The fourth edition of ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities reveals common ground between medical and exercise professionals, creating a more collaborative approach to patient care. Developed by the American College of Sports Medicine (ACSM) with contributions from a specialized team of experts, this text presents a framework for optimizing patients' and clients' functionality by keeping them physically active. Featuring new content on common comorbid conditions, this edition is streamlined and updated to better suit chronic populations.

This fourth edition of ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities outlines why exercise is significant in the treatment and prevention of disease, advises medical and exercise professionals in considering proper exercise prescription protocols, and provides evidence-informed guidance on devising individualized exercise programs.

Major advancements and features of the fourth edition include the following:
Current evidence on exercise management for persons with multiple conditions, providing guidance on working with these common yet complex populations
A refocused goal of using physical activity to optimize patients' and clients' functionality and participation in life activities rather than only to treat and prevent disease
Specific content to help physicians prescribe physical activity and exercise to patients for promotion of health, well-being, and longevity
Reorganization of case studies into one streamlined chapter along with commentary from the senior editor to encourage critical thinking and recognize the unique needs of each patient
The case studies in the text are real-life scenarios that help professionals and clinicians combine scientific knowledge with experience to find appropriate solutions for each individual. Commentary on the case studies from the senior editor illustrates when improvisation may be appropriate and where further research is needed. Tables are highlighted throughout the text to help readers quickly reference important clinical information. Evidence-informed guidelines, suggested websites, and additional readings further encourage practical use of information and identify further learning opportunities. For instructors, an ancillary PowerPoint presentation package aids in classroom discussion.

The critical element that distinguishes the fourth edition of ACSM's Exercise Management for Persons With Chronic Diseases and Disabilities is its unifying mission to incorporate physical activity and exercise in both disease treatment and prevention. Its emphasis on assisting people with multiple conditions, which is ever present in health care today, moves beyond primary and secondary prevention to focus on how patients and clients can be kept physically active and functionally fit.

Contents

Foreword
Preface
Acknowledgments
Notice and Disclaimer
Part I. Foundations of Exercise in Chronic Disease and Disability
Geoffrey E. Moore, J. Larry Durstine, and Patricia L. Painter

Chapter 1. Exercise Is Medicine in Chronic Care
Robert Sallis and Geoffrey E. Moore
Exercise Is Medicine
Take-Home Message
Suggested Readings

Chapter 2. Basic Physical Activity and Exercise Recommendations for Persons With Chronic Conditions
Benjamin T. Gordon, J. Larry Durstine, Patricia L. Painter, and Geoffrey E. Moore
Definitions Used in This Book
Basic CDD4 Recommendations for Physical Activity or Exercise in Chronic Conditions
How to Prescribe Physical Activity or Exercise in Chronic Care
Graded Exercise Testing
Minimum Exercise Recommendations When an Exercise Test Is Not Available
Clinically Supervised Exercise Programming
ACSM's Exercise Personnel Certifications
Suggested Readings

Chapter 3. Art of Clinical Exercise Programming
Patricia L. Painter and Geoffrey E. Moore
Step 1: Assess Current Health Status
Step 2: Assess Current Level of Physical Activity
Step 3: Identify Exertional Symptoms That Limit Physical Activity
Step 4: Evaluate Physical Function and Performance
Step 5: Selecting Physical Performance Assessments
Activities of Daily Living and Instrumental Activities of Daily Living
Commonly Used Tests of Physical Functioning
Step 6: Considerations for Formal Exercise Tolerance Testing
Step 7: Considerations for Program Referral
Step 8: Develop a Strategy for Monitoring Progress
Take-Home Message
Suggested Readings
Additional Resources

Chapter 4. Art of Exercise Medicine: Counseling and Socioecological Factors
Geoffrey E. Moore, Michael Costello, and Patricia L. Painter
Common Behavioral Techniques Used in Exercise Counseling
Other Aspects of Exercise Counseling
Socioecological Disparities and Exercise in Chronic Conditions
Integration Into a Medical Home Model
Suggested Readings
Additional Resource
Part II. Common Chronic Conditions and Comorbidities
Geoffrey E. Moore and J. Larry Durstine

Chapter 5. Approach to the Common Chronic Conditions
Geoffrey E. Moore, Patricia L. Painter, J. Larry Durstine, and Benjamin T. Gordon
Nature of Multiple Conditions and Related Comorbidities
General Recommendations for Exercise
Recommendations for Exercise Assessment
Recommendations for Exercise Programming
CDD4 Alternative Recommendation: The Functional Exercise Trial
General Solutions for Common Chronic Conditions
Integration Into a Medical Home Model
Suggested Readings

Chapter 6. Chronic Conditions Strongly Associated With Physical Inactivity
J. Larry Durstine, Geoffrey E. Moore, Patricia L. Painter, Richard Macko, Benjamin T. Gordon, and William E. Kraus
Hypertension and Dyslipidemia
Overweight, Obesity, Prediabetes, and Type 2 Diabetes Mellitus
Arthritis and Back Pain
Osteoporosis
Suggested Readings
Additional Resources
Web Resources

Chapter 7. Chronic Conditions Very Strongly Associated With Tobacco
Christopher B. Cooper, Brett A. Dolezal, J. Larry Durstine, Benjamin T. Gordon, Sherry O. Pinkstaff, Abraham S. Babu, and Shane A. Phillips
Chronic Obstructive Pulmonary Disease
Coronary Artery Disease and Atherosclerosis
Angina and Silent Ischemia
Peripheral Arterial Disease
Suggested Readings
Additional Resources

Chapter 8. Cancer
Kathryn Schmitz
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Suggested Readings
Additional Resources

Chapter 9. Significant Sequelae Related to Common Chronic Conditions
Jessica S. Oldham, Patricia L. Painter, Elizabeth J. Protas, Geoffrey E. Moore, and Richard Macko
Depression as a Comorbidity
Lower-Limb Amputation
Frailty
Suggested Readings
Additional Resource
Part III. Cardiovascular Diseases
Jonathan N. Myers and Peter H. Burbaker

Chapter 10. Chronic Heart Failure
Peter H. Brubaker and Jonathan N. Myers
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 11. Atrial Fibrillation
Jonathan N. Myers and J. Edwin Atwood
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 12. Pacemakers and Implantable Cardioverter-Defibrillators
Clinton A. Brawner and Barry Lewis
Permanent Pacemakers
Implantable Cardioverter-Defibrillators
Combination Pacemaker Defibrillator Devices
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Suggested Readings
Additional Resources

Chapter 13. Valvular Heart Disease
Matthew W. Parker
Basic Pathophysiology
Mitral Valve Disease
Aortic Valve Disease
Right-Sided Valvular Heart Disease
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 14. Heart Transplantation
Audrey B. Silva and Gerson Cipriano Jr.
Effects on the Exercise Response
Effects of Exercise Training
Management and Medications
Recommendations for Exercise Testing
Recommendations for Exercise Training
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 15. Aneurysms
Holly Fonda and Jonathan N. Myers
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources
Part IV. Pulmonary Diseases
Tony Babb

Chapter 16. Chronic Restrictive Pulmonary Disease
Connie C. W. Hsia
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings

Chapter 17. Asthma
Kenneth W. Rundell
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 18. Cystic Fibrosis
Erik Hulzebos, Maarten S. Werkman, Bart C. Bongers, and Tim Takken
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 19. Pulmonary Hypertension
Kelly Chin
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resource
Part V. Immunological, Hematological, and Organ Failure
David C. Nieman

Chapter 20. Chronic Kidney and Liver Disease
Patricia L. Painter
Renal Disease
Liver Disease
Management and Medications for Kidney Disease
Management and Medications for Liver Disease
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 21. Acquired Immune Deficiency Syndrome
David C. Nieman, Gregory A. Hand, G. William Lyerly, and Wesley D. Dudgeon
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 22. Chronic Fatigue Syndrome
Steven P. Bailey and David C. Nieman
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 23. Fibromyalgia
David C. Nieman
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 24. Hemostasis Disorders
Michael Lockard and David C. Nieman
Basic Pathophysiology of Hemorrhagic Disorders
Basic Pathophysiology of Thrombotic Disorders
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources
Part VI. Neuromuscular Conditions
Elizabeth J. Protas and Richard Macko

Chapter 25. Stroke, Brain Trauma, and Spinal Cord Injuries
Richard Macko
Basic Pathophysiology of Stroke
Basic Pathophysiology of Traumatic Brain Injury
Basic Pathophysiology of Spinal Cord Injury
Common Elements
Systemic Effects of Central Nervous System Injury
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings

Chapter 26. Peripheral Neuropathy, Myopathy, and Myasthenia Gravis
Charlene Hafer-Macko
Basic Pathophysiology of Peripheral Neuropathy
Basic Pathophysiology of Myopathy
Basic Pathophysiology of Myasthenia Gravis
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 27. Cerebral Palsy
Désirée Maltais
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 28. Multiple Sclerosis
Tara Patterson and Jill Seale
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 29. Parkinson's Disease
Elizabeth J. Protas and Rhonda K. Stanley
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 30. Muscular Dystrophy
Janke de Groot and Bart Bartels
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources
Part VII. Cognitive and Psychological Disorders
Bradley D. Hatfield

Chapter 31. Dementia and Alzheimer's Disease
Jessica S. Oldham, Jo B. Zimmerman, and Bradley D. Hatfield
Basic Pathophysiology
Management and Medications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources

Chapter 32. Depression and Anxiety Disorders
Jessica S. Oldham, Jo B. Zimmerman, and Bradley D. Hatfield
Basic Pathophysiology
Management andMedications
Effects on the Exercise Response
Effects of Exercise Training
Recommendations for Exercise Testing
Recommendations for Exercise Programming
Integration Into a Medical Home Model
Take-Home Message
Suggested Readings
Additional Resources
Part VIII Case Studies
Geoffrey E. Moore

Abdominal Aortic Aneurism
Amyotrophic Lateral Sclerosis
Asthma
Atrial Fibrillation
Becker Muscular Dystrophy
Breast Cancer Survivor
Cerebral Palsy
Chronic Fatigue Syndrome
Chronic Heart Failure With Mild COPD
Chronic Kidney Disease: Stage 4, Renal Insufficiency
Chronic Kidney Disease: Stage 5, Treated With Hemodialysis
Chronic Kidney Disease: Status/Post-Renal Transplantation
Chronic Obstructive Pulmonary Disease
Coronary Artery Disease and Dyslipidemia, Status Post-Angioplasty With Stent Placement
Cystic Fibrosis
Deep Venous Thrombosis
Dementia and Frailty
Fibromyalgia
Hearing Impairment
Heart Transplant
Human Immunodeficiency Virus
Hypertension, Dyslipidemia, and Obesity
Interstitial Lung Disease (Chronic Restrictive Lung Disease)
Major Depressive Disorder
Multiple Sclerosis
Myasthenia Gravis
Myocardial Infarction
Parkinson's Disease
Peripheral Artery Disease
Pulmonary Hypertension
Refractory Angina
Spinal Cord Injury
Stroke
Type 2 Diabetes and Disability From Morbid Obesity With Multiple Chronic Conditions
Type 2 Diabetes and Obesity With Osteoarthrosis
Valvular Heart Disease
Visual Impairment
Appendix A. Common Medications
Appendix B. Basic CDD4 Recommendations
Index
About the ACSM
Contributors

Audiences

A reference for physical therapists, rehabilitation specialists, nurses, physicians, health and fitness instructors, exercise physiologists, and clinical program directors; also a textbook for exercise management courses covering chronic disease and disabilities.