ACSM's Resource Manual for Guidelines for Exercise Testing and Prescription, 2d ed.

Durstine JL, King AC, Painter PL, Roitman JL, eds. Malvern, PA 19355-9725, Lea & Febiger, 1993, hardback, 596 pp, illus, $59.50.

This book attempts to serve as the primary study guide for those preparing to take the American College of Sports Medicine's (ACSM's) certification examinations in preventive- and rehabilitative-exercise programming. Rather than serving as a sole reference, this text is designed to be used with the ACSM's Guidelines for Exercise Testing and Prescription and other references that provide more in-depth coverage of the topics.

The first five chapters review elementary anatomy, physiology, and biomechanics that are relevant to exercise testing and prescription. This section includes a chapter on exercise and low back pain. This chapter presents a balanced approach to therapeutic exercise for low back dysfunction and emphasizes the concept that rest is not the treatment of choice for the patient with low back pain. There are, however, serious flaws in this chapter. For instance, the only potential cause of low back pain the authors address is a lesion of the intervertebral disk.

The next section of the book reviews the principles of exercise physiology and includes excellent overviews of skeletal muscle fatigue and specificity of exercise. The remainder of the book is divided into the following sections: "Pathophysiology"; "Health Appraisal and Exercise Testing"; "Exercise Programming;" "Safety, Injuries, and Emergency Procedures"; "Human Development and Aging"; "Human Behavior/Psychology"; and "Administrative Concerns." There are two appendixes, one on exercise physiology terminology, and the other is a 1992 position paper from the American Society of Hypertension entitled, "Recommendations for Routine Blood Pressure Measurements by indirect Cuff Sphygmomanometry." Especially noteworthy chapters include "Pharmacologic Factors in Exercise and Exercise Testing"; "Additional Diagnostic Tests: Special Populations"; "Home Exercise Training for Coronary Patients"; "The Safety of Exercise Testing and Participation"; "Physiologic Changes Over the Years"; "Weight Management"; and "Legal Consideration."

The authors have made very good use of illustrations and tables throughout the text, using them to support rather than replace written material. The material is organized well and is comprehensive. Most of the chapters reference early, seminal primary reports as well as current material, but a few authors rely heavily on secondary or outdated primary references. The newest primary reference in one chapter was published in 1984; others, however, refer to original research reported in 1992.

Overall, the authors of this book do a very good job of accomplishing their objective-- serving as a study guide for someone preparing to take the various ACSM certification examinations. The material, however, does not contain sufficient detail for a student of exercise physiology and is too basic for a practicing clinician. I do not believe most physical therapists will find the book useful unless they are preparing for ACSM certification. Individuals practicing in the area of cardiac rehabilitation, however, may find the book useful as a quick reference almost any aspect of exercise testing and prescription.