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March 9, 1970, Vol 211, No. 10 >
ARTICLE | March 9, 1970

Guidelines in the Management of the Exercising Patient FREE

Lt Col Kenneth H. Cooper, MC
[+] Author Affiliations

Reprint requests to Box 368842, CMR 8, Lackland Air Force Base, Tex 78236 (Lt Col Cooper).


JAMA. 1970;211(10):1663-1667. doi:10.1001/jama.1970.03170100025004
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References

The current widespread interest in jogging and the frequency of ischemic heart disease in the American male population have prompted many physicians to request specific guidelines in the management of patients who wish to begin an exercise program. This communication provides such guidelines in the following areas: The type and the importance of the initial medical examination; physical fitness testing, its value and its risks; contraindications and abnormal responses to exercise; and restrictions to be placed upon the older exercising patient. With this information, physicians can better advise their patients about the hazards associated with exercise as well as the use of exercise as a therapeutic tool.

REFERENCES

1 +
Doan AE, et al:  Myocardial ischemia after maximal exercise in healthy men . Amer Heart J 69:11-21, 1965;.
2 +
Kattus AA Jr, et al:  Diagnosis, medical and surgical management of coronary insufficiency . Ann Intern Med 69:114-136, 1968;.
3 +
Balke B: Correlation of Static and Physical Endurance: I. A Test of Physical Performance Based on the Cardiovascular and Respiratory Responses to Gradually Increased Work , report 1, project No. 21-32-004. Randolph Air Force Base, Tex. US Air Force School of Aviation Medicine, 1952;.
4 +
Cooper KH:  A means of assessing maximal oxygen intake: Correlation between field and treadmill testing . JAMA 203:201-204, 1968;.
5 +
Astrand I, Atrand PO, Rodahl K:  Maximum heart rate during work in older men . J Appl Physiol 14:562-566, 1959;.
6 +
Von Dobeln W:  A simple bicycle ergometer . J Appl Physiol 7:222-224, 1954;.
7 +
 Is your patient fit? Committee on Exercise and Physical Fitness . JAMA 201:117-118, 1967;.
8 +
Doan AE, et al:  Myocardial ischemia after maximal exercise in healthy men: One-year followup of physically active and inactive men . Amer J Cardiol 17:9-19, 1966;.
9 +
Bruce RA, Hornsten TR, Blackmon JR:  Myocardial infarction after normal response to maximal exercise . Circulation 38: 552-558, 1968;.
10 +
Balke B: A Simple Field Test for the Assessment of Physical Fitness , CARI Report 63-18. Oklahoma City, Civil Aeronautical Research Institute, Federal Aviation Agency, 1963;.
11 +
Cooper KH: Aerobics . New York, M Evans & Co, 1968;.
12 +
Brummer P:  Coronary heart disease and the living standard . Acta Med Scand 182 (pt (4) ):523-527, 1967;.
13 +
Morris JN, et al:  Coronary heart disease and physical activity of work . Lancet 2:1053-1056, 1953;.
14 +
Frank CW, et al:  Physical inactivity as a lethal factor in myocardial infarction among men . Circulation 34:1022-1033, 1966;.
15 +
Brunner D:  The influence of physical activity on the incidence and prognosis of ischemic heart disease , in Prevention of Ischemic Heart Disease . Springfield, Ill, Charles C Thomas Publisher, 1966;, p 236.
16 +
Barry AJ, et al:  Effects of physical training in patients who have had myocardial infarction . Amer J Cardiol 17:1-8, 1966;.
17 +
Gottheiner V:  Long range strenuous sports training for cardiac reconditioning and rehabilitation . Amer J Cardiol 22: 426-435, 1968;.
18 +
Hellerstein HK, et al:  The influence of active conditioning upon coronary atherosclerosis , in Brest AN, Moyer JH (eds): Atherosclerotic Vascular Disease , New York, Appleton-Century-Crofts, Inc, 1967;, pp 115-129.
19 +
Eckstein RW:  Effects of exercise and coronary artery narrowing on coronary collateral circulation . Circulation Res 5:230-235, 1957;.

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1 +
Doan AE, et al:  Myocardial ischemia after maximal exercise in healthy men . Amer Heart J 69:11-21, 1965;.
2 +
Kattus AA Jr, et al:  Diagnosis, medical and surgical management of coronary insufficiency . Ann Intern Med 69:114-136, 1968;.
3 +
Balke B: Correlation of Static and Physical Endurance: I. A Test of Physical Performance Based on the Cardiovascular and Respiratory Responses to Gradually Increased Work , report 1, project No. 21-32-004. Randolph Air Force Base, Tex. US Air Force School of Aviation Medicine, 1952;.
4 +
Cooper KH:  A means of assessing maximal oxygen intake: Correlation between field and treadmill testing . JAMA 203:201-204, 1968;.
5 +
Astrand I, Atrand PO, Rodahl K:  Maximum heart rate during work in older men . J Appl Physiol 14:562-566, 1959;.
6 +
Von Dobeln W:  A simple bicycle ergometer . J Appl Physiol 7:222-224, 1954;.
7 +
 Is your patient fit? Committee on Exercise and Physical Fitness . JAMA 201:117-118, 1967;.
8 +
Doan AE, et al:  Myocardial ischemia after maximal exercise in healthy men: One-year followup of physically active and inactive men . Amer J Cardiol 17:9-19, 1966;.
9 +
Bruce RA, Hornsten TR, Blackmon JR:  Myocardial infarction after normal response to maximal exercise . Circulation 38: 552-558, 1968;.
10 +
Balke B: A Simple Field Test for the Assessment of Physical Fitness , CARI Report 63-18. Oklahoma City, Civil Aeronautical Research Institute, Federal Aviation Agency, 1963;.
11 +
Cooper KH: Aerobics . New York, M Evans & Co, 1968;.
12 +
Brummer P:  Coronary heart disease and the living standard . Acta Med Scand 182 (pt (4) ):523-527, 1967;.
13 +
Morris JN, et al:  Coronary heart disease and physical activity of work . Lancet 2:1053-1056, 1953;.
14 +
Frank CW, et al:  Physical inactivity as a lethal factor in myocardial infarction among men . Circulation 34:1022-1033, 1966;.
15 +
Brunner D:  The influence of physical activity on the incidence and prognosis of ischemic heart disease , in Prevention of Ischemic Heart Disease . Springfield, Ill, Charles C Thomas Publisher, 1966;, p 236.
16 +
Barry AJ, et al:  Effects of physical training in patients who have had myocardial infarction . Amer J Cardiol 17:1-8, 1966;.
17 +
Gottheiner V:  Long range strenuous sports training for cardiac reconditioning and rehabilitation . Amer J Cardiol 22: 426-435, 1968;.
18 +
Hellerstein HK, et al:  The influence of active conditioning upon coronary atherosclerosis , in Brest AN, Moyer JH (eds): Atherosclerotic Vascular Disease , New York, Appleton-Century-Crofts, Inc, 1967;, pp 115-129.
19 +
Eckstein RW:  Effects of exercise and coronary artery narrowing on coronary collateral circulation . Circulation Res 5:230-235, 1957;.

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