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Chapter 1 The Scientific Rationale for Integrated Training Objectives • Explain the history of personal training. • Identify common characteristics of personal training clients. • Demonstrate an understanding of the principles of integrated exercise program design. • Describe the Optimum Performance Training (OPTTM) model. Overview • Personal training industry is expected to increase much faster than average according to USDL • The large increase in demand is due to escalation of diabetes, obesity and chronic diseases • Many health and fitness clubs rely on personal trainers for their largest source of non-dues revenue, which when combined with the poor health of the public creates high demand 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” – Bill Bowerman publishes Jogging 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 The Past • Throughout the 1970s and early 1980s, personal computers, cell phones, and technology were not as prevalent as they are today. • Physical education was still mandated in school. 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 The Present • 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 – The annual costs is estimated at 503.2 billion annually Obesity • Another chronic condition associated with cardiovascular disease is obesity which is a worldwide problem. – Obesity is a BMI >30 or who is at least 30lbs over weight – A desirable BMI for adults is between 18.524.9 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 – Experts predict by 2015 nearly 25% of children will be overweight Overweight • Overweight: A person with a BMI of 2529.9 or who is between 25-30 pounds over the recommended weight for their height. – Being overweight is associated with cardiovascular disease, osteoarthritis, and decreased quality of life. 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” High Cholesterol • A healthy cholesterol level is less than 200 mg/dL. – A borderline high cholesterol is between 200 and 239 mg/dL. – A high risk level is greater than 240 mg/dL. – More than 50% of adults in the US have a total cholesterol over 200 mg/dL. Diabetes Mellitus • Diabetes mellitus is a condition in which blood sugar is unable to enter cells due to a lack of production of insulin or inability to utilize insulin. – There are two types of diabetes commonly known as Type 1 and Type 2 Diabetes Mellitus • Type 1: – Often referred to as juvenile diabetes, because the symptoms typically first appear in childhood, is caused by the pancreas not producing insulin, as a result blood sugar can not enter the cells causing high blood sugar levels Diabetes Mellitus • Type 2: – 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 Mellitus • 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 Lack of Physical Activity • Research has shown that decreased activity can lead to a higher risk of chronic diseases that are related to lifestyle. – Despite the well known benefits of exercise, physical activity levels continue to decline because of increased television viewing, use of computers, and use of passive forms of transportation (cars, buses, subways). – Physical education and after school programs has been drastically cut from schools Physical Activity • In 2008 the US government issued its most current guidelines to provide information on the types and amounts of physical activity that provide health benefits 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. – Work-related injuries • 43% are sprains and strains • 60% involve the trunk – 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 • Training program must be designed 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 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.