Exercise Physiology Basis of Human Movement in Health and Disease

by Brown, Stanley P.; Miller, Wayne C.; Eason, Jane M.

• ISBN13: 9780781735926
• ISBN10: 0781735920
• Format: Paperback
• Copyright: 2005-12-14
• Publisher: LWW

Summary

Bridging the gap between exercise physiology principles and clinical practice, this text provides comprehensive coverage of both traditional basic science and clinical exercise physiology principles. The book presents clinical applications and examples that connect theory to practice. More than 500 full-color illustrations and numerous graphs and tables complement the text. Reader-friendly features including Perspective Boxes, Research Highlights, Biography Boxes, and Case Studies engage readers and reinforce key concepts.A bonus three-dimensional interactive anatomy CD-ROM from Primal Pictures and a Student Resource CD-ROM accompany the book. LiveAdvise online faculty support and student tutoring services are available free with the text.

Table of Contents

Foreword	p. vii
Preface	p. ix
User's Guide	p. xiii
Acknowledgements	p. xvii
Reviewers	p. xix
Energy: the Basis of Human Movement	p. 1
Exercise Bioenergetics: Energy Developed
Introduction to Exercise Physiology	p. 2
A Future Perspective on Exercise	p. 2
What is Exercise Physiology?	p. 5
The Academic Setting	p. 5
A Unified Vision of Exercise Science as a Discipline	p. 6
Exercise Physiology and the Disablement Model	p. 8
Movement, Physical Activity, and Exercise	p. 11
Exercise and Physical Activity as Stressors	p. 15
A Brief History of Exercise in Medicine	p. 17
The "Laws of Health" from Ancient Medicine to the 19th Century	p. 17
19th Century Foundation and The Rise of Exercise Physiology	p. 18
Nutrients for Physical Activity	p. 21
Nutrients: Building Blocks of Energy	p. 22
Carbohydrates	p. 22
Monosaccharides	p. 23
Disaccharides	p. 23
Polysaccharides	p. 23
Digestion and Absorption of Carbohydrates	p. 25
The Role of Carbohydrates in the Body	p. 25
Fats	p. 27
Triglycerides and Fatty Acids	p. 27
Phospholipids	p. 30
Lipoproteins	p. 30
Glycolipids	p. 31
Sterols	p. 31
Digestion and Absorption of Fats	p. 31
The Role of Fats in the Body	p. 31
Proteins	p. 32
Digestion and Absorption of Proteins	p. 33
The Role of Proteins in the Body	p. 34
Vitamins	p. 34
Fat-Soluble Vitamins	p. 36
Water-Soluble Vitamins	p. 37
Minerals	p. 38
The Major Minerals	p. 38
The Trace Minerals	p. 40
Water	p. 40
Dietary Guidelines	p. 43
Food Guide Pyramid	p. 43
Vegetarianism	p. 45
Energy Sources and Production	p. 49
Energy Defined	p. 49
Energy Forms	p. 51
Biochemical Reactions are Linked	p. 51
Anabolism and Catabolism	p. 52
Phosphate Energy	p. 53
ATP-The Energy Exchange Currency	p. 53
Energy Flows from Creatine Phosphate to ADP	p. 54
Oxidation-Reduction Reactions	p. 55
Sarcoplasmic Catabolism	p. 56
The Energy Continuum	p. 56
Immediate Energy	p. 58
Short-term Energy	p. 60
Lypolysis	p. 64
Mitochondrial Catabolism	p. 66
[beta] Oxidation	p. 68
Krebs Cycle	p. 68
Electron Transport Chain	p. 71
Tallying ATP	p. 73
Metabolic Transitions During Exercise	p. 75
Rest-to-Exercise Transitions	p. 76
Energy Accessibility	p. 76
Energy Systems Stressed by Exercise	p. 77
Response to Exercise Energy Demands: Hormonal Regulation	p. 78
Results of an Exercise-Induced Rise in Metabolism	p. 86
Maintaining Energy Supply During Exercise	p. 89
Exercise Intensity and Fuel Selection	p. 91
Exercise Duration and Fuel Supply	p. 92
Recovery From Exercise: Resynthesis of Fuels	p. 94
Regeneration of ATP and PC	p. 94
Reformation of Glucose	p. 94
Synthesis of Glycogen	p. 95
Synthesis of Fatty Acids and Triglycerides	p. 96
Ergometry and Calorimetry: The Measurement of Work and Energy	p. 98
Ergometry: The Measurement of Work	p. 98
Units of Measurement	p. 100
Common Ergometers	p. 104
Calorimetry: The Measurement of Energy	p. 107
Direct Calorimetry	p. 107
Indirect Calorimetry	p. 109
Measuring Vo[subscript 2] and Vco[subscript 2] by Open-Circuit Spirometry	p. 111
Standardizing Gas Volumes	p. 111
Energy Expenditure	p. 114
Expressing Vo[subscript 2]	p. 114
Respiratory Exchange Ratio	p. 115
Basal and Resting Metabolic Rate	p. 116
Efficiency and Economy	p. 116
Efficiency	p. 117
Economy	p. 119
Clinical Applications	p. 120
Energy Cost of Physical Activity	p. 120
Relationship Between Heart Rate and VO[subscript 2]	p. 123
Estimating Submaximal Vo[subscript 2]: The Metabolic Equations	p. 124
Heart and Lungs: Energy Delivered
Respiratory Exercise Physiology	p. 127
Exchange of Respiratory Gases at the Alveolar-Capillary Interface	p. 128
Respiratory Gases Move By Diffusion	p. 129
Driving Pressure and Gas Diffusion	p. 129
Short Distances Enhance Diffusion	p. 132
Diffusivity Determines Rapidity of Diffusion	p. 132
Diffusion and Transit Time	p. 133
Ventilating the Lungs	p. 134
Ventilatory Parameters	p. 134
The Ventilatory Pump	p. 137
The Respiratory Tree	p. 139
Ventilation/Perfusion Matching	p. 141
Pulmonary Perfusion	p. 141
Physiology of V/Q Matching	p. 143
Transport of Oxygen and Carbon Dioxide	p. 145
Oxygen Transport	p. 145
Carbon Dioxide Transport	p. 149
Control of Breathing	p. 151
Exercise Ventilation	p. 151
Central and Peripheral Roles	p. 153
Chemical Control of Respiration	p. 155
Cardiovascular Exercise Physiology	p. 161
The Heart and Circulation	p. 161
Cardiac Structure	p. 162
Cardiac Electrical Activity	p. 164
Cardiac Cycle	p. 169
Arteries, Arterioles, Metarterioles, and Capillaries	p. 173
Veins	p. 173
Regulation of Peripheral Blood Flow	p. 175
Distribution of Blood Flow	p. 175
Factors Controlling Muscle Blood Flow	p. 175
Determinants of Blood Flow	p. 176
Cardiac and Circulatory Dynamics	p. 177
Blood Pressure	p. 178
Cardiac Output	p. 181
Cardiovascular Adjustments to Acute and Chronic Exercise	p. 184
Heart Rate	p. 185
Cardiac Output and Stroke Volume	p. 188
Blood Pressure	p. 191
[Delta]a-vO[subscript 2]	p. 193
Homothermal Control: Temperature Regulation During Exercise	p. 195
Temperature Balance During Exercise	p. 195
Heat Exchange by Conduction	p. 197
Heat Exchange by Convection	p. 197
Heat Exchange by Radiation	p. 198
Heat Exchange by Evaporation	p. 198
Assessment of Body Temperature	p. 199
Integration of Heat Transfer Mechanisms	p. 199
Temperature Regulation in Hot Environments	p. 201
The Thermal Regulatory Center	p. 201
Cardiovascular Adjustments to Heat Exposure	p. 202
Acclimatization to Heat	p. 203
Heat Disorders	p. 204
Assessing Environmental Heat Stress	p. 205
Age and Gender Differences in Heat Regulation	p. 207
Protection Against Heat Disorders	p. 209
Temperature Regulation in Cold Environments	p. 211
The Thermal Regulatory Center	p. 211
Cardiovascular Adjustments to Cold Exposure	p. 212
Acclimatization to the Cold	p. 212
Health Risks from Cold Exposure	p. 212
Assessing Environmental Cold Stress	p. 212
Age and Gender Differences in Cold Tolerance	p. 212
Protection Against Cold Exposure	p. 213
Muscles: Energy Used
Neuroanatomy and Neuromuscular Control of Movement	p. 217
Nervous System Organization	p. 218
The Neuron	p. 218
Parts of the Neuron	p. 219
Functions of Neurons	p. 220
Action Potentials	p. 220
Synaptic Transmission	p. 221
Central Nervous System	p. 225
The Brain	p. 225
The Spinal Cord	p. 229
Supporting Cells of the Central Nervous System	p. 233
Peripheral Nervous System	p. 233
Cranial Nerves	p. 233
Spinal Nerves	p. 235
Autonomic Nervous System	p. 237
Sympathetic Nervous System	p. 237
Parasympathetic Nervous System	p. 237
Somatic Motor System	p. 239
Motor Neurons	p. 239
Spinal Control of Motor Units	p. 240
Motor Programming	p. 244
Feedback and Practice	p. 245
Skeletal Muscle Architecture and Contraction	p. 247
Skeletal Muscle Structure	p. 247
Gross Structure of Muscle	p. 248
Muscle Morphology and Architecture	p. 252
Muscle Contraction	p. 255
Sliding Filament Theory	p. 255
Energy for Contraction	p. 255
Excitation-Contraction Coupling	p. 256
Muscle Fiber Types	p. 258
Muscle Biopsy	p. 259
Histochemical Classification	p. 259
Biochemical Classification	p. 259
Molecular Classification	p. 259
Physiologic Properties of Fiber Types	p. 261
Maximum Tension Generation	p. 262
Maximal Velocity of Shortening	p. 263
Metabolic and Biochemical Differences	p. 263
Structural Differences	p. 263
Muscle Fiber Plasticity	p. 264
Aerobic Exercise	p. 264
Resistance Training	p. 264
Age-related Changes	p. 264
Immobilization-Induced Changes	p. 266
Muscle Mechanics During Activity	p. 270
The Motor Unit	p. 270
Motor Unit Anatomy and Function	p. 271
Fatigue Index	p. 272
Motor Unit Recruitment	p. 272
Muscle Mechanics	p. 273
Length-Tension Curve	p. 275
Force-Velocity Relationship	p. 275
Muscle Fatigue	p. 276
Muscle Strength	p. 277
Skeletal Muscle Adaptations to Strength Training	p. 277
Measurement of Muscle Strength	p. 278
Applied Exercise Physiology	p. 287
Physiology of Health, Fitness, and Performance
Nutrition and Exercise Performance	p. 288
Carbohydrate Intake and Exercise Performance	p. 288
High-Carbohydrate Diets	p. 289
Carbohydrate Ingestion Prior to Exercise	p. 290
Carbohydrate Ingestion During Exercise	p. 291
Carbohydrate Ingestion After Exercise	p. 292
High-Fat Diets	p. 295
High-Protein Diets	p. 296
Fad Diets and Weight Loss	p. 297
Exercise Performance and Vitamin/Mineral Supplements	p. 300
Vitamin Supplements	p. 300
Mineral Supplements	p. 301
Evaluation of Dietary Supplements	p. 303
Exercise Performance and Fluid Intake	p. 306
Assessment of Body Composition	p. 310
Ideal Body Weight	p. 310
Body Fat and Disease Risk	p. 311
Body Composition and Athletic Performance	p. 312
Methods for the Assessment of Body Composition	p. 313
Measures of Circumference	p. 314
Body Mass Index (BMI)	p. 315
Hydrostatic Weighing	p. 316
Air Displacement Plethysmography	p. 318
Skinfold Thickness	p. 320
Total Body Water Measures	p. 323
Total Body Electrical Conductivity (TOBEC)	p. 323
Bioelectrical Impedance Analysis (BIA)	p. 323
Ultrasound	p. 324
Nuclear Magnetic Resonance (NMR)	p. 324
Near-Infrared Interactance	p. 326
Computed Tomography	p. 326
Dual-energy X-ray Absorptiometry (DXA)	p. 326
Body Composition Assessment in Children	p. 331
Body Mass Index in Children	p. 331
Body Composition Measures in Children	p. 332
Training for Physical Fitness and Sport	p. 334
Principles of Training	p. 334
Specificity	p. 335
Overload	p. 341
Training for Muscular Fitness	p. 344
Training for Strength Performance	p. 344
Training for Power Performance	p. 347
Training for Speed Performance	p. 351
Training for Aerobic Endurance	p. 352
Exercise Dosage	p. 353
Determining Exercise Intensity	p. 354
Endurance Training Techniques	p. 358
Exercise Performance for Specific Populations
Pediatric Exercise Physiology	p. 361
Growth, Development and Maturation	p. 361
Anthropometric Growth and Development	p. 362
Physiological Development	p. 362
Evaluating Fitness and Physical Activity in Children	p. 365
Fitness Testing of Children	p. 366
Clinical Exercise Testing of Children	p. 372
Assessing Physical Activity in Children	p. 374
Childhood Responses to Physical Activity and Exercise Training	p. 378
Exercise Capacities of Children Versus Adults	p. 379
Exercise Injuries in Children	p. 379
Emotional Distress in Young Athletes	p. 382
Behavior Carryover	p. 383
Exercise Prescription, Guidelines, and Recommendations for Children	p. 384
Geriatric Exercise Physiology	p. 387
Aging	p. 387
Definition of Aging	p. 388
Theories of Aging	p. 389
Aging, Physical Inactivity, and Disability	p. 390
Aging, Health Status, and Functional Capacity	p. 391
Exercise Physiological Changes with Aging	p. 393
The Cardiovascular System	p. 394
The Pulmonary System	p. 397
The Neuromuscular System	p. 397
Exercise Training for the Elderly	p. 400
Exercise Guidelines for Older Adults	p. 400
Female-Specific Issues	p. 405
Comparisons Between the Sexes	p. 405
Morphological Differences	p. 406
Physiological Differences	p. 407
Trainability	p. 411
Gynecological Considerations	p. 413
Menstruation	p. 413
Pregnancy	p. 414
Lactation	p. 417
Menopause	p. 419
Nutritional Issues	p. 419
Osteoporosis	p. 420
Iron Deficiency	p. 421
Eating Disorders	p. 421
Female Athlete Triad	p. 423
Excessive Exercise Disorder	p. 424
Special Nutritional Needs for Women	p. 424
Exercise Physiology for Clinical Populations	p. 429
Clinical Foundations
Introduction to Pharmacology and Pathophysiology	p. 430
Basic Pharmacology	p. 430
Definition of Pharmacology	p. 431
Pharmacokinetics and Pharmacodynamics	p. 431
Commonly Encountered Medications in Clinical Exercise Programs	p. 436
Cardiovascular Medications	p. 436
Pulmonary Medications	p. 442
Overview of Cardiovascular Pathophysiology	p. 444
Signs and Symptoms of Cardiovascular Disease	p. 444
Cardiovascular Disorders	p. 447
Overview of Pulmonary Pathophysiology	p. 450
Chronic Obstructive Pulmonary Diseases	p. 451
Restrictive Lung Disease	p. 452
Respiratory Acidosis and Alkalosis	p. 453
Overview of Metabolic Pathophysiology	p. 455
Diabetes Mellitus	p. 455
Metabolic Acidosis and Alkalosis	p. 455
Disablement and Exercise Prescription	p. 458
Conceptualization of Disability	p. 458
A Public Health Initiative	p. 458
Pathway to Disablement	p. 460
Disablement Models	p. 462
The Nagi Model of Disablement	p. 462
A New Perspective on the Disablement Process Model	p. 464
Disability and the Exercise Prescription	p. 466
Passive Stimulus-Response Paradigm	p. 466
Exercise Prescription Intervention Triad	p. 468
Functional Status	p. 471
Activity and Dosage	p. 471
Clinical Exercise Testing	p. 474
Measuring Cardiovascular Endurance	p. 474
Ventilatory and Lactate Threshold	p. 475
Determining VO[subscript 2max]	p. 475
Principles of Exercise Testing	p. 479
Sensitivity, Specificity, and Predictive Accuracy of Exercise Testing	p. 480
Health Screening and Risk Stratification Prior to Exercise Testing	p. 481
Selecting the Graded Exercise Protocol	p. 484
Treadmill Protocols	p. 486
Leg and Arm Ergometer Protocols	p. 487
Field and Submaximal Exercise Testing	p. 488
Exercise Electrocardiography	p. 489
The 12-Lead Electrocardiogram	p. 489
Recognizing Ischemic Responses	p. 496
Recognizing Arrhythmias	p. 499
The Graded Exercise Test	p. 506
Preparation for Testing	p. 506
Components of the Graded Exercise Test	p. 509
Absolute Indications	p. 509
Relative Indications	p. 510
Interpreting Results	p. 510
Exercise Rehabilitation and Specific Disorders
Exercise for Cardiopulmonary Disorders	p. 513
Cardiovascular Endurance, Physical Activity, and Health	p. 513
The Exercise Prescription	p. 517
The Exercise Prescription Intervention Triad	p. 518
Exercise Prescription for Cardiovascular Endurance Impairment	p. 518
Cardiopulmonary Rehabilitation	p. 519
The Exercise Session	p. 523
Sequencing	p. 525
Environment and Feedback	p. 526
Exercise for Obesity and Weight Control	p. 529
Problems with Obesity	p. 529
The Prevalence of Obesity	p. 530
Obesity and Disease Risk	p. 530
Exercise, Body Weight, and Health	p. 531
Assessment of the Overweight Patient	p. 532
Etiology of Obesity	p. 532
Genetics and Body Weight	p. 532
Energy Intake and Body Fatness	p. 535
Diet Composition and Body Composition	p. 536
Inactivity and Overweight	p. 537
Metabolic Rate and Overweight	p. 538
Psychological Aspects of Obesity	p. 539
The Psychological Profile of the Obese Person	p. 539
Body Image Disparagement	p. 540
Emotional Distress and Weight Control	p. 541
Barriers to Weight Control	p. 543
Effectiveness of Exercise in Weight Control	p. 544
Exercise and Metabolism	p. 544
Exercise Intensity and Substrate Use	p. 547
Exercise and Weight-Loss Success	p. 547
The Exercise Prescription	p. 548
Relapse Prevention	p. 550
Exercise for Oncological and Neuromusculoskeletal Disorders	p. 554
Brain and Nerve Disorders	p. 554
Stroke	p. 555
Multiple Sclerosis	p. 557
Muscular Dystrophy	p. 560
Epilepsy	p. 562
Parkinson Disease	p. 563
Alzheimer Disease	p. 563
Cancers	p. 566
Etiologies, Symptoms, and Prognosis	p. 566
Exercise Benefits	p. 568
Exercise Prescription	p. 571
Bone and Joint Disorders	p. 571
Etiologies, Symptoms and Prognosis	p. 572
Exercise Benefits	p. 573
Exercise Prescription	p. 573
Experiences in Work Physiology	p. 577
Tests and Measures Used in Exercise Physiology	p. 578
Analyzing Your Diet	p. 579
Temperature Regulation During Exercise	p. 581
Measuring Metabolic Transitions from Rest to Exercise	p. 582
Measuring Cycling Efficiency	p. 584
Ventilatory Threshold	p. 585
Isometric Contractions and Cardiovascular Function	p. 586
Cardiovascular Adjustments to Exercising in the Heat or Cold	p. 588
Nerve Conduction Velocity	p. 590
Muscle-Length Tension Relationship	p. 591
Taking SOAP Notes to Evaluate Dietary Supplements	p. 592
Body Composition	p. 594
Fitness Testing and Activity Monitoring	p. 597
Comparison of Fitness Evaluations Between Genders	p. 599
Discussing Differential Diagnosis of Chest Pain	p. 602
The Relationship Between VO[subscript 2] and Heart Rate During Wheelchair Exercise	p. 604
Vector Analysis of the Mean QRS Axis	p. 605
Assessment of the Overweight Patient	p. 607
Appendices
Answers to Summary Knowledge Questions	p. 609
Glossary	p. 621
Index	p. 639
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