Exercise Therapy

Prevention and Treatment of Disease

John Gormley, Juliette Hussey, John Gormley, Juliette Hussey

• Publisher: Wiley-Blackwell
• Year: 2009
• Print ISBN: 9781405105279
• eBook ISBN: 9781405144551
• Edition: 1
• Topic: Medicine
• Subtopic: Physiotherapy, Physical Medicine & Rehabilitation

Though exercise has been the mainstay of musculoskeletal physiotherapy for decades, its value in other systems of the body, such as cardiovascular, respiratory and neurological has emerged in recent years. This trend is being increasingly reflected in degree curricula.

This novel textbook is designed predominantly for physiotherapists and offers a dynamic insight into the applications of exercise therapy across the body's systems in disease management and health promotion.

The focus on exercise as a crucial modality in preventing and treating disease will attract readers following courses in sport & exercise science and physical activity as well as physiotherapy. The book will also appeal to practitioners, particularly those pursuing post-qualification courses in rehabilitation.

Table of contents

• PREFACE
• ACKNOWLEDGEMENTS
• CONTRIBUTORS
• SECTION 1
• Chapter 1
• INTRODUCTION
• Juliette Hussey
• Exercise as a part of physiotherapy
• Exercise recommendations for health
• Physical activity and its health benefits
• How physical activity levels have decreased
• The future
• References
• Bibliography
• Chapter 2
• CARDIOVASCULAR RESPONSES TO EXERCISE
• Christopher Bell and Saoirse E. O’Sullivan
• Introduction
• Acute exercise
• Muscle blood flow
• Systemic circulatory adjustments
• Pulmonary circulatory adjustments
• Cardiovascular limitations to acute exercise
• Limits to heart rate
• Limits to effective blood volume
• Limits in women and children
• Potentially adverse cardiovascular effects of exercise
• Renal ischaemia
• Haemolysis
• Hyperthermia
• Foetoplacental insufficiency
• Syncope
• Hypertension
• Chronic exercise
• Blood volume changes
• Cardiac changes
• Blood pressure control
• Structural and functional adaptations of the vasculature
• Cardiovascular detraining
• Exercise in the ageing patient
• References
• Bibliography
• Chapter 3
• EXERCISE AND THE PULMONARY SYSTEM
• Stephen J. Lane and Richard J. Hawksworth
• Introduction
• The external environment and the lung
• Structure and function of the lung
• Control of ventilation
• Respiratory failure
• Exercise and the pulmonary system
• Changes in the respiratory system with ageing
• Respiratory responses to exercise
• Dead space
• Pulmonary ventilation
• Respiratory work
• Minute ventilation
• Effects of physical activity and training on lung function parameters
• References
• Bibliography
• Chapter 4
• EXERCISE AND THE MUSCULOSKELETAL SYSTEM
• Gareth W. Davison, Tony Ashton and Ciara M. Hughes
• Introduction
• SKELETAL MUSCLE
• Muscle structure and function
• The muscle fibre
• Human skeletal muscle
• Structure
• Skeletal muscle fibre types
• Skeletal muscle connective tissue
• Muscle innervation by the nervous system
• Action potential conduction and synaptic transmission
• The neuromuscular junction
• Muscle contraction
• Skeletal muscle strength and endurance
• Muscle strength
• Muscle endurance
• Skeletal muscle adaptations to aerobic exercise training
• Myoglobin content
• Mitochondrial volume, size and enzymes
• Substrate utilisation
• Skeletal muscle, oxidative stress and antioxidants
• Oxidative stress and exercise
• Enzymatic antioxidant defences
• Non-enzymatic antioxidant defences
• Summary
• BONES AND JOINTS
• Bone and joint structure
• Anatomy of a bone
• Bone histology
• Joint structure
• Bone and joint adaptations to exercise
• Summary
• References
• Chapter 5
• EXERCISE IN DIABETES AND OBESITY
• Donal O’Gorman and John Nolan
• Introduction
• Obesity
• Classification of obesity
• Aetiology of obesity
• Obesity, type 2 diabetes and cardiovascular disease
• Type 2 diabetes
• Impaired glucose tolerance (IGT) and type 2 diabetes
• Symptoms of type 2 diabetes
• Aetiology of type 2 diabetes
• Complications associated with type 2 diabetes
• Young type 2 diabetes
• Exercise for obesity and type 2 diabetes
• Body weight and energy balance
• Exercise and weight loss
• Insulin resistance
• Exercise in obesity, type 2 diabetes and cardiovascular disease
• Prevention strategies
• The Finnish Diabetes Prevention Study
• The Diabetes Prevention Program
• Exercise prescription for obese and type 2 diabetes patients
• Needs analysis and goal setting
• Screening prior to exercise prescription
• Exercise prescription in type 2 diabetes
• A case study of exercise prescription and type 2 diabetes
• References
• Bibliography
• SECTION 2
• Chapter 6
• MEASUREMENT OF PHYSICAL FITNESS AND HABITUAL PHYSICAL ACTIVITY
• Juliette Hussey
• Introduction
• Exercise testing
• Exercise testing in the laboratory
• Exercise tests in the field/clinical setting
• Monitoring exercise responses
• Screening and safety
• Muscle strength
• Flexibility
• Anthropometry
• Measurement of habitual physical activity
• Observation
• Self report/diaries/questionnaires
• Motion sensors
• Heart rate monitoring
• Summary
• Appendix 6.1
• References
• Chapter 7
• GUIDELINES FOR EXERCISE PRESCRIPTION
• Juliette Hussey
• Introduction
• Safety and pre-participation screening
• Exercise prescription
• Principles of exercise prescription for increasing and/or maintaining fitness
• Intensity
• Duration
• Frequency
• FITT principles
• Warm up, cool down and stretching
• Muscle strengthening exercises
• Guidelines for exercise prescription in the elderly and children
• Elderly
• Children and adolescents
• Exercise prescription for diseases/conditions not referred to elsewhere in this book
• Renal disease
• Chronic fatigue syndrome
• HIV
• Cancer
• Psychological well-being
• Learning disability
• References
• Bibliography
• Chapter 8
• EXERCISE IN PREVENTION AND TREATMENT OF CARDIOVASCULAR DISEASE
• John Gormley
• Introduction
• The problem of cardiovascular disease
• Cardiovascular diseases
• Diseases of the heart
• Cerebrovascular disease
• Peripheral vascular disease
• Risk factors for cardiovascular disease
• Non-modifiable risk factors
• Modifiable risk factors
• Exercise as a preventative measure for cardiovascular disease
• Hyperlipidaemia
• Hypertension
• Exercise in the treatment of myocardial infarction (cardiac rehabilitation)
• Exercise test
• Phase III
• Phase IV
• Exercise in the treatment of other cardiovascular disease
• References
• Bibliography
• Chapter 9
• EXERCISE IN THE TREATMENT OF RESPIRATORY DISEASE
• Brenda O’Neill, Judy M. Bradley and Fidelma Moran
• Introduction
• The abnormal responses to exercise in patients with respiratory disease
• Evidence of benefit of exercise in respiratory disease
• Exercise testing and assessment of outcome in respiratory disease
• Maximal versus sub-maximal exercise tests
• Clinical laboratory testing in respiratory disease
• Field exercise tests in respiratory disease
• Peak tests
• Sub-maximal tests
• General principles for exercise testing in respiratory disease
• Training required
• Indications for stopping an exercise test
• Other outcome measures used in the evaluation of exercise training for respiratory conditions
• General principles of exercise training and prescription in respiratory disease
• Intensity
• Frequency and duration of exercise sessions
• Type of exercise
• Duration of exercise programmes
• Precautions to exercise in respiratory disease
• Monitoring during exercise in respiratory patients
• Pulmonary rehabilitation
• Special considerations for exercise in respiratory disease
• Conclusion
• References
• Bibliography
• Chapter 10
• EXERCISE IN THE TREATMENT OF MUSCULOSKELETAL DISEASE
• Fiona Wilson-O’Toole
• Introduction
• Exercise in the management of inflammatory arthropathies
• Aerobic training
• Range of movement exercises
• Strengthening exercises
• Flexibility
• Exercise in water
• Exercise in the management of osteoporosis
• Signs and symptoms of osteoporosis
• Aerobic training
• Strengthening exercises
• Flexibility and range of movement exercises
• Proprioceptive and balance training
• Exercise in the management of osteoarthritis
• Signs and symptoms of osteoarthritis
• Aerobic training
• Strengthening exercises
• Flexibility and range of movement exercises
• Proprioceptive and balance training
• Exercise in the treatment of low back pain
• Aerobic training
• Strengthening exercises
• Flexibility and range of movement exercises
• Proprioceptive and balance training
• References
• Chapter 11
• EXERCISE AS PART OF THE MULTIDISCIPLINARY MANAGEMENT OF ADULTS AND CHILDREN WITH OBESITY
• Alison Quinn and Juliette Hussey
• Introduction
• Understanding obesity
• Health risks of obesity
• Treatment of adults with obesity
• Physiotherapy management of the adult with obesity
• Exercise prescription
• Monitoring/review
• Exercise prescription following surgery
• Treatment of children with obesity
• Physiotherapy management of the child
• The fit/fat debate
• Prevention of obesity
• Exercise treatment in type 2 diabetes
• Exercise treatment in type 1 diabetes
• References
• Bibliography
• Chapter 12
• EXERCISE IN TREATMENT OF STROKE AND OTHER NEUROLOGICAL CONDITIONS
• Margaret Brownlee and Brian Durward
• Introduction
• Stroke
• Strength deficits in stroke patients
• Evidence of strength deficits in stroke patients
• Factors contributing to strength deficits in stroke
• Measurement of strength
• Medical Research Council (MRC) Scale
• Hand held dynamometry (HHD)
• Isokinetic dynamometry
• Distribution of weakness in stroke patients
• Strength training following stroke
• Strength training and spasticity
• Effects of strength training
• Cardiorespiratory deficits in stroke
• Co-morbid deficits
• Resultant deficits
• Measurement of cardiorespiratory fitness
• Aerobic exercise following stroke
• Effects of aerobic training
• Exercise in other neurological conditions
• Spinal cord injury
• Traumatic brain injury
• Parkinson’s disease
• Multiple sclerosis
• References
• Bibliography
• Chapter 13
• ADHERENCE TO EXERCISE
• John Gormley
• Introduction
• The definition of adherence
• Patient factors
• Age
• Gender
• Socio-economic group
• Fear
• Patient perceptions and beliefs
• Social support
• Programme factors
• Personnel
• Education
• Individualised attention
• Group dynamics
• Logistics of a programme
• The exercise prescription
• Frequency
• Duration
• Intensity
• Behavioural change
• References
• Bibliography
• Chapter 14
• PROMOTING PHYSICAL ACTIVITY: BUILDING SUSTAINABLE INTERVENTIONS
• Lindsey Dugdill and Rebecca Graham
• Introduction
• Rationale for the promotion of physically active lifestyles
• Strategies for changing physical activity behaviour
• Promoting physical activity in different settings
• Socio-ecological models for physical activity promotion
• A European perspective on physical activity promotion: HEPA – Health Enhancing Physical Activity
• Research case study 1: evaluation of the Liverpool Corporate Cup
• Rationale for the corporate series
• Development of the corporate series
• Developing the evidence base: the research design
• Research findings
• Research case study 2: evaluation of an adult exercise referral scheme, EXCEL, Sefton, Merseyside
• Rationale for primary care based exercise promotion
• EXCEL – Excel to Health exercise referral intervention
• Research design
• Research findings
• GPs’ views and opinions on the EXCEL programme
• Summary of main findings
• Conclusions
• Acknowledgements
• References
• INDEX