The 12th edition of the Guidelines presents evidence-based standards with new several new sections, including updates on sex differences, transgender and gender diverse individuals, spontaneous coronary artery dissection, postural orthostatic tachycardia syndrome, pediatric patients with cardiac conditions, metabolic dysfunction-associated steatotic liver disease, and myalgic encephalomyelitis/chronic fatigue syndrome. Also, a section on respiratory muscle testing and training was added to the section on pulmonary disease as much evidence has shown clinically meaningful outcomes. Significant updates based on current evidence-based practices were made to Chapter 12 on Behavioral Theories and for the resistance training section in Chapter 5. Highlights of this edition include: 

• Updated content reflects current ACSM guidance on best practices for exercise testing and prescription, based on changes in the field and advances in research. 

• Expanded coverage on the application of exercise testing and prescription in applied settings, as well as updated coverage on behavioral theories and resistance training. 

• Reader-friendly features include abbreviations and common acronyms listed up front; boxes, tables, and figures that highlight key concepts in quick-reference, easy-to-digest formats; case studies that reflect real-world experience; FITT tables that apply Frequency, Intensity, Time, and Type principles; and useful appendices on common medications, ECG interpretation tips, metabolic calculations, and more.