Exercise Testing and Interpretation: a Practical Approach.

Cooper CB, Storer TW. New York, NY 10011-4211, Cambridge University Press, 2001, paperback, 289 pp, illus, ISBN: 0-521-64842-4, $44.95.

Fitness evaluations and the management of patients with cardiopulmonary disorders are growing segments of physical therapist practice. Unfortunately, many professional physical therapist education programs provide only cursory coverage of the evaluation of cardiopulmonary fitness, and most texts used in physical therapist education programs do not provide sufficient detail to be stand-alone sources for exercise testing and interpretation. Numerous exercise testing guides exist; however, they are often too simplistic for sophisticated clinical settings or are designed for research laboratories and use measurement techniques that are impractical in patient care.

Cooper and Storer promise a "practical and systematic approach to the acquisition, interpretation and reporting of physiological responses to exercise." The authors deliver on their promise and have provided a succinct, but thorough and practical, book on exercise testing and interpretation that should be of interest to physical therapists who are seeking to improve their knowledge in this area.

The book is divided into 6 chapters. Chapter 1 provides general background content and the obligatory coverage of basic energy metabolism. Chapter 2 covers equipment needs for exercise testing and some basic concepts of measurement such as validation, calibration, precision of measures, gas analysis, measurement of ventilation, pulse oximetry, and related topics. Chapter 3 covers specifics on the technical aspects of testing (eg, maximal and submaximal testing, field tests and performance tests, and testing modes such as treadmill cycle ergometers and walk tests), professional requirements for supervision of testing, and safety considerations. Chapter 4 covers the data collected from exercise testing and provides information on basic ergometry concepts (eg, work, power) and then covers cardiovascular and pulmonary response variables. The figure that compared and contrasted the flow volume loops for a subject without impairments, a patient with chronic obstructive pulmonary disorder, and a person with restrictive lung disease was very useful, and many of my students found the figure helpful. Chapter 5 covers the more complex task of synthesizing the data collected from testing and presents a systematic analytical process that should help demystify data synthesis for students. Chapter 6 provides case studies and testing reports for typical subjects who receive exercise testing with an analysis of data based on the authors' system. The appendixes provide many useful tables and other pertinent information, enhancing the value of the text.

Overall, I believe the authors have delivered on their promise to provide a practical and systematic approach to clinical exercise testing. The coverage of information is more in-depth than that typically found in cardiopulmonary rehabilitation texts. It is clearly written, liberally illustrated, and thoroughly referenced. In my opinion, this work would be an excellent choice for a special topics course on exercise testing in medical, physical therapist, or exercise science education programs.

Daniel Martin, PT, PhD
University of Florida
Gainesville, Fla

Dr Martin is Associate Professor in the Department of Physical Therapy. His current research projects include effects of inspiratory muscle training on dyspnea perception in patients with chronic obstructive pulmonary disorder and the effects of inspiratory muscle training for patients who are dependent on ventilators.