vigorous
about the problems of inactivity and obesity, and success
physical activity in terms of health outcomes, and
stories already exist. This text will help you get on your
it deals with the importance of fitness versus fatness
way. You will learn how to screen participants for exercise
relative to health risk.
programs, evaluate the various fitness components, and
prescribe exercise to improve each fitness component. In • Chapter 2, Health Appraisal, adds a flow chart to
addition, you will learn how to help people with chronic assist with risk stratification and determination
disease (e.g., hypertension) or specific conditions (e.g., of the need for physician consent prior to fitness
pregnancy). Recent advances in how to approach these testing and beginning an exercise program. A table
issues demanded a revision of the text, and we hope you to assist in the identification of cardiovascular,
enjoy the result. metabolic, and pulmonary diseases is also included.
• Chapter 3, Functional Anatomy and Biomechanics,
has been extensively revised, with new figures, new
Updates to the Sixth Edition
concepts, and more focused objectives included.
In 2008, the U.S. government published its first ever Physi- • Chapter 5, Nutrition, has been updated based on the
cal Activity Guidelines for Americans. These guidelines latest Dietary Guidelines for Americans as well as
were the result of a systematic review of research published the current standards for nutritional intake, includ-
in the area of physical activity, fitness, and health, and they ing recommended diets (e.g., MyPlate, DASH diet).
provide physical activity recommendations for people of all A special section has been added to discuss scope
ages, those with chronic disease, those who are pregnant, of practice issues for fitness professionals.
and so on. We have used that document, as well as others • Chapter 6, Energy Costs of Physical Activity, has
published by major national organizations and societies, to a new section on measuring physical activity and
update the information in this edition of the text. shows how to calculate exercise volume in MET-
Given the aging of the population and the chronic dis- minutes.
eases that accompanies it, the development of the Exercise
• Chapter 8, Assessment of Body Composition, pro-
is Medicine program by the American College of Sports
vides a comparison of the various techniques for
Medicine (ACSM) will be of interest to many readers,
measuring body composition and adds new photos
be they interested in a career in fitness, allied health, or
of skinfold sites.
medicine. The career goals of our undergraduates at the
• Chapter 11, Exercise Prescription for Cardiorespi-
University of Tennessee reflect this diversity of interests,
ratory Fitness, provides details related to Exercise
with the majority choosing careers in physical therapy. The
is Medicine, and it emphasizes progression and
Exercise is Medicine program emphasizes the importance
the use of both moderate-intensity and vigorous-
of communication between professionals in medicine and
intensity physical activity to realize health and
allied health with those in the fitness arena (and vice versa)
fitness goals. The use of pedometers and exercise
when patients are discharged. This textbook will help that
diaries is addressed as a means to increase physi-
conversation along by giving you a sound foundation on
cal activity.
which to prescribe exercise and deliver physical activity
and fitness programs for various populations. • Chapter 13, Exercise Prescription for Muscular
In this edition of the text, every chapter has been updated Fitness, has been updated with special attention
based on the latest standards, guidelines, and research, be to the most recent and relevant position stands for
they related to special populations or low-back pain and children, seniors, and pregnant women.
viii