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By studying this chapter, you should be able to do the following:

  1. Describe the difference between type 1 and type 2 diabetes.

  2. Explain why exercise may complicate the life of a person with type 1 diabetes, while being a recommended and primary part of a program for someone with type 2 diabetes.

  3. Describe the changes in diet and insulin that might be made prior to a person with diabetes doing exercise.

  4. Describe the cause of exercise-induced asthma, and how one may deal with this problem as part of an exercise prescription.

  5. Contrast chronic obstructive pulmonary disease (COPD) with asthma in terms of causes, prognosis, and the role of rehabilitation programs in a return to “normal” function.

  6. Identify the types of patient populations that one might see in a cardiac rehabilitation program.

  7. Contrast Phase I with Phase II and Phase III cardiac rehabilitation programs.

  8. Describe the physiological changes in older adults that result from an endurance-training program.

  9. Outline the physical activity recommendations for older adults who cannot do the regular adult program.

  10. Describe the guidelines for exercise programs for pregnant women.



  • Exercise and Diabetes


  • Diagnosis and Causes

  • Prevention/Relief of Asthma

  • Exercise-Induced Asthma

Chronic Obstructive Pulmonary Disease

  • Testing and Training


Cardiac Rehabilitation

  • Population

  • Testing

  • Exercise Programs

Exercise for Older Adults

  • Maximal Aerobic Power

  • Response to Training

  • Bone Health and Osteoporosis

  • Strength

Exercise During Pregnancy

  • Exercise and Cancer

  • Individualized Exercise Prescriptions

  • Managing Functional Limitations

  • Supervised and Independent Exercise

  • Exercise Recommendations for Cancer Patients

Key Terms


beta-receptor agonist (β2-agonist)

coronary artery bypass

graft (CABG)

cromolyn sodium

diabetic coma


insulin shock


mast cell

myocardial infarction (MI)


percutaneous transluminal

coronary angioplasty (PTCA)

Chapter 16 presented some recommendations for planning an appropriate exercise program for the apparently healthy individual. Exercise has also been used as a primary nonpharmacological intervention for a variety of problems, such as obesity and mild hypertension, and as a normal part of therapy for the treatment of diabetes and coronary heart disease. More recently, exercise rehabilitation has been introduced as a treatment option for those with cancer and other serious conditions. This chapter discusses the special concerns that must be addressed when exercise is used for populations with specific diseases, disabilities, or limitations. However, the student of exercise science should recognize that this information is introductory in nature. See ACSM’s Exercise Management for Persons with Chronic Diseases and Disabilities in Suggested Readings for a comprehensive look at this topic.


Exercise and Diabetes

As described in Chap. 15, diabetes is a disease characterized by hyperglycemia (elevated blood glucose) resulting from inadequate insulin secretion (type 1), reduced insulin action (type 2), or both (8). In Chaps. 4 and 5, we described how exercise increases the rate at which muscle removes glucose from the blood to provide energy ...

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