图书简介
The loss of exercise capacity is diagnostically and prognostically important; and loss of exercise tolerance indicates that something is wrong with an individual. This is a practical, physiologically-based guide to understanding human response to exercise in both health and disease. It provides normal physiology integrated with indications for and evaluation of disease states. With a fresh and clinical approach, it helps answer reoccurring questions such as, “What are the clinical reasons for needing exercise testing? What risks are there for my patient? How do I utilize the test to help my patient?” This book makes sense of complex topics by distilling them to basic concepts.
Section I: Introduction to Exercise Physiology. Common and unique features between humans and other mammals. The transition of metabolism from rest to exercise to insure survival. Humans? ability for sustained work, similar and unique features in the animal kingdom. Section II: Human Physiologic Responses from Rest to Maximal Sustained Effort by System. Aerobic metabolic response-cellular demands. Acid-base responses to a range of exercise efforts. Cardiac response. Peripheral circulation response. Pulmonary response. Muscular response. Section III: Normal Response to Clinical Exercise Testing. Rationale for CPET (Cardio Pulmonary Exercise Test) protocol as a test of exercise capacity. Choosing an exercise protocol to answer the clinical question. Measurements obtained in a standard CPET. Oxygen Consumption. Carbon dioxide output. Heart rate, Blood Pressure, and EKG. Spirometry and Ventilation measurements Tidal Volume, rate, MVV. Respiratory exchange ration (R). Ventilatory equivalent for O2 and CO2. O2 pulse. Identifying a ventilatory threshold and what it means to define sustainable workCutting-balloon angioplasty. Section IV: Clinical Reasons for Subject or Patient Referral: Why do they come in the first place? Section V: CPET in patients with disease. Pretesting Checklist. Risks for CPET in patients with known (or undocumented) disease, ?Red flags? for safety in the patients. Drop in Blood Pressure During or After Exercise. Cardiac events. Syncope. Section VI: Patterns of CPET responses in disease. Underlying heart disease. Underlying Pulmonary Disease: Obstructive (asthma, COPD, Emphysema). Underlying Pulmonary Disease: Restrictive (fibrosis, interstitial lung disease). Underlying Pulmonary Vascular Disease. Myopathies. Combinations of clinical entities. Section VII: Exercise Responses outside the laboratory. Exercise response to training. Normal aging. Extreme endurance athletes. Altitude response. Exercise in extreme heat or cold. Different exercise modes: Cross-country skiing running, biking, swimming. Overtraining Syndrome. Ergogenic Aids, Legal and Illegal. Genetics of training and trainability. Appendix: Exercise Systems and Technology.
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