Clinical Exercise Physiology 6th Edition

Clinical Exercise Physiology, Sixth Edition, is a comprehensive guide to the clinical aspects of exercise physiology, providing in-depth coverage of 32 chronic diseases and conditions and addressing a variety of populations. The sixth edition continues a legacy that began with the first edition in 2003. It is an ideal resource for students preparing for clinical exercise certifications, including those offered by American College of Sports Medicine (ACSM-CEP), American Council on Exercise (Medical Exercise Specialist), Canadian Society for Exercise Physiology (CSEP-CEP), Chartered Association of Sport and Exercise Sciences (CASES Exercise Science Certified Practitioner), and Exercise & Sports Science Australia (ESSA AEP).

Clinical Exercise Physiology, Sixth Edition, employs a full-color layout and a logical progression of content to provide greater coverage and depth of diseases than is found in other clinical exercise physiology texts. It examines the effects of exercise on 32 chronic diseases and conditions, covering the epidemiology, pathophysiology, clinical considerations, drug and surgical therapies, and exercise testing and prescription issues for them. One of its many strengths lies in its treatment of comorbidities, addressing how one condition may affect others. Plus, specific chapters are devoted to examining exercise-related issues for four special populations.

Each chapter in this sixth edition is revised and updated to include the latest research, clinical guidelines, and position statements from professional organizations. In addition, it incorporates the following new elements:

• A new chapter on exercise and immunity helps readers understand the effects of exercise on prevention of and rehabilitation from respiratory tract infections, including COVID-19 and long COVID.
• A new chapter on electrocardiogram (ECG) tests helps clinical exercise physiologists interpret results and review abnormalities that suggest disease.
• The Index of Common Questions points to the corresponding chapter where each of those topics is covered, helping readers to quickly access the information.

In addition to sidebars throughout the text that emphasize critical information and practical application, the sixth edition also has online tools to support student learning. More than 60 case studies are presented in a SOAP note format so students can explore clinical evaluations, looking closely at subjective and objective data, assessments, and plans. Discussion questions and interactive key term flash cards foster better understanding and retention.

Endorsed by CEPA, CASES (formerly BASES), CEP-UP, BASA, and ESSA, Clinical Exercise Physiology, Sixth Edition, offers a contemporary review of the variety of diseases and conditions that students and professionals may encounter in the field. New and veteran clinical exercise physiologists, as well as those preparing for clinical exercise certification exams, will appreciate the in-depth coverage of the clinical populations that benefit from physical activity.

Note: A URL to access the online materials is included in this print book.

Audience

Text for upper-undergraduate- and graduate-level clinical exercise physiology courses as well as a study resource for clinical exercise physiology certifications, including certifications from ACSM, CSEP, CASES, and ESSA. This is an ideal resource for clinical exercise physiologists, sports medicine practitioners, exercise and sports science educators, physical therapists, athletic trainers, and physicians interested in treating their patients with exercise.

Part I. Introduction to Clinical Exercise Physiology

Chapter 1. Preparation for a Career in Clinical Exercise Physiology
Jonathan K. Ehrman, PhD, Paul M. Gordon, PhD, MPH, Paul S. Visich, PhD, MPH, and Steven J. Keteyian, PhD
The Past, Present, and Future of Clinical Exercise Physiology
Professional Organizations and Certifications Throughout the World
Professionalization of Clinical Exercise Physiology
Conclusion

Chapter 2. Behavior and Promoting Exercise and Physical Activity
Sarah-Beth Garner, BA, Sarah E. Williams, PhD, Manu Kapa, Danielle A. Young, PsyD, and Annie T. Ginty, PhD
Physical Activity Guidelines
Benefits of Physical Activity
Participation in Regular Physical Activity
Theories and Models of Physical Activity Promotion
Conclusion

Chapter 3. General Principles of Pharmacology
Steven J. Keteyian, PhD
General Properties of Drugs
Routes of Administration
Phases of Drug Effect
Mechanism of Action
Pharmacotherapy
Conclusion

Chapter 4. General Interview and Examination Skills
Sarah Gorgis, MD
General Interview
Physical Examination
Conclusion

Chapter 5. Review of Electrocardiography
Alexander H.K. Montoye, PhD, and Marlene R. Wenta, MA
Cardiac Electrical Signaling
Standard Electrocardiogram Preparation
Interpreting the Electrocardiogram
ECG Usage and Limitations
Conclusion

Chapter 6. Graded Exercise Testing
Steven J. Keteyian, PhD
Indications
Contraindications
Procedures for Preparing, Conducting, and Interpreting a Graded Exercise Test
Other Tests That Incorporate Graded Exercise
Conclusion

Chapter 7. Exercise Prescription
Steven J. Keteyian, PhD
Exercise Training Sequence
Goal Setting
Principles of the Exercise Prescription
Applying the Principles of Exercise Prescription
Conclusion

Chapter 8. Clinical Exercise Programming
Jonathan K. Ehrman, PhD
Cardiac Rehabilitation
Pulmonary Rehabilitation
Supervised Exercise Therapy for Patients With Peripheral Artery Disease
Cancer Rehabilitation
Renal Rehabilitation
General Exercise Programs for Patients With Chronic Disease
Conclusion

Part II. Diseases of the Endocrine System and Metabolic Disorders

Chapter 9. Diabetes
Sheri R. Colberg, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 10. Obesity
David C. Murdy, MD, Dennis J. Kerrigan, PhD, and Jonathan K. Ehrman, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 11. Hypertension
Fernando Ribeiro, PhD, PT, Alberto J. Alves, PhD, and Linda S. Pescatello, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 12. Hyperlipidemia and Dyslipidemia
Paul G. Davis, PhD, Peter W. Grandjean, PhD, and J. Larry Durstine, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 13. Metabolic Syndrome
James R. Churilla, PhD, MPH, MS
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 14. Chronic Kidney Disease
Samuel Headley, PhD, Kenneth Wilund, PhD, Michael Germain, MD, and João Viana, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Part III. Diseases of the Cardiovascular System

Chapter 15. Acute Coronary Syndromes: Unstable Angina Pectoris and Acute Myocardial Infarction
Ray W. Squires, PhD, and Amanda R, Bonikowske, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training: Inpatient Cardiac Rehabilitation
Exercise Training: Early Outpatient Cardiac Rehabilitation
Conclusion

Chapter 16. Cardiac Interventions
Patrick D. Savage, MS
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription and Training
Conclusion

Chapter 17. Chronic Heart Failure
Steven J. Keteyian, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 18. Peripheral Artery Disease
Ryan J. Mays, PhD, MPH, Ivan P. Casserly, MB, BCh, and Judith G. Regensteiner, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 19. Cardiac Electrical Pathophysiology
Kerry J. Stewart, EdD, and David D. Spragg, MD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription and Training
Conclusion

Chapter 20. Stroke
Christopher J. Womack, PhD, FACSM
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Part IV. Diseases of the Respiratory System

Chapter 21. Chronic Obstructive Pulmonary Disease
Satvir S. Dhillon, MSc, CCRP, Owen D. Harris, MSc, Kathryn M. Milne, MD, MSc, FRCPC, Dennis Jensen, PhD, and Jordan A. Guenette, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 22. Asthma and Lower Airway Dysfunction
Andréanne Côté, MD, and Krystelle Godbout, MD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 23. Cystic Fibrosis
Kelley Crawford, PT, DPT, MS, CCS
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Part V. Diseases of the Immune System and Oncology

Chapter 24. Exercise and Immunity
Meghan L. Spears, PhD, and Mary P. Miles, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 25. Cancer
Dennis J. Kerrigan, PhD, and Karen Wonders, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 26. Human Immunodeficiency Virus
Vitor H.F. Oliveira, PhD, Christine Horvat Davey, PhD, RN, Andre P. dos Santos, PhD, and Allison R. Webel, PhD, RN, FAAN
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Part VI Disorders of the Bones and Joints

Chapter 27. Arthritis
George S. Metsios, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 28. Osteoporosis
Lora M. Giangregorio, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 29. Nonspecific Low Back Pain
Matthew Somma, PT, DPT, and Mike Lawrence, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription and Training
Conclusion

Part VII. Disorders of the Neuromuscular System

Chapter 30. Spinal Cord Injury
Sean M. Tweedy, PhD, Emma M. Beckman, PhD, Mark J. Connick, PhD, Anne L. Hart, PT, PhD, Kati Karinharju, PhD, Kelly M. Clanchy, PhD, Claire Panagoda, FAFRM (RACP), and Matthew G. Heffernan, MSc
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 31. Multiple Sclerosis
Ulrik Dalgas, PhD, and Lars G. Hvid, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 32. Cerebral Palsy
Rosalee M. Dewar, PhD, BPhty (Hons), Grad Dip NR (Paeds), and Iain Dutia, PhD, BPhty (Hons)
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 33. Parkinson’s Disease
Angela L. Ridgel, PhD, FACSM, and Brittany E. Smith, PhD, ACSM-CEP
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Part VIII. Special Populations

Chapter 34. Children
Timothy J. Michael, PhD, and Carol Weideman, PhD
Definition
Scope
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Chapter 35. Aging
Jerome L. Fleg, MD, and Daniel E. Forman, MD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription and Training
Conclusion

Chapter 36. Mental Health
Grace M. McKeon, PhD, Chiara Mastrogiovanni, MSc (Res), and Simon Rosenbaum, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription and Training
Conclusion

Chapter 37. Intellectual Disability
Tracy Baynard, PhD, and Bo Fernhall, PhD
Definition
Scope
Pathophysiology
Clinical Considerations
Exercise Prescription
Exercise Training
Conclusion

Link to Glossary and References
Index of Common Questions
Index
 

Jonathan K. Ehrman, PhD, is the director of cardiac rehabilitation and preventive cardiology at Henry Ford Hospital in Detroit, where he also serves on the clinical bioscientific staff and as chair of the institutional review board. He is also an associate professor in the Michigan State University’s College of Human Medicine. He has a 40-year background in clinical exercise physiology and is certified by the American College of Sports Medicine (ACSM) as a clinical exercise physiologist and as a program director. He previously served as the chair of the clinical exercise physiologist credentialing committee for ACSM.

Dr. Ehrman is a fellow of the ACSM, American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), American Heart Association (AHA), and American College of Cardiology (ACC). He is the author of more than 200 manuscripts and abstracts as well as several textbooks and chapters. He has served as editor in chief of Journal of Clinical Exercise Physiology and was an associate editor of the 10th edition of ACSM’s Guidelines for Exercise Testing and Prescription. He is also the coeditor of the sixth edition of the AACVPR’s Guidelines for Cardiac Rehabilitation Programs. Dr. Ehrman earned his PhD in clinical exercise physiology from The Ohio State University.

Paul M. Gordon, PhD, MPH, is a professor and member of the department of health, human performance, and recreation at Baylor University. He is certified by the American College of Sports Medicine (ACSM) as a clinical exercise physiologist and has over 20 years of experience teaching clinical exercise physiology curricula and directing cardiopulmonary rehabilitation programs. Dr. Gordon’s areas of expertise include physical activity and lifestyle-based research related to obesity and its comorbidities across the life span. He has published more than 200 papers and abstracts as well as several chapters, including contributions to ACSM’s Guidelines for Exercise Testing and Prescription. He has also served as an examiner and coordinator for ACSM certification and credentialing.

Dr. Gordon is a fellow of ACSM, the Obesity Society, and the Centers for Disease Control Physical Activity Research Program. He is an international member of the Royal Society of Medicine. He earned his PhD in exercise physiology and an MPH in epidemiology from the University of Pittsburgh.

Paul S. Visich, PhD, MPH, is a professor and chair of the exercise and sport performance department at the University of New England. He has over 20 years of experience in clinical exercise physiology and previously served as director of the Human Performance Laboratory in the College of Health Professions at Central Michigan University. He worked for 12 years in a clinical setting that included cardiac and pulmonary rehabilitation and primary disease prevention. His research interests involve the assessment of cardiovascular disease risk factors in children, the influence of resistance training in elderly populations, and altitude physiology.

Dr. Visich previously served as a member of the American College of Sport Medicine (ACSM) exercise physiology credentialing committee and as chair of their professional education committee. He is the author of more than 70 published scientific articles and abstracts. He earned a PhD in exercise physiology and an MPH in epidemiology from the University of Pittsburgh.

Steven J. Keteyian, PhD, has more than 50 years of experience working as a clinical exercise physiologist. He is a member of the clinical bioscientific staff in the Division of Cardiovascular Medicine at Henry Ford Hospital in Detroit, Michigan. He is also a professor at Michigan State University’s College of Human Medicine. Over the course of his career, Dr. Keteyian has focused on exercise and physical activity in both healthy individuals and those with chronic diseases. He has secured nearly 25 years of continuous external funding for his research and is the author of more than 300 scientific articles and book chapters, as well as four textbooks. He previously served as editor in chief for ACSM’s Health & Fitness Journal.

Dr. Keteyian is a member of the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) and the American Heart Association (AHA). He received the President’s Award from AACVPR in 2013, 2017, and 2019. He earned his PhD from Wayne State University in Detroit.

“In the rapidly expanding field of clinical exercise physiology, staying current with knowledge and resources is essential. The sixth edition of Clinical Exercise Physiology decisively meets this need. Ehrman, Gordon, Visich, and Keteyian have once again delivered an invaluable resource that not only reflects the latest scientific understanding but also actively helps shape the future of our profession. For every clinical exercise physiologist committed to upholding the highest standards of our profession, this edition is an indispensable resource.”

—Matthew Thomas, MBA, MS, RCEP, FAACVPR, President of the Clinical Exercise Physiology Association

“Clinical Exercise Physiology, Sixth Edition, is a comprehensive guide to the clinical aspects of exercise physiology. It is a great resource for students as well as for AHCS-registered clinical exercise physiologists in the UK.”

—Ian Wilson, Chief Executive Officer of CASES

“An excellent resource that underpins the training and professional practice of clinical exercise physiologists in the UK.”

—Helen Jones, Chair of the CASES Clinical Exercise Physiology UK Group

“The sixth edition of Clinical Exercise Physiology represents an outstanding advancement in the field, combining the latest scientific evidence with practical clinical application in exercise rehabilitation and health promotion. It serves as an essential resource for practitioners, educators, and students alike, supporting the delivery of safe, effective and evidence-based rehabilitation interventions across diverse clinical populations. This book continues to set a benchmark for excellence as well as the advancement of clinical exercise science, reinforcing the vital role of clinical exercise physiology within multidisciplinary health care in South Africa and beyond.”

—Natasha Deley, President of the Biokinetics Association of South Africa (BASA)

“The Clinical Exercise Physiology, 6th Edition is a significant contribution to the profession, providing a comprehensive and practical resource that supports the application of exercise physiology across diverse clinical settings and populations. It is a valuable reference for those seeking to strengthen their knowledge and application of exercise-based care.” 

—Katie Lyndon, Chief Executive Officer and Accredited Exercise Physiologist of the Exercise & Sports Science Australia (ESSA) 

All ancillaries are free to adopting instructors through HKPropel.

Test package. Contains over 1,000 questions in true-false, fill-in-the-blank, essay and short-answer, and multiple-choice formats The files may be downloaded for integration with a learning management system or printed for use as paper-based tests. Instructors may also create their own customized quizzes or tests from the test bank questions.

Chapter quizzes. Contains ready-made quizzes (10-15 questions each) to assess student comprehension of the most important concepts in each chapter.

Presentation package. Features more than 950 PowerPoint slides of text, artwork, and tables from the book that can be used for class discussion and presentation. The slides in the presentation package can be used directly within PowerPoint or printed to make handouts for students. Instructors can easily add, modify, and rearrange the order of the slides.

Image bank. Includes most of the figures, content photos, and tables from the text, sorted by chapter. These can be used in developing a customized presentation based on specific course requirements.