Exercise Physiology John P. Porcari, PhD, RCEP, MAACVPR, FACSM Program Director Clinical Exercise Physiology University of Wisconsin La Crosse Executive Director La Crosse Exercise and Health Program La Crosse, Wisconsin Cedric X. Bryant, PhD, FACSM Chief Science Officer American Council on Exercise San Diego, California Fabio Comana, MA, MS Faculty Instructor San Diego State University, School of Exercise & Nutritional Sciences National Academy of Sports Medicine San Diego, California F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com Copyright © 2015 by F. A. Davis Company Copyright © 2015 by F. A. Davis Company. All rights reserved. This product is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Publisher:Quincy McDonald Director of Content Development: George W. Lang Developmental Editor: Nancy J. Peterson Art and Design Manager: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Library of Congress Cataloging-in-Publication Data Proudly sourced and uploaded by [StormRG] Porcari, John P., 1955- , author. Kickass Torrents | TPB | ET | h33t Exercise physiology / John P. Porcari, Cedric X. Bryant, Fabio Comana. p.; cm. Includes bibliographical references and index. ISBN 978-0-8036-2555-6 (alk. paper) I. Bryant, Cedric X., 1960- , author. II. Comana, Fabio, author. III. Title. [DNLM: 1. Exercise—physiology. 2. Physical Fitness—physiology. QT 256] QP301 612’.044—dc23 2014038201 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 978-0-8036-2555-6 / 1 0 + $.25. iii I dedicate this book to my parents, Virginia and Michael (deceased) Porcari. There is a book by Robert Fulghum entitled All I Really Need to Know I Learned in Kindergarten: Uncommon Thoughts on Common Things.I would say that everything I needed to learn about life I learned at 110 Wheeler Avenue in Orange, Massachusetts...my home. My parents raised four children and treated us all with selflessness and unequivocal love. For that, my brother, my two sisters, and I will be forever grateful. —J.P. To my late parents, Joe and Buelah, who are without question the two people most re- sponsible for any success I have experienced personally or professionally. I thank them for instilling in me a love of learning and a commitment to “doing the right things the right way.” I share any and all accomplishments with them. —C.X.B. To my parents...the beacons in my life. Words will never convey my gratitude for all you have given to me. Thank you for your relentless and unwavering support. —F.C. iii Foreword Exercise Physiologyis a well-conceived, bold new publi- also transcend different careers, so the diverse reader- cation that wonderfully bridges the gap between the ship of the text will actually be able to identify with the theory and practice of all areas in exercise physiology. situations. The book content is richly supported with This book is sensibly targeted to students who are seek- numerous graphics, tables, illustrations, photographs, ing careers in exercise physiology, exercise science, and ancillary materials. physical education, physical therapy, occupational One of the highlights of Exercise Physiologyis the use therapy, sports nutrition, athletic performance, and of enlightening practical examples of complex physio- sports medicine. Exercise Physiologyalso clearly provides logical and/or metabolic principles. In each chapter, a relevant, evidence-based source for professionals in various sport, clinical, health, and fitness examples are the fitness industry, including group fitness instructors, included that supplement and expand on the content. personal trainers, strength and conditioning specialists, These examples are written to stimulate students to athletic coaches, and health coaches. This resource is analyze and better understand scientific principles of optimally targeted for students who have completed exercise physiology. basic college course work in general biology, chemistry, Compelling features throughout the text include Re- and anatomy and physiology. search Highlights. The Highlights are succinctly written One of the overriding achievements that the editors briefs that convey the core findings of eye-opening of and contributors to this textbook successfully accom- research, insight into thought-provoking research plish is providing educational material that is applica- questions, answers to controversial concepts, and/or ble, meaningful, and understandable. Each chapter interview responses from preeminent researchers. proceeds in a logical and readable format, beginning These self-contained objective statements describe a with specific learning outcomes that are followed by a larger investigation with informative and useful study real-world vignette, which immediately captures and findings. engages the interest of the reader. The original vi- The authors positively engage the readers with the gnettes are descriptive narratives that reveal meaning- use of In Your Own Words features within chapters, ful issues based on the chapter topic. They introduce a which are interactive questions to the reader. These ex- tone for the chapter with resonating questions that are periential learning events help the student integrate resolved at the end of the chapter. The authors the concepts of the chapter with a student-centered thoughtfully showcase a breadth and depth of individ- learning approach. Also, the Critical Thinking Ques- uals by age, sex, and ethnicity with the vignettes. They tions at the end of chapters motivate the student to v vi Foreword synthesize some all-inclusive learning outcomes, thus Exercise Physiology is going to have a dominant and increasing the student’s curiosity for, and engagement long-lasting influence in the field of exercise physiol- with, the chapter material. ogy. This text is a welcome new addition to some Another special feature of Exercise Physiology is the vintage resources that have not addressed the needs of Doing the Math section in certain chapters. The au- present-day students and professionals. The authors thors provide the reader with the tools to do the nec- methodically incorporate contemporary principles of essary physiological calculations and then provide exercise physiology, scrupulously researched material, real-world associations to functional concepts. By compelling figures and graphics, and mind-opening teaching the reader how to execute the calculations, a pedagogical strategies into an easy-to-understand text- better understanding of the framework of the question book. All of this combined will truly capture the inter- is developed. est of the exercise physiology student and hopefully Perhaps the most significant difference between this inspire her or him to read and learn with a passion to 30-chapter textbook and others currently on the mar- understand. ket is Part IV: Physiology of Training. This part includes the following seven chapters: Principles of Exercise Len Kravitz, PhD Training, Stability and Mobility Training, Cardiorespi- Coordinator of Exercise Science ratory Training, Resistance Training, Flexibility Train- Department of Health, Exercise ing, Skill-Related Training, and Mind–Body Exercise and Sports Sciences and Fitness. These subjects are so timely and relevant University of New Mexico in providing the reader with the skills, knowledge, and Albuquerque, New Mexico “hands-on” tools to apply the theory in a real-world situation. The Physiology of Training chapters represent a unique blending of exercise physiology with exercise and practical application. Preface Over the past several years, curricula in exercise Today, ACE educates, certifies, and represents more science programs have been moving toward a more than 55,000 fitness professionals, health coaches, and applied direction, integrating science with practice. other allied health professionals. ACE advocates for a Much of this movement has been triggered by growth new intersection of fitness and health care, bringing in the job market in the fitness industry and students’ the highly qualified professionals that ACE represents desire to acquire the necessary knowledge, skills, and into the healthcare continuum so they can contribute abilities to compete for those jobs. Current textbooks to the national solution to physical inactivity and obe- and training materials tend toward a theoretical and sity. ACE is the largest certifier in its space; all four of scientific approach, often leaving students confused its primary certification programs are accredited by about the relevancy of this education to their future the National Commission for Certifying Agencies careers. Therefore, the burden has fallen on educa- (NCCA), the gold standard in the U.S. for assessing tors to connect knowledge with application. professional competence. ACE also plays an important The partnership of F.A. Davis with the American public-service role, conducting research and making Council on Exercise (ACE) has provided the opportunity available science-based information and resources on to create a textbook package that is application based safe and effective physical activity and sustainable and geared toward today’s students and future exercise behavior change. science professionals. This text marries a robust group of ACE’s leadership on this endeavor has resulted in a features with technologically driven ancillaries to pro- relevant, timely, and comprehensive primary course vide students and educators with a complete teaching textbook on exercise physiology. This text meets the and learning package endorsed by one of the most cred- needs of exercise science students who take an exercise ible organizations in the health and fitness industry. physiology course as part of their coursework toward a Founded in 1985, ACE is a nonprofit organization degree in exercise science, athletic training, coaching, that is committed to America’s health and well-being. exercise physiology, fitness, health and human perform- Over the past 30 years, ACE has become an established ance, physical education, nutrition, physical therapy, resource for both fitness professionals and consumers, or sports medicine. It will also benefit individuals who providing comprehensive, unbiased, scientific research already are members of the fitness industry, including impacting the fitness industry and proving to be a personal trainers, medical or clinical exercise specialists, trusted authority on fitness. group fitness instructors, and health coaches, who are vii viii Preface preparing for examinations or simply strengthening (cid:129)Part IV: Physiology of Training focuses on their knowledge base. the practical application and incorporation As an edited text, Exercise Physiology utilizes experts of many of the principles presented in earlier from diverse areas within the field to author chapters chapters. General principles of exercise training on their specialty topics. Combined with a rigorous re- are followed by chapters covering specific view and development process, the text has benefited topics such as stability and mobility, cardiores- from the guidance and expertise of many of the bright- piratory training, resistance training, flexibility est and most active minds in the field. training, skill-related training, and mind–body exercise. (cid:129)Part V: Nutritional Strategies outlines the lat- est information relative to nutrition, hydration, GUIDING PRINCIPLES and ergogenic aids for exercise and sports. Several philosophical principles guide the tone and (cid:129)Part VI: Obesity and Weight Management content of this textbook: covers an area of major concern for many of the (cid:129)Application—The main distinguishing feature of clients with whom health and fitness profession- this textbook is its applied approach: a hands-on, als work on a daily basis. application-based manual that is practical and (cid:129)Part VII: Fitness Across the Life Spanad- relevant. This approach is evident through in-text dresses information relative to exercising during examples, special features, and the art program. all decades of life—from the growth and matura- (cid:129)Focus on Diverse Populations—This textbook tion process in young exercisers to specific focuses on exercise physiology principles that are programming guidelines for older adults. applied to a wide variety of populations, not just (cid:129)Part VIII: Special Considerations explains athletes. common medical conditions and environmental (cid:129)Affective Domain—This textbook includes the challenges that are likely to be encountered by emotional/affective aspect of exercise physiology health and fitness professionals as they work practice, such as interpersonal communication with clients. This part also provides the latest and exercise as an experience, in translating guidelines for programming exercise for special the science into practical knowledge. populations. Exercise-related injuries are described, (cid:129)Forward Looking—This textbook looks forward, followed by guidelines for safely progressing focusing on current trends and research, without individuals during the recovery process. extensive historical coverage. UNIQUE FEATURES ORGANIZATION Educators and students alike find special features to be Exercise Physiology is organized for an intuitive, logical useful in helping the learner comprehend and retain flow of content in the following manner: new information, as well as envision how it will apply (cid:129)Part I: Introduction to Exercise Physiology to practice. Exercise Physiology offers several unique ped- gives students an appreciation of the field of ex- agogical features: ercise physiology as a discipline and an under- (cid:129)Vignettes open each chapter and pose a standing of how it fits into the “real world.” It thought-provoking question or concept to grab clarifies the differences and interrelationships the reader’s interest and showcase the relevance among physical activity, fitness, and health. of content. Vignettes progress through the chap- (cid:129)Part II: Fueling Physical Activity explains ter and are resolved in a Vignette Conclusion the relationship between energy and physical at the end. Importantly, they are extremely activity and exercise, beginning with the diverse in terms of individuals (i.e., age, ethnic- macronutrients and micronutrients in the diet ity, and sex), types of professionals/careers (i.e., and their specific roles within the body, and con- athletic trainers, physical therapists, and exercise tinuing with the energy pathways that make it physiologists), and settings (i.e., gym, field, or possible to perform physical work. laboratory), so students from all fields will see (cid:129)Part III: Physiological Systems describes the themselves in the “story.” many physiological systems that must work in a (cid:129)In Your Own Words entries provide students coordinated fashion to allow the body to main- with opportunities to focus on and practice es- tain sustained physical exertion: the respiratory sential affective skills that will help to make them system, cardiovascular system, muscular and successful professionals. For example, students nervous system, endocrine system, and ther- are presented with a situation and then asked to moregulatory system, including both acute and articulate, in their own words, how they would chronic (adaptive) responses of these systems to respond. This feature encourages professional exercise. behavior in students and future professionals. Preface ix (cid:129)Research Highlightfeatures emphasize evi- not overly theoretical. Students and educators can also dence-based practice by presenting key research be assured of a sound evidence base supporting all con- and how it applies to practice today. tent, evidenced by current references for all statistics, (cid:129)From Theory to Practicefeatures showcase exercise guidelines, and other sensitive information. real-world examples of how an exercise physiol- Rigorous development and review processes were ogy principle affects fitness and sports perfor- followed to ensure the most timely, clearly organized mance, and how it can be manipulated by health and written, and fully accurate and relevant content. and fitness professionals to improve performance. A completely new, full-color art program including (cid:129)Doing the Mathexamples give an applications photographs and illustrations has been created to bring perspective to math calculations, giving the stu- the words to life and clarify what can be complex topics dents the context for how the numbers are used for students. in practice and why they matter. (cid:129)Sex Differencesfeatures highlight significant differences in male and female responses to STUDENT AND EDUCATOR RESOURCES activity and other exercise physiology concepts. (cid:129)Critical Thinking Questions wrap up each Go beyond the book to DavisPlus for additional chapter to give students problem-solving experi- resources that support and reinforce content. Learn- ence. Answer prompts are provided in the ers can see concepts from the book come to life Instructor Resources. via 18 animated videos that describe physiological (cid:129)Additional Resources lists supplemental con- processes within the context of body movement and tent available to readers to support understanding exercise. Online quizzes for each chapter help learn- of chapter content. ers assess their understanding of chapter concepts. To (cid:129)Practice What You Know features are the keep learners up to date on the latest news and career laboratory component of the text, presenting trends related to exercise physiology, podcasts featur- step-by-step experiential exercises to expand ing ACE experts will be posted quarterly. Finally, the student’s knowledge base and practical learners will be able to access links to nutrition experience. calculators to aid their study and practice. For educators, DavisPlusfeatures a test bank with op- tional ExamView Pro software, which makes it easy to customize tests. PowerPoint presentations for each EDITORIAL AND ART GOALS chapter support lectures, and an instructor’s guide and The editors of Exercise Physiologyhave worked with the an image bank help in planning and pacing courses. To contributors to ensure an open, accessible tone and access these valuable online student and instructor re- consistent writing level that will engage students—it is sources, go to DavisPlus at: http://davisplus.fadavis.com.