ACSM’s Exercise Management for Persons With Chronic Diseases and Disabilities, 4th ed.

Exercise intervention on cardiorespiratory fitness in rheumatoid arthritis patients with high cardiovascular disease risk: a single-arm pilot study

“…The exclusion criteria were (1) co-morbidity which severely affects functional ability (Cumulative Illness Rating Score (CIRS) ≥ 2); (2) Kellgren-Lawrence (K&L) grading score of ≥ 3 for hip and/or knee osteoarthritis; (3) contra-indications for exercise testing as indicated by the ACSM guideline (i.e. progressive increase in heart failure symptoms, myocardial infarction less than 3 months before the start of the training programme, severe cardiac ischemia of the upon exertion, respiratory frequency of more than 30 breaths per minute and heart rate (HR) at rest > 110 beats per minute) [16] and (4) insufficient control of the Dutch language and/or cognitive impairments.…”

“…The frequency, intensity, time, type and progression of the exercises were based on a cardiology rehabilitation exercise programme, a rheumatology rehabilitation programme and opinions of experts (cardiologist, rheumatologists, physiotherapists, exercise physiologists). It was also aligned with the ACSM guidelines [16] and the Implementation of Physical Activity into Routine Clinical Practice in Rheumatic Musculoskeletal Disease (IMPACT-RMD) exercise prescription toolkit [23], a newly published process of appropriately reporting exercise dosage. The intensity of the exercise programme was based on the maximum heart rate (HR max ) determined from the baseline exercise tests which started at 65% and progressed to 85% of the HR max .…”

“…After 4 weeks of training, three functional and/or muscle strength exercises were added to the training programme, as per the ACSM guidelines which suggest that muscle strength training should be introduced after 4 weeks of aerobic training [16]. The patients had to perform one mandatory exercise -either the squat (with or without a ball) or sit-standing exercise.…”

“…Although significant improvements of CRF were found in patients with RA, the eligibility criteria for RA patients from existing published studies required them to have a low CVD risk. This is common in RA and exercise physiology research, given that it is more likely that RA patients who participate in exercise research studies are the ones that are better controlled via medication and have lower levels of co-morbidities while high risk CVD patients are excluded since they require further cardiovascular disease screening, given the present guidelines by the American College of Sports Medicine (ACSM) [16]. This means that such sample populations may not properly represent the overall RA population which is characterised by high CVD risk [14,15].…”

A syndemics approach to exercise is medicine

“…Exercise science emphasises the medicinal benefits of exercise (Sallis and Moore, 2016) and tends toward a perception that exercise is a "panacea" (Cairney et al, 2015) for all human ailments and with sufficient exercise, people can ensure their health, longevity and able-bodiedness. This paradigm is heavily critiqued by a small group of scholars, largely sport sociologists (Andrews et al, 2013;Neville, 2013;Smith, 2016).…”