Chapter 1The Scientific Rationale for Integrated Training

Objectives

• Explain the history of personal training.• Discuss the increasing need for personal

trainers.• Demonstrate an understanding of the principles

of integrated exercise program design.• Describe the Optimum Performance Training

(OPTTM) model.

The Past

• In the 1950s and 1960s, gym members were – Predominantly men training for specific goals

such as size (bodybuilders), strength (power lifters), explosive strength (Olympic lifters), or a combination of all of these goals (athletes).

– Jack LaLanne opens first gym of “health salon”– Joe Gold opens the first “Golds Gym”

The Past

• In the 1970’s the popularity of health clubs had grown immensely, gyms become centers for health and fitness, as well as a place to socialize

• Most “experts” were gym staff, who’s physiques may not guarantee knowledge, many injuries occurred due to bad training

Rise of Chronic Disease

• Chronic diseases such as diabetes and heart disease are rampant. Such diseases are largely preventable with good lifestyle choices

• Chronic disease now accounts for 70% of all deaths in the US. Chronic disease now affects nearly everyone in American in some way

Common Chronic Diseases

• The US Center for Disease Control (CDC) reported in 2006 that 5 of the 6 leading causes of death were from chronic disease.– 57 % are caused by cardiovascular disease

and cancer alone. Of these deaths, 80% could have been prevented with a healthy lifestyle

Obesity

• At present 66% of Americans over age 20 are overweight and 34% or 72 million are obese– More than nine million youth are overweight or

obese

BMI and Obesity

Obesity is a BMI >30 or who is at least 30lbs over weight

–An Overweight classification is 25 – 30 or needing to lose 20lbs to 30 lbs.

–Obesity-related health problems increase when body mass index (BMI) exceeds 25.*

–A desirable BMI for adults is between 18.5-24.9

–A body fat of 25% or greater is considered obese for men, while 39% or greater is obese for women.

High Cholesterol

• Blood lipids also known as cholesterol and triglycerides are carried in the bloodstream by protein molecules, there are two main forms

– High Density Lipoprotein or HDL is the “good cholesterol”

– Low Density Lipoprotein or LDL is the “bad cholesterol”

– A healthy total cholesterol level is less than 200 mg/dL.

Diabetes

There are two types of diabetes commonly known as Type 1 and Type 2

•Type 1 or Juvenile Diabetes

– Caused by the pancreas not producing insulin, as a result blood sugar can not enter the cells causing high blood sugar levels

•Type 2 or Adult Onset Diabetes

– Often called adult onset is associated with obesity, especially abdominal obesity accounts for 90-95% of all diabetes.

– Type 2 diabetics produce adequate amounts of insulin but their cells are resistant to it, and do not allow the cells to bring adequate amounts of glucose into the cell.

– This is known as Insulin Resistance

Diabetes

• More than 80% of patients with type 2 diabetes are overweight or have a history of weight gain.– Complications from diabetes can include:

nerve damage, vision loss, kidney damage, sexual dysfunction, decreased immune function

Aging Population

• Americans are living longer lives. The US Census projects that between 2000 and 2030 the population of people over 65 will increase from 12.4-19.6% of the population. – Over 80% of all persons older than 65 have at

least one chronic condition, and 50% have at least two.

Lack of Physical Activity

• In 2002 the World Health Organization (WHO) recognized lack of physical activity as a significant contributor to the risk factors for several chronic diseases– Despite this very few people engage in the

recommended 30 minutes of activity 5 days a week

Evidence of Increased Injury

• Low Back Pain– Low back pain affects at least 80% of adults. – The predominance of people who have low

back pain work in office buildings or manual labor jobs and often display altered lordosis

Evidence of Increased Injury

• Knee Injuries– 80,000 to 100,000 anterior cruciate ligament

(ACL) injuries occur annually in the United States in the general population.

– Approximately 70% of these are noncontact injuries.

– Most ACL injuries occur between 15 and 25 years of age

Evidence of Increased Injury

• Other Musculoskeletal Injuries– Unnatural posture caused by improper sitting

results in increased neck, mid- and lower back, shoulder, and leg pain.

– Monetary value of these injuries• $120 billion

Current Training Program

• The intensity required by sedentary people trying to improve their cardiorespiratory fitness level might put them in a state of excessive overload.

• In the initial 6 weeks of training, there was a 50–90% injury rate.

Current Training Program

• Deconditioned is more than being out of breath when climbing stairs. It is a state of potential muscles imbalances, decreased flexibility, or lack of core and joint stability. – These conditions can affect the ability to

produce power properly and increase risk of injury.

Current Training Program

• Most traditional training programs do not emphasize– Multiplanar movements

• Many injuries occur in the transverse plane

– Full muscle action spectrum – Proprioceptively enriched environment

The Future

• Due all of the above, the personal training industry is expected to increase much faster than other industries according to US Department of Labor.

• Training programs must be designed by personal trainers with consideration toward the person, the environment, and the tasks to be performed.

• NASM presents the rationale for integrated training and the Optimum Performance Training (OPT) model.

Integrated Training and the OPT™ Model

• Integrated training is a concept that applies to all forms of training:– Flexibility– Cardiorespiratory– Core– Balance– Plyometric (Reactive)– Resistance

What Is the OPT™ Model?

• A process of programming that systematically progresses any client to achieve optimum levels of physiologic, physical, and performance adaptation

• Divided into three training levels– Stabilization– Strength – Power

• Each level contains specific phases of training

Stabilization Level

• The main focus of stabilization training is to increase stabilization strength and develop optimum neuromuscular efficiency.

• The progression for this stage of training is proprioceptively based.

• The stabilization training block consists of one phase of training:– Phase 1: Stabilization Endurance Training

Stabilization Level Phase 1

• Stabilization Endurance Training– Goal

• Enhance joint stability• Increase flexibility• Enhance postural control • Increase neuromuscular efficiency• Improve muscular endurance*

Strength Level

• The emphasis is to maintain stabilization strength while increasing prime mover strength.

• Individuals will also progress to this level of training if their goals are hypertrophy or maximal strength.

• The strength training level consists of three phases of training:– Phase 2: Strength Endurance Training– Phase 3: Hypertrophy Training– Phase 4: Maximal Strength Training

Strength Training Phase 2

• Strength Endurance Training– Goal

• Improve stabilization endurance and increase prime mover strength

• Improve overall work capacity• Enhance joint stabilization• Increase lean body mass

– Training Strategies• Resistance training

– Superset one strength exercise with one stabilization exercise per body part

» Example: Bench press followed by a stability ball push-up

Strength Level Phase 3

• Hypertrophy Training– Goal

• Achieve optimum levels of muscular hypertrophy– This phase is optional depending on the client’s goals.

Strength Level Phase 4

• Maximal Strength Training– Goal

• Increase motor unit recruitment• Increase frequency of motor unit

recruitment• Improve peak force

– This phase is optional depending on the client’s goals.

Power Level

• This stage of training emphasizes the development of speed and power (rate of force production).

• The power training block consists of one phase of training:– Phase 5: Power Training

Power Level Phase 5

• Power Training – Goal

• Enhance neuromuscular efficiency• Increase rate of force production• Enhance speed strength

– Training Strategies• Resistance training

– Superset one strength exercise with one power exercise per body part

» Example, perform a barbell squat followed by squat jumps

Summary

• Today’s automated environment produces more inactive and nonfunctional people and leads to dysfunction and increased incidents of injury including low back pain, knee injuries, and chronic diseases.

• The Optimum Performance Training (OPT™) Model provides a system for properly and safely progressing today’s client to his or her goals by using integrated training methods.

• The OPT™ Model consists of three building blocks: stabilization, strength, and power.