Chapter 1
The 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.