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Índice
1 Benefits and Risks Associated with Physical Activity, p. 1

Introduction, p. 1
Physical Activity and Fitness Terminology, p. 1
Public Health Perspective for Current Recommendations, p. 4
Sedentary Behavior and Health, p. 6
Health Benefits of Regular Physical Activity and Exercise, p. 7
Health Benefits of Improving Muscular Fitness, p. 8
Risks Associated with Physical Activity and Exercise, p. 10
Exercise-Related Musculoskeletal Injury, p. 10
Sudden Cardiac Death Among Young Individuals, p. 11
Exercise-Related Cardiac Events in Adults, p. 12
Exercise Testing and the Risk of Cardiac Events, p. 14
Risks of Cardiac Events during Cardiac Rehabilitation, p. 15
Prevention of Exercise-Related Cardiac Events, p. 15
Online Resources, p. 16
References, p. 17

2 Exercise Preparticipation Health Screening, p. 22
Introduction, p. 22
Preparticipation Health Screening, p. 25
Self-Guided Methods, p. 28 .
American College of Sports Medicine Preparticipation Screening Algorithm, p. 28
Algorithm Components, p. 28
Using the Algorithm, p. 35
Risk Stratification for Patients in Cardiac Rehabilitation and Medical Fitness Facilities, p. 39
Summary, p. 39
Online Resources, p. 41
References, p. 42

3 Preexercise Evaluations, p. 44
Introduction, p. 44
Informed Consent, p. 44
Medical History and Cardiovascular Disease Risk Factor Assessment, p. 45
Physical Examination and Laboratory Tests, p. 50
Blood Pressure, p. 53
Lipids and Lipoproteins, p. 56
Blood Profile Analyses, p. 58
Pulmonary Function, p. 58

Participant Instructions, p. 61
Online Resources, p. 62
References, p. 62

4 Health-Related Physical Fitness Testing and Interpretation, p. 66
Introduction, p. 66
Purposes of Health-Related Physical Fitness Testing, p. 66
Basic Principles and Guidelines, p. 67
Pretest Instructions, p. 67
Test Organization, p. 67
Test Environment, p. 68
A Comprehensive Health Fitness Evaluation, p. 68
Measurement of Resting Heart Rate and Blood Pressure, p. 69
Body Composition, p. 69
Anthropometric Methods, p. 70
Densitometry, p. 74
Other Techniques, p. 77
Body Composition Norms, p. 77
Cardiorespiratory Fitness, p. 79
The Concept of Maximal Oxygen Uptake, p. 81
Maximal versus Submaximal Exercise Testing, p. 82
Cardiorespiratory Test Sequence and Measures, p. 82
Test Termination Criteria, p. 84
Modes of Testing, p. 84
Interpretation of Results, p. 92
Muscular Fitness, p. 94
Rationale, p. 95
Principles, p. 95
Muscular Strength, p. 96
Muscular Endurance, p. 101
Flexibility, p. 102
Online Resources, p. 105
References, p. 105

5 Clinical Exercise Testing and Interpretation, p. 111
Introduction, p. 111
Indications for a Clinical Exercise Test, p. 111
Conducting the Clinical Exercise Test, p. 117
Testing Staff, p. 117
Testing Mode and Protocol, p. 119
Monitoring and Test Termination, p. 120
Postexercise, p. 126
Safety, p. 126
Interpreting the Clinical Exercise Test, p. 126
Heart Rate Response, p. 127
Blood Pressure Response, p. 127
Rate-Pressure Product, p. 128

Electrocardiogram, p. 128
Symptoms, p. 130
Exercise Capacity, p. 130
Cardiopulmonary Exercise Testing, p. 131
Maximal versus Peak Cardiorespiratory Stress, p. 131
Diagnostic Value of Exercise Testing for the Detection of Ischemic Heart Disease, p. 135
Sensitivity, Specificity, and Predictive Value, p. 135
Clinical Exercise Test Data and Prognosis, p. 137
Clinical Exercise Tests with Imaging, p. 138
Field Walking Tests, p. 139
Online Resources, p. 139
References, p. 140

6 General Principles of Exercise Prescription, p. 143
An Introduction to the Principles of Exercise Prescription, p. 143
General Considerations for Exercise Prescription, p. 144
Components of the Exercise Training Session, p. 145
Aerobic (Cardiorespiratory Endurance) Exercise, p. 147
Frequency of Exercise, p. 147
Intensity of Exercise, p. 148
Exercise Time (Duration), p. 151
Type (Mode), p. 157
Exercise Volume (Quantity), p. 158
Rate of Progression, p. 160
Muscular Fitness, p. 161
Frequency of Resistance Exercise, p. 163
Types of Resistance Exercises, p. 163
Volume of Resistance Exercise (Sets and Repetitions), p. 164
Resistance Exercise Technique, p. 166
Progression/Maintenance, p. 166
Flexibility Exercise (Stretching), p. 167
Types of Flexibility Exercises, p. 169
Volume of Flexibility Exercise (Time, Repetitions, and Frequency), p. 170
Neuromotor Exercise, p. 171
Sedentary Behavior and Brief Activity Breaks, p. 172
Exercise Program Supervision, p. 173
Online Resources, p. 173
References, p. 174

7 Exercise Prescription for Healthy Populations with Special Considerations, p. 180
Children and Adolescents, p. 180
Exercise Testing, p. 181
Exercise Prescription, p. 182
Special Considerations, p. 183


Low Back Pain, p. 184
Exercise Testing, p. 185
Exercise Prescription, p. 186
Special Considerations, p. 187
Older Adults, p. 188
Exercise Testing, p. 189
Exercise Prescription, p. 192
Special Considerations for Exercise Programming, p. 194
Online Resources, p. 195
Pregnancy, p. 195
Exercise Testing, p. 196
Exercise Prescription, p. 197
Special Considerations, p. 199
Online Resources, p. 202
References, p. 202

8 Environmental Considerations for Exercise Prescription, p. 209
Exercise in High-Altitude Environments, p. 209
Medical Considerations: Altitude Illnesses, p. 209
Prevention and Treatment of Altitude Sickness, p. 210
Rapid Ascent, p. 211
Altitude Acclimatization, p. 211
Assessing Individual Altitude Acclimatization Status, p. 212
Exercise Prescription, p. 213
Special Considerations, p. 213
Organizational Planning, p. 213
Exercise in Cold Environments, p. 214
Medical Considerations: Cold Injuries , p. 214
Clothing Considerations, p. 216
Exercise Prescription, p. 216
Exercise in Hoc Environments, p. 217
Counteracting Dehydration, p. 217
Medical Considerations: Exertional Heat Illnesses, p. 219
Exercise Prescription, p. 221
Special Considerations, p. 222
Online Resources, p. 223
References , p. 24

9 Exercise Prescription for Patients with Cardiac,
Peripheral, Cerebrovascular, and Pulmonary Disease, p. 226
Introduction, p. 226
Cardiac Diseases, p. 226
Inpatient Cardiac Rehabilitation Programs, p. 227
Outpatient Cardiac Rehabilitation, p. 231
Patients with Heart Failure, p. 237
Patients with a Sternotomy, p. 240
Pacemakpr and Implantable Cardioverterdefibrillator, p. 241
Patients after Cardiac Transplantation, p. 243
Patients with Peripheral Artery Disease, p. 245
Exercise Prescription for Patients with a
Cerebrovascular Accident (Stroke), p. 248
Exercise Testing, p. 248
Exercise Prescription, p. 249
Exercise Training Considerations, p. 249
Other Considerations, p. 249
Exercise TYaining for Return to Work, p. 250
Pulmonary Diseases, p. 251
Asthma, p. 251
Chronic Obstructive Pulmonary Disease, p. 255
Exercise Training for Pulmonary Diseases Other than Chronic Obstructive Pulmonary Disease, p. 260
Online Resources, p. 261
References, p. 261


10 Exercise Prescription for Individuals with Metabolic
Disease and Cardiovascular Disease Risk Factors, p. 268
Introduction, p. 268
Diabetes Mellitus, p. 268
Benefits of Regular Physical Activity for Diabetes, p. 270
Exercise Testing, p. 270
Exercise Prescription, p. 270
Special Considerations, p. 273
Online Resources, p. 276
Dyslipidemia, p. 276
Exercise Testing, p. 277
Exercise Prescription, p. 2 77
Special Consideration, p. 279
Online Resources, p. 279
Hypertension, p. 279
Exercise Testing, p. 280
Exercise Prescription, p. 281
Special Considerations, p. 282
Online Resources, p. 283
Metabolic Syndrome, p. 283
Exercise Testing, p. 284
Exercise Prescription/Special Considerations, p. 284
Online Resources, p. 286
Overweight and Obesity, p. 287
Exercise Testing, p. 288
Exercise Prescription, p. 288
Special Considerations, p. 290
Bariatric Surgery, p. 290
Online Resources, p. 291
References, p. 291


11 Exercise Testing and Prescription for Populations
with Other Chronic Diseases and Health Conditions, p. 297
Introduction, p. 297
Arthritis, p. 297
Exercise Testing, p. 298
Exercise Prescription, p. 299
Special Considerations, p. 301
Online Resources, p. 301
Cancer, p. 302
Exercise Testing, p. 302
Exercise Prescription, p. 304
Special Considerations, p. 310
Online Resources, p. 311
Cerebral Palsy, p. 311
Exercise Testing, p. 315
Exercise Prescription, p. 317
Special Considerations, p. 317
Online Resources, p. 319
Fibromyalgia, p. 320
Exercise Testing, p. 321
Exercise Prescription, p. 322
Special Considerations, p. 324
Online Resources, p. 324
Human Immunodeficiency Virus, p. 325
Exercise Testing, p. 326
Exercise Prescription, p. 326
Special Considerations, p. 328
Online Resources, p. 328
Intellectual Disability and Down Syndrome, p. 328
Exercise Testing, p. 329
Exercise Prescription, p. 331
Special Considerations, p. 333
Special Considerations for Individuals with Down Syndrome, p. 333
Online Resources, p. 334
Kidney Disease, p. 334
Exercise Testing, p. 335

Exercise Prescription, p. 336
Special Considerations, p. 338
Online Resources, p. 338
Multiple Sclerosis, p. 339
Exercise Testing, p. 341
Exercise Prescription, p. 342
Special Considerations, p. 344
Online Resources, p. 344

Osteoporosis, p. 345
Exercise Testing, p. 345
Exercise Prescription, p. 346
Special Considerations, p. 347
Online Resources, p. 347
Parkinson Disease, p. 348
Exercise Testing, p. 350
Exercise Prescription, p. 352
Special Considerations, p. 354
Online Resources, p. 355
Spinal Cord Injury, p. 355
Exercise Testing, p. 355
Exercise Prescription, p. 357
Special Considerations, p. 359
Online Resources, p. 361
Multiple Chronic Diseases and Health Conditions, p. 361
Exercise Testing, p. 362
Exercise Prescription, p. 362
Special Considerations, p. 362
References, p. 363

12 Behavioral Theories and Strategies for Promoting Exercise, p. 377
Introduction, p. 377
Exercise Prescription, p. 377
Frequency/Time, p. 378
Intensity, p. 378
Type, p. 378
Theoretical Foundations for Understanding Exercise Behavior, p. 379
Social Cognitive Theory, p. 379
Transtheoretical Model, p. 380
Health Belief Model, p. 382
Self-Determination Theory, p. 382
Theory of Planned Behavior, p. 384
Social Ecological Models, p. 385
Decreasing Barriers to Physical Activity, p. 385
Cognitive and Behavioral Strategies for Increasing Physical Activity Behavior, p. 388
Enhancing Self-Efficacy, p. 388
Goal Setting, p. 389
Reinforcement, p. 390
Social Support, p. 391
Self-Monitoring, p. 392
Problem Solving, p. 392
Relapse Prevention, p. 392

Theoretical Strategies and Approaches to Increase
Exercise Adoption and Adherence, p. 392
Brief Counseling and Motivational Interviewing, p. 392
Stage of Change Tailored Counseling, p. 394
Group Leader Interactions, p. 394
Special Populations, p. 397
Cultural Diversity, p. 397
Older Adults, p. 398
Youth, p. 398
Individuals with Obesity, p. 399
Individuals with Chronic Diseases and Health Conditions, p. 399
Online Resources, p. 400
References, p. 400


Appendix A Common Medications, p. 405

Appendix B Emergency Risk Management, p. 434

Appendix C Electrocardiogram Interpretation, p. 441

Appendix D American College of Sports Medicine Certifications, p. 449

Appendix E Accreditation of Exercise Science Programs, p. 456

Appendix F Contributing Authors to the Previous Two Editions, p. 458

Index, p. 463