ACSM's Resources for Clinical Exercise Physiology: Musculoskeletal, Neuromuscular, Neoplastic, Immunologic and Hematologic Conditions

337 Pages·2009·2.22 MB·English

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ACSM’s
Resources for
Clinical Exercise Physiology
Musculoskeletal, Neuromuscular, Neoplastic,
Immunologic, and Hematologic Conditions
SECOND EDITION
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SENIOREDITORS SECTION EDITORS
Jonathan Myers, PhD, FACSM Georgia Frey, PhD, FACSM
Clinical Professor Associate Professor
Cardiology Division Department of Kinesiology
Veterans Administration Palo Alto Health Care System Indiana University
Stanford University Bloomington, Indiana
Palo Alto, California
Kenneth Pitetti, PhD, FACSM
David Nieman, PhD, FACSM Professor
Professor College of Health Professions
Department of Health, Leisure, and Exercise Science Wichita State University
Appalachian State University Wichita, Kansas
Boone, North Carolina
David Nieman, PhD, FACSM
Professor
Department of Health, Leisure, and Exercise Science
Appalachian State University
Boone, North Carolina
William Herbert, PhD, FACSM
Professor
Department of Human Nutrition, Foods, and Exercise
Virginia Tech
Blacksburg, Virginia
Anthony S. Kaleth, PhD
Associate Professor
Department of Physical Education
Indiana University—Purdue University Indianapolis
Indianapolis, Indiana
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ACSM’
S
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Resources for
Clinical Exercise Physiology
Musculoskeletal, Neuromuscular, Neoplastic,
Immunologic, and Hematologic Conditions
SECOND EDITION
AMERICAN COLLEGE
OF SPORTS MEDICINE
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Copyright © 2010 and 2002 American College of Sports Medicine
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Library of Congress Cataloging-in-Publication Data
ACSM's resources for clinical exercise physiology : musculoskeletal,
neuromuscular, neoplastic, immunologic, and hematologic conditions /
American College of Sports Medicine. – 2nd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-7817-6870-2 (alk. paper)
1. Exercise therapy. I. American College of Sports Medicine. II.
Title: Resources for clinical exercise physiology.
[DNLM: 1. Exercise Therapy–Practice Guideline. 2.
Exercise–physiology–Practice Guideline. WB 541 A1875 2010]
RM725.A34 2010
615.8'2--dc22
2008047172
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Preface
The application of exercise as a preventive and therapeutic role of exercise in managing individuals with a particular
medium was once largely limited to patients with pul- condition.
monary or cardiovascular disease, mainly those who had Although this text is intended to be a resource for in-
recently sustained a myocardial infarction. Over the last dividuals preparing for the RCEP examination, it is also
three decades, many resources and guidelines have been an appropriate resource for any individual trained in the
published that have been directed toward the application exercise sciences working in the clinical setting among
of exercise evaluation and therapy in cardiovascular and persons with chronic conditions and disabilities beyond
pulmonary disease. The range of individuals for whom ap- cardiovascular and pulmonary disease. It should serve as
propriately prescribed exercise has documented benefits a reference for physical therapists, nurses, physicians,
has broadened considerably in recent years. This text was and other rehabilitation specialists who deal with the
written in response to the need for guidance among exer- conditions addressed in these chapters. These resources
cise clinicians working with patients with a broad range of generally apply to patients with chronic disease who, in
chronic diseases and disabilities beyond cardiovascular the opinion of their physician provider, are clinically sta-
and pulmonary disease, including orthopedic, neurologic, ble and have sufficient functional capabilities to partici-
metabolic, musculoskeletal, neoplastic, and immunodefi- pate in individually prescribed exercise that is aimed at
ciency conditions—populations that have been largely un- improving fitness, function, physical work potential, and
derserved. It is intended to complement and extend exist- quality of life, and which reduces exercise-related risk
ing ACSM publications, including ACSM’s Guidelines for factors that have an impact on progression of their dis-
Exercise Testing and Prescription and ACSM’s Resource ease. Much recent research has been performed related to
Manual for Exercise Testing and Prescription. the benefits of exercise for patients with the wide variety
The ACSM Registered Clinical Exercise Physiologist of conditions described in this text. Many physicians and
(RCEP) pilot examination, initiated in 1999, was de- other health professionals have embraced the use of exer-
signed to establish the existence of appropriate knowl- cise in the diagnosis, prevention, and treatment of vari-
edge, skills, and abilities for healthcare professionals ous chronic health problems. However, similar to cardio-
working with individuals with a broad range of chronic vascular disease, exercise as an intervention is greatly
diseases and disabilities. Ten years later, the RCEP has be- underutilized for most of these conditions. The multi-
come established as a standard certification for individu- tude of disorders associated with a sedentary lifestyle ap-
als working in clinical settings among patients with plies to individuals with chronic disabilities just as it ap-
chronic diseases and disabilities. The ACSM has defined plies to those without such disabilities. An important
the RCEP as a “healthcare professional who works in the goal must be to better convey the value of appropriately
application of exercise and physical activity for those clini- applied exercise therapy for these patients so that it is an
cal and pathological situations where it has been shown to integrated part of the healthcare paradigm. This text rep-
provide therapeutic or functional benefit. Patients for whom resents another step, however small, in bringing this re-
services are appropriate may include, but are not limited to, search to the public and the medical community to foster
those with cardiovascular, pulmonary, metabolic, muscu- a greater appreciation of the value of the therapeutic ben-
loskeletal, neuromuscular, neoplastic, immunologic, and efits of exercise across a broad spectrum of patients.
hematologic diseases and conditions. The RCEP applies ex- In this new edition of the RCEP resources, chapters
ercise principles to groups such as geriatric, pediatric, or ob- from the first edition have been updated and a section has
stetric populations, and to society as a whole in preventive been added on Clinical Practice Issues for the RCEP. The
activities. The RCEP performs exercise evaluation, exercise Clinical Practice Issues section includes chapters on the
prescription, exercise supervision, exercise education, and evolution of the clinical exercise physiologist, demon-
exercise outcome evaluation.” For each of the conditions strating functional outcomes for health and fitness, legal
covered in this text, the chapters are therefore organized and ethical considerations, and client referral and con-
by epidemiology, pathophysiology, diagnosis, medical sulting relations with allied professions. The latter sec-
and surgical treatments, exercise/fitness/functional test- tion was included to help provide the RCEP and other
ing, and exercise prescription and programming. Where healthcare professionals with a better the understanding
appropriate, case studies are included to underscore the of their role and how they can have an important and
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vi PREFACE
integral place in today’s healthcare environment. In- important role of the exercise physiologist in the clinical
cluded in the Appendix are the updated knowledge, setting, as well as to extend the principles and recom-
skills, and abilities that have been developed to address mendations of exercise programming to a broader spec-
the role of the clinical exercise physiologist in the exercise trum of the population.
management of patients with chronic diseases and disabil-
ities. We hope that this text serves not only as resource for Jonathan Myers, PhD
credentialing by ACSM, but also to help further define the David Nieman, PhD
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Contributors
Mark A. Anderson, PT, PhD, ATC Nadine M. Fisher, EdD
Department of Rehabilitation Sciences Assistant Professor
University of Oklahoma Health Sciences Center Department of Occupational Therapy
Oklahoma City, Oklahoma State University of New York at Buffalo
Buffalo, New York
Yagesh Bhambhani, PhD
Lisa Fleisher, MS, PT
Professor
Department of Occupational Therapy School of Physical Therapy
University of Alberta Texas Women’s University
Edmonton, Alberta, Canada Dallas, Texas
Richard Glazier, MD, MPH
Thomas J. Birk, PhD, MPT, FACSM
Associate Professor
Associate Professor
Health Policy, Management and Evaluation
Department of Physical Therapy, Physical Medicine
Faculty of Medicine
and Rehabilitation
University of Toronto
Wayne State University
Toronto, Ontario, Canada
Detroit, Michigan
D. Shaun Gray, MD, PhD, CCFP, FRCPC
Louise Burke, MD
Associate Professor
Head, Department of Sports Nutrition
Division of Physical Medicine and Rehabilitation
Australian Institute of Sport
University of Alberta
Belconnen, Canberra, Australia
Edmonton, Alberta, Canada
Department Chief
Kerry S. Courneya, PhD
Halvar Johnson Centre for Brain Injury
Professor
David Thompson Health Region
Department of Physical Education
Ponoka, Alberta, Canada
University of Alberta
Edmonton, Alberta, Canada
David Herbert, JD
Senior Partner
Timothy J. Doherty, MD, PhD, FRCPc
David L. Herbert and Associates, LLD
Associate Professor
Canton, Ohio
Departments of Clinical Neurological Sciences and
Rehabilitation Medicine Schulich School of Medicine Kurt Jackson, PhD, PT, GCS
and Dentistry Neurology Coordinator
The University of Western Ontario Doctor of Physical Therapy Program
London, Ontario Department of Health and Sports Science
University of Dayton
Kieran Fallon, PhD
Dayton, Ohio
Associate Professor
Head, Department of Sports Medicine Anthony S. Kaleth, PhD
College of Medicine and Health Sciences Associate Professor
The Australian National University Department of Physical Education
Canberra, Australia Indiana University—Purdue University Indianapolis
Indianapolis, Indiana
Stephen F. Figoni, PhD, RKT, FACSM
Research Health Scientist Jennifer Kaleth, PT
Physical Medicine and Rehabilitation Service Department of Rehabilitation
Veterans Administration West Los Angeles The Shelbourne Knee Center at Methodist Hospital
Los Angeles, California Indianapolis, Indiana
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viii CONTRIBUTORS
Steven J. Keteyian, PhD, FACSM David L. Nichols, PhD
Division of Cardiovascular Medicine Assistant Research Professor
The Henry Ford Heart and Vascular Institute Institute for Women’s Health
Henry Ford Hospital Texas Women’s University
Detroit, Michigan Denton, Texas
Carl N. King, EdD Terry Nicola, MD, FACSM
President and CEO Director of Sports Medicine and Rehabilitation
Cardiovascular Consultant Department of Orthopedics
Hickory, North Carolina University of Illinois Medical Center
Chicago, Illinois
B. Jenny Kiratli, PhD
Research Health Scientist David Nieman, PhD, FACSM, Section Editor
Spinal Cord Injury Center Professor
Veterans Administration Palo Alto Health Department of Health, Leisure, and Exercise Science
Care System Appalachian State University
Palo Alto, California Boone, North Carolina
Cliff Klein, PhD, MA, BA Stephanie Nixon, PhD, MSc, BHSc(PT), BA
Assistant Professor Assistant Professor
Department of Physical Therapy Department of Physical Therapy
University of Toronto University of Toronto
Toronto, Ontario, Canada Toronto, Ontario, Canada
John J. LaManca, PhD Kelly O’Brien, BSc, BScPT
Research Coordinator/ Exercise Physiologist Lecturer
Heart Failure and Cardiac Transplantation Department of Physical Therapy
New York Presbyterian Hospital University of Toronto
New York, New York Toronto, Ontario, Canada
James J. Laskin, PT, PhD Robin Parisotto, BAppSci
Department of Physical Therapy Laboratory Manager
University of Montana Sports Haematology and Biochemistry Laboratory
Missoula, Montana Australian Institute of Sport
Leverrier Crescent
Laurel T. MacKinnon, PhD, FACSM Bruce, Australian Capitol Territory, Australia
Freelance Writer and Editor
Queensland, Australia Jonathan Peake, PhD
School of Human Movement Studies
Robert C. Manske, MPT, CSCS The University of Queensland
Associate Professor Queensland, Australia
Department of Physical Therapy
Wichita State University Carolyn J. Peddle, MS
Wichita, Kansas Department of Physical Education and Recreation
University of Alberta
Margaret L. McNeely, PT, MSc, PhD Edmonton, Alberta, Canada
Professor
Department of Physical Education and Recreation Mark T. Pfefer, RN, MS, DC
University of Alberta Cleveland Chiropractic College
Edmonton, Alberta, Canada Overland Park, Kansas
Janet A. Mulcare, PhD, PT, FACSM Kenneth Pitetti, PhD, FACSM, Section Editor
Professor of Physical Therapy Professor
Department of Health Sciences College of Health Professions
College of Mount St. Joseph Wichita State University
Cincinatti, Ohio Wichita, Kansas