Live Stronger, Live Longer: An Exercise and Lifestyle Program for Over 40s.

Awerbuch M. Roseville, NSW, Australia, 2069, McGraw-Hill Australia Pry Ltd, 2001, paperback, 248 pp, illus, ISBN: 0-07-471087-7, $29.95.

The author of this book sets out to present "a formula with the potential to improve the quality and duration of life of people over 40 and persons with arthritis irrespective of age." The book is written to be used by lay people with minimal supervision from fitness professionals or physical therapists.

The book is divided into 2 parts, with 3 appendixes and an extensive bibliography. The first part consists of 10 chapters. The first 4 chapters present the dangers of inactivity and obesity. Chapters 5 and 6 outline a general framework for a healthy diet and discuss several types of dietary fat and their effects on general health and arthritis.

In chapter 7, the author reviews general exercise adaptations for people with 4 types of arthritis: osteoarthritis, chronic inflammatory arthritis, fibromyalgia, and ankylosing spondylitis. The topic of functional classifications for people with arthritis is presented here and referred to in the section of the book on exercise programs. Part 1 closes with a discussion of the role of exercise in reducing the negative consequences of aging and offers practical considerations in starting to exercise (eg, footwear, clothing, posture, and scheduling).

Part 2 presents specific exercises and a plan to develop an exercise regimen. Chapter 11 describes a simple warm-up and cool-down consisting of cardiovascular exercise and a series of 7 stretches. Chapter 12 contains descriptions of 47 strength training exercises. Each exercise is presented on a single page with 2 or 3 photographs, clearly written instructions, and several tips on form and safety. In chapter 13, the author presents his method for determining the appropriate level at which to begin exercising. For all readers, the criteria include age, exercise experience, and current fitness level; for those readers with arthritis, functional class is also considered. Chapter 14 outlines 4 strength training programs of increasing volume and intensity. Program formulas and sample routines are presented in table form.

Chapters 15 and 16 present cardiovascular exercise in a similar fashion, using the criteria in chapter 13 to determine an appropriate program level. Chapter 17 describes a supplemental exercise program for readers with low back pain that emphasizes strengthening the transverse abdominus muscle. The book concludes with a chapter on goal setting and motivation.

There are several limitations to the exercise prescriptions contained in this book, which may reduce its value to its intended audience. First, the book's intermediate and advanced strength training programs far exceed the American College of Sports Medicine's recommendations for resistance training. Second, the cardiovascular programs emphasize intensity over frequency and duration, which is not consistent with recommendations often found in current rehabilitation literature. Third, the progression time frames described in the strength training programs should be appropriate for exercisers in their 40s and 50s, but they may prove ambitious for exercisers who are elderly, Older exercisers may also require a longer period of cardiovascular activity in their warm-ups than the 2 minutes recommended in chapter 11.

Fourth, the content in part 2 related to people with arthritis is cursory. Most of the author's recommendations involve seeking professional guidance to start and modify exercise programs. Although the lowest level training programs are appropriate for deconditioned exercisers, the author makes no specific recommendations on what to do if a particular exercise causes pain.

Fifth, Live Longer, Live Stronger contains some references to Australian culture, alternative spellings, and metric measurements that may be confusing to American readers. Many of the resources listed in the appendixes will not be of value to people living outside of Australia.

It would be appropriate to recommend this book to clients who are healthy and under 60 years of age and to clients with mild to moderate arthritis. Clients over 60 years of age and those with debilitating arthritis will require supervision and program modifications to use the exercise regimens in this book safely and successfully.

Gerard G Fluet, PT, MS JFK-Johnson Rehabilitation Institute Edison, NJ

Mr Fluet is Senior Physical Therapist at Johnson Rehabilitation Institute and an adjunct instructor at the University of Medicine and Dentistry of New Jersey. Mr Fluet has taught PACE classes for the Arthritis Foundation, and his research interests include complementary and alternative exercise interventions for people with arthritis.