ACSM’s Guidelines for Exercise Testing and Prescription, 11th edition | Q&A With Senior Editor Dr. Gary Liguori

ACSM’s Guidelines for Exercise Testing and Prescription, 11th edition | Q&A With Senior Editor Dr. Gary Liguori

Gary Liguori, Ph.D., FACSM |  Jan. 12, 2021

ACSM Guidelines 11th edition cover imageIn December 2017, the call was put out for applications for the Senior Editor role of ACSM’s Guidelines for Exercise Testing and Prescription, 11th Edition. ACSM’s Guidelines for Exercise Testing and Prescription is the lead title in the American College of Sports Medicine (ACSM) book portfolio. The first edition of Guidelines was published in 1975, and it maintains its status as the most widely circulated set of guidelines for exercise professionals. The book is a definitive resource in the industry and is used in the classroom, for certification preparation and in practice. Guidelines is published by ACSM’s publishing partner Wolters Kluwer and is updated every four to six years by leading experts in the field to ensure the content is up-to-date and meeting the needs of the dedicated individuals within the exercise science environment.

The process for selecting the Senior Editor included preliminary reviews, phone interviews and voting through the ACSM governance process. Upon completion of this rigorous selection process, ACSM was delighted to announce Gary Liguori, Ph.D., FACSM, as the senior editor of the 11th edition of Guidelines. Dr. Liguori has been a member of ACSM since 1994 and a fellow since 2011. Dr. Liguori is also an ACSM-Certified Clinical Exercise Physiologist. In his time as an ACSM member, Dr. Liguori has served as an associate editor of the A-to-Z column and as Associate Editor-in-Chief for ACSM’s Health & Fitness Journal®. Additionally, Dr. Liguori acted as the senior editor of ACSM’s Health-Related Physical Fitness Assessment, 5th Edition, the senior editor of the first edition of ACSM’s Resources for the Exercise Physiologist, and as an associate editor on ACSM’s Guidelines for Exercise Testing and Prescription, 10th edition. As Senior Editor, Dr. Liguori selected Yuri Feito, Ph.D., MPH, FACSM, Charles Fountaine, Ph.D., FACSM, and Brad A. Roy, Ph.D., FACSM, as associate editors for the text.

We sat down with Dr. Liguori to discuss some of the changes that readers can expect to see in the 11th edition of ACSM’s Guidelines for Exercise Testing and Prescription. Don’t forget to check out more information on the 11th edition!

What can you tell us about how your team integrated industry updates in the text?

As with every new edition, the editors and contributors for the 11th edition integrated the most up-to-date recommendations available from ACSM position stands and other relevant professional organizations’ scientific statements, making Guidelines the most current, primary resource for exercise testing and prescription. Additionally, the most recent guidelines and recommendations available, including the 2018 Physical Activity Guidelines for Americans, were integrated throughout the text.

What’s one of the biggest changes in terms of content included?

This edition of Guidelines presents an entirely new chapter focused on the role of exercise in conditions that affect the brain. Chapter 11 includes Cerebral Palsy, Parkinson’s Disease and Intellectual Disability and Down Syndrome, which were in the 10th edition, and now also includes brand new coverage on the conditions of Attention-Deficit/Hyperactivity Disorder, Alzheimer’s Disease, Anxiety and Depression and Autism Spectrum Disorder. The goal of adding this chapter is to bring forth the most current evidence and specific strategies for these ever more present conditions, thereby providing timely and relevant preparation for engaging with individuals with these conditions.

Are there any organizational changes readers will see?

Chapters 2 (Exercise Preparticipation Health Screening) and 3 (Preexercise Evaluation) from the previous edition were merged into one chapter titled Preexercise Evaluation. In this 11th edition of Guidelines, what is now chapter 2 clarifies the recommended order in which to conduct the preexerccise evaluation screenings. This chapter also includes specific guidance for informed consent, preparticipation health screening, the ACSM Preparticipation Screening Process and Algorithm and Medical History and Cardiovascular Disease Risk Factor Assessment. The CV risk factor analysis is separate from the algorithm screening as the former is for client education and the latter is for initiating an exercise program.

Are there broader guideline updates that were incorporated into the recommendations in the new edition?

For Cardiovascular coverage we made changes within two chapters; specifically, within Chapter 8, Exercise Prescription for Individuals with Cardiovascular and Pulmonary Diseases, we include updated guidance for the post-CABG patient in regard to fewer restrictions on arm movement, encouraging the vast majority of individuals to initiative arm movement immediately after surgery, within reason of course. We also made revisions to Chapter 9, Exercise Prescription for Individuals with Metabolic Disease and Cardiovascular Disease Risk Factors, to include updated hypertension guidelines. We know how important it is for the exercise professional to be familiar with both the ACC/AHA and JNC7 blood pressure thresholds and classifications, and therefore have included both sets of guidelines with equal importance. Both of these blood pressure guidelines are also presented in Chapter 2.

What other input did you use to help guide what we’ll see in the upcoming edition?

Based on feedback from students and faculty during the 2018 ACSM focus group we realized we wanted to make significant revisions to the appendices. We decided to integrate the information from the Common Medications appendix directly into the chapter text wherever appropriate and we also consulted with numerous practicing clinicians to understand which were the most common medications exercise professionals were likely to encounter in routine practice. This resulted in a significantly shorter Medication section in the final appendix, which will be much easier for students to reference. Our ACSM Facebook study groups also shared that ECG and metabolic calculations are topics of significant importance, so we decided to update the appendices on electrocardiogram interpretation with a greater emphasis on the ‘normal’ ECG. An entirely new appendix was created to house all of the most critical metabolic calculations, along with numerous examples of how to use them. Our focus groups felt they were awkwardly placed within the text, so we anticipate this new appendix to be a much handier student and practitioner reference. And finally, we shortened the appendix on ACSM certifications, as the most up-to-date information lives on the certification section of the ACSM website.

Anything you would like to add?

Overall, I am extremely proud of the work that our team has put into this new edition and believe the updates will be exceedingly useful to students, instructors and practitioners in every stage of their career. We hope you find them as useful as we do.

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Gary Liguori, Ph.D., FACSM, is the dean of the College of Health Sciences and a professor of kinesiology at the University of Rhode Island in Kingston, Rhode Island. He is the Senior Editor of the 11th edition of ACSM's Guidelines for Exercise Testing and Prescription (GETP11).