Exercise in Rehabilitation Medicine

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Walter Frontera, David Dawson, David Slovik
2nd Edition
2006
US Price: $95
464 pages
9780736055413

About the Editors | Table of Contents

Therapists, exercise physiologists, and physicians will find Exercise in Rehabilitation Medicine, Second Edition, a highly useful reference in designing exercise rehabilitation programs for patients with various disabling illnesses and conditions. This book provides an understanding of the basic physiological adaptations to exercise and aids health professionals in properly matching a training program with the impairment, activity, activity level, and participation goal appropriate for the patient.

Written by the most distinguished rehabilitation clinicians in the field, Exercise in Rehabilitation Medicine, Second Edition, provides a comprehensive approach to the use of exercise as a primary modality in the arsenal of rehabilitation specialists. Thoroughly updated, this new edition focuses on the basic sciences and clinical correlates affecting the use of exercise, and it includes new chapters on the use of exercise in patients with HIV/AIDS, end-stage renal disease, and cancer recovery. It also includes the following features:

• Discussion of equipment and protocols used for testing the capacity of the patient, with specific reference to strength, endurance, flexibility, and balance
• 12 clinical chapters, each including a case study that shows how the information applies to a specific patient, indicating the practical importance of the knowledge presented
• More than 200 tables, illustrations, and photos to reinforce and clarify the text
• Subject and citation indexes, along with extensive reference lists for each chapter, making it easy to access the information and explore subjects in greater depth

In Part I, the focus is on biological considerations, including physiological responses to exercise and adaptations regarding strength, endurance, flexibility, balance, and coordination. Only by understanding these basic facts can a health professional properly match a training program with a patient. Part II details special clinical considerations, including the principles of exercise testing and exercise prescription and examining the role of exercise in preventing chronic illness. Part III discusses the rationale and clinical importance of exercise in the rehabilitation of patients with various disabling conditions, and it addresses the factors that must be weighed when prescribing exercise for these conditions. Among the diseases discussed in these 12 chapters are diseases of the heart, circulatory system, lungs, kidneys, joints, and bones and the endocrine, immune, and neuromuscular systems. Part IV includes two chapters on special populations: the elderly and elite athletes with disabilities.

Exercise in Rehabilitation Medicine, Second Edition, combines theory with practical and clinical information, establishing both the “how” and “why” of exercise rehabilitation. Its clarity will help those with little technical expertise to follow it and put it to use, and its detail and advanced material will aid those who are experienced to significantly improve their understanding.

About the Editors

Walter R. Frontera, MD, PhD, is Earle P. and Ida S. Charlton professor and chairman of the department of physical medicine and rehabilitation (PM&R) at Harvard Medical School. He is the chief of PM&R at the Spaulding Rehabilitation Hospital, the Massachusetts General Hospital and the Brigham and Women’s Hospital in Boston, Massachusetts. He is board-certified in the medical specialty of PM&R and has a PhD in exercise physiology. He has more than 20 years of experience in the practice of PM&R and in the use of exercise in various patient populations. He is the secretary general of the International Sports Medicine Federation and the editor in chief of the American Journal of Physical Medicine and Rehabilitation.

David M. Slovik, MD, is chief of medicine at Spaulding Rehabilitation Hospital in Boston, Massachusetts, where he has worked for 30 years. He has also served as medical director of the musculoskeletal program at Spaulding. Dr. Slovik trained in endocrinology at the Massachusetts General Hospital where he continues to teach and practice. He is an expert on osteoporosis and related disorders, including the effects of exercise on osteoporosis. He is also an associate professor of medicine at Harvard Medical School, with 30 years of teaching experience. He is a member of the American Society of Bone and Mineral Research.

David M. Dawson, MD, is professor of neurology at Harvard Medical School and a member of the Department of Neurology at the Brigham and Women’s Hospital. He has extensive experience in teaching and in residency supervision and is an expert in clinical neurology with an emphasis on neuromuscular disease and multiple sclerosis. He has served on various boards of the National Multiple Sclerosis Society.

Table of Contents

• Part I: Biological Considerations
  • Chapter 1. Acute Physiological Responses to Dynamic Exercise
    Roger A. Fielding, PhD; and Jonathan Bean, MD, MS
    • Cardiorespiratory Response to Dynamic Exercise
    • Metabolic Response During Dynamic Exercise
    • Acute Exercise Response in Diabetes Mellitus
    • Cardiorespiratory Changes With Activity and Inactivity
    • Physiological Adjustments to Isometric Exercise
  • Chapter 2. Adaptations to Endurance Exercise Training
    Martin D. Hoffman, MD
    • Physiological Adaptations to Endurance Exercise Training
    • Psychological Adaptations to Endurance Exercise Training
    • Factors Affecting Adaptations to Endurance Exercise Training
    • Simultaneous Strength and Endurance Exercise Training
  • Chapter 3. Adaptations to Strength Training
    Bette Ann Harris, DPT, MS; and Mary P. Watkins, DPT, MS
    • Anatomical and Physiological Considerations
    • Functional Biomechanics
    • Factors Influencing Muscle Strength
    • Principles of Strength Training
    • Adaptations to Strength Conditioning
  • Chapter 4. Training Flexibility
    Lisa S. Krivickas, MD
    • Definition of Flexibility
    • Factors Influencing Flexibility
    • Response of Muscle to Stretch
    • Relationship Between Muscle Stiffness and Flexibility
    • Measuring and Quantifying Muscle Flexibility and Ligamentous Laxity
    • Relationship Between Muscle Flexibility and Injury
    • Relationship Between Ligamentous Laxity and Injury
    • Effect of Stretching on Delayed Onset Muscle Soreness
    • Effect of Disease Processes on Flexibility
    • Relationship Between Flexibility and Athletic Performance
    • Flexibility and Activities of Daily Living in the Elderly or Disabled
    • Stretching Techniques and Prescription of a Flexibility Training Program
    • Effect of Strength Training on Flexibility
• Part II: Special Clinical Considerations
  • Chapter 5. Testing the Capacity to Exercise in Disabled Individuals: Cardiopulmonary and Neuromuscular Models
    James C. Agre, MD, PhD
    • Rationale for Health Screening and Risk Stratification
    • Rationale for Exercise Testing
    • Protocols for Exercise Testing, With Examples
  • Chapter 6. A Behavioral Approach to Prescribing Physical Activity for Health and Fitness
    Gregory W. Heath, DHSc, MPH
    • Preliminary Factors Important for Exercise Prescription
    • General Exercise Prescription Guidelines
    • Theories and Models Used in Physical Activity Promotion
  • Chapter 7. Exercise and the Prevention of Chronic Disabling Illness
    Carlos J. Crespo, DrPH, MS, FACSM; and Edith M. Williams, MS
    • Definitions
    • Physical Activity and Fitness
    • Physical Activity and Health
    • Physical Activity and Prevention of Heart Disease
    • Exercise and the Prevention of Type 2 Diabetes
    • Exercise and Primary Prevention of Cancer
    • Physical Activity and the Prevention of Osteoporosis and Falls
    • Exercise in the Prevention of Arthritis
    • Exercise in the Prevention of Low Back Pain
    • Physical Activity and Primary Prevention of Obesity
    • Physical Activity and Psychological Well-Being
• Part III: Exercise in the Rehabilitation of Specific Diseases and Conditions
  • Chapter 8. Heart Diseases
    Ruy S. Moraes, MD, ScD; and Jorge P. Ribeiro, MD, ScD
    • Responses and Adaptations of Cardiac Patients to Exercise
    • Effect of Cardiovascular Drugs on Exercise Responses and Adaptations
    • Evaluation of Cardiac Patients
    • Indications for Cardiac Rehabilitation
    • Contraindications for Cardiac Rehabilitation
    • Exercise Prescription for the Cardiac Patient
    • Outcomes of Cardiac Rehabilitation Programs
  • Chapter 9. Respiratory Disease
    Bartolome R. Celli, MD
    • Physical Reconditioning
    • Respiratory Muscles and Breathing Training
  • Chapter 10. Diabetes Mellitus
    Edward S. Horton, MD
    • What Is Diabetes?
    • Exercise in Type 1 Diabetes
    • Exercise in Type 2 Diabetes
  • Chapter 11. Major Inflammatory and Non-Inflammatory Arthritides
    Maura Daly Iversen, SD, DPT, MPH; Matthew H. Liang, MD, MPH; and Axel Finckh, MD, MS
    • Rheumatoid Arthritis
    • Osteoarthritis
    • Spondylarthropathies
    • Systemic Lupus Erythematosus
    • Polymyositis/Dermatomyositis
    • Systemic Sclerosis
    • Improving Patient Adherence
  • Chapter 12. Neuromuscular Diseases
    David D. Kilmer, MD; and Susan Aitkens, MS
    • Physiologic and Functional Consequences of Neuromuscular Diseases
    • Causes of Reduced Neuromuscular Function in NMD
    • Effects of Resistance (Strengthening) Exercise in NMD
    • Effects of Aerobic (Endurance) Exercise in NMD
    • Exercise Recommendations in Neuromuscular Disorders
  • Chapter 13. Spinal Cord Injury
    Mark S. Nash, PhD, FACSM
    • Health Consequences of Spinal Cord Injury
    • Exercise for Persons With Spinal Cord Injury
    • Restoration of Function Following Long-Standing Paralysis
    • Exercise Risks for Persons With Spinal Cord Injury
    • Medications That May Influence Exercise Performance After Spinal Cord Injury
  • Chapter 14. Stroke
    Joel Stein, MD
    • Scope of the Problem
    • Effects of Stroke on Neuromuscular Function
    • Mechanisms of Motor Recovery Poststroke
    • Exercise for Motor Control
    • Strengthening Exercises
    • Exercise for Ataxia
    • Exercise for Aerobic Conditioning
    • Other Benefits of Exercise
    • Home and Community Based Exercise
  • Chapter 15. Osteoporosis
    David M. Slovik, MD
    • Mechanical Properties of Bone: Effects of Exercise
    • Disuse, Weightlessness, and Immobilization
    • Physical Activity and Bone Mass
    • Physical Activity, Fall Prevention, and Fractures
  • Chapter 16. Human Immunodeficiency Virus
    Susan D. Driscoll, MPH, MSN, ANP; and Steven Grinspoon, MD
    • The HIV Pandemic
    • Exercise to Improve Physical Function in HIV-Infected Patients
    • Exercise to Improve Psychosocial and Quality of Life Issues in HIV
    • Exercise Effects on Immune Status and Lactic Acid
  • Chapter 17. Obesity
    Ronenn Roubenoff, MD, MHS
    • Health Implications of Obesity
    • Body Composition Through the Life Cycle
    • Etiology of Obesity
    • Exercise for Treatment of Obesity
    • Effect of Exercise on Serum Lipoproteins and Glucose Metabolism
  • Chapter 18. Cancer
    Kerry S. Courneya, PhD; Lee W. Jones, PhD; and John R. Mackey, MD
    • What Is Cancer?
    • Epidemiology of Cancer
    • Medical Treatments for Cancer
    • Exercise in Cancer Survivors
    • Exercise Testing and Prescription Guidelines for Cancer Survivors
    • Exercise Motivation in Cancer Survivors
    • Future Research Directions
  • Chapter 19. End-Stage Renal Disease
    Pelagia Koufaki, PhD; and Tom Mercer, PhD
    • What is End-Stage Renal Disease?
    • Renal Replacement Therapy
    • Renal Transplantation
    • Scale and Nature of the Problem
    • Pathophysiology and Physical Dysfunction in End-Stage Renal Disease
    • Exercise Rehabilitation Aims
    • Feasibility and Safety of Exercise Rehabilitation Options in End-Stage Renal Disease
    • Exercise Prescription in End-Stage Renal Disease
    • Effectiveness of Exercise Rehabilitation in End-Stage Renal Disease
• Part IV: Specific Patient Populations
  • Chapter 20. Aging, Function, and Exercise
    Jonathan F. Bean, MD, MS; and Charles T. Pu, MD
    • The International Demographics of Aging
    • A Functional Perspective
    • Effects of Exercise on Physiologic Aging
    • Effect of Exercise on Function and Disability
    • Practical Recommendations
  • Chapter 21. Elite Athletes With Impairments
    Rory A. Cooper, PhD; Michael L. Boninger, MD; Ian Rice, MS, OTR/L; Sean D. Shimada, PhD; and
    Rosemarie Cooper, MPT, ATP
    • From Patient to Athlete
    • Organizational Structure of Sports for People With Disabilities
    • Sport Equipment Technology and Use
    • Classification
    • Exercise Science and the Athlete With Impairments
    • Training Techniques for Elite Athletes With Disabilities
    • Injuries Experienced by Athletes With Disabilities
• References
• Subject Index
• Citation Index
• About the Editors
• About the Contributors

Audiences

A reference for physical and occupational therapists, clinical exercise specialists, and physiatrists and rehabilitation specialists. Also a reference for physicians and chiropractors.