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NASM Essentials of Personal Fitness Training (6th ed.

Chapter 1 – The Scientific Rationale for Integrated Training

Over the past few decades, the incidence of chronic health conditions—such as obesity, diabetes, and heart
disease—has continued to rise. A large part of this is due to modern technology and automation. While productivity
and efficiency rise, the requirement for our bodies to move and work during activities of daily living continues to
decline. More and more people spend most of their days seated in front of a computer or behind the wheel of a
To help address this issue, NASM developed the Optimum Performance Training™ (OPT™) model. Simply put,
the OPT™ model is a comprehensive method of fitness program design that systematically progresses any client
toward any goal. It incorporates all components of exercise into an easy-to-follow system. OPT™ safely allows for
optimal development of physiological, physical, and performance adaptations; improving overall fitness and
reducing the risks of chronic disease, musculoskeletal pain, and injury.

Chapter Highlights
The Rise of Chronic Disease
Chronic diseases (e.g., asthma, obesity, cancer, diabetes, and heart disease) account for around 70% of deaths each
year in the United States. Around 75 cents of every dollar we collectively spend on healthcare goes toward treating
chronic diseases; this equates to around $1.7 trillion annually. Obesity is of particular note, as this condition greatly
increases the risk of other chronic diseases. Roughly 66% of Americans over the age of 20 are overweight, with
around 34% classified as obese.

Muscular Dysfunction and Increased Injury

Chronic pain and injuries are more common than ever too, mainly attributed to the overall decrease in physical
activity. Low-back pain affects nearly 80% of all adults, while an estimated 80,000– 100,000 ACL injuries occur in the
general population each year. Work-related back injuries alone collectively account for around 39 million days of
restricted activity in the workforce, costing approximately $120 billion in lost productivity annually.

Current Training Programs

Many traditional and current forms of exercise programming do not use safe and effective training principles. Low-
to-moderate intensity workouts are great for the majority of adults, but if intensities get too high for a person’s
current level of fitness, excessive overload can occur and lead to injury. Training programs need to emphasize
multiplanar movements through the full muscle action spectrum and should be performed in an environment that
enriches proprioception.

The Components of Integrated Training

Integrated training is the concept of combining all the various types of fitness training into a progressive system. The
components of integrated training are flexibility; cardiorespiratory; core; balance; plyometric; speed, agility, and
quickness (SAQ); and resistance training. It is difficult to reach optimal levels of fitness without the concurrent
development of each component as part of a well-rounded training system.

The OPT™ Model

NASM’s OPT™ model provides a clear method of incorporating all the components of integrated training into an
exercise program. It consists of three levels subdivided into five phases. The first level is Stabilization and includes
just one phase, Phase 1: Stabilization Endurance Training. Here, clients work to build their fitness foundations (e.g.,
improving flexibility, balance, joint stability, and endurance) in preparation for more intense forms of training to
come. The next level is Strength, with three unique phases in which clients then work to increase how long their
muscles can work for (Phase 2: Muscular Endurance Training), muscle size (Phase 3: Hypertrophy Training), and the
maximum amount they can lift (Phase 4: Maximal Strength Training). Then, the final level (and 5th phase) is Power,
putting everything together to increase clients’ abilities to generate forces at functionally realistic speeds.

Key Terms
Muscle imbalance—Alteration of a muscle length surrounding a joint.
Obesity—The condition of being considerably overweight, referring to a person with a body mass index of 30 or
greater, or who is at least 30 pounds over the recommended weight for their height.
Overweight—A person with a body mass index of 25 to 29.9, or who is 25 to 30 pounds over the recommended
weight for their height.
Blood lipids—Cholesterol and triglycerides, carried in the bloodstream by protein molecules known as high-density
lipoproteins (HDL) and low-density lipoproteins (LDL).
Diabetes mellitus—Chronic metabolic disorder caused by insulin deficiency which impairs carbohydrate usage and
enhances usage of fats and proteins.
Deconditioned—A state of lost physical fitness which may include muscle imbalances, decreased flexibility, and a
lack of core and joint stability.
Proprioception—The cumulative sensory input to the central nervous system from all mechanoreceptors that sense
body position and limb movement.
Proprioceptively enriched environment—An unstable (yet controllable) physical situation in which exercises are
performed that cause the body to use its internal balance and stabilization mechanisms.
Phases of training—Smaller division of training progressions that fall within the building blocks of training.
Muscular endurance—A muscle’s ability to contract for an extended period of time.
Neuromuscular efficiency—The ability of the neuromuscular system to enable all muscles to efficiently work
together in all planes of motion.
Prime mover—The muscle that acts as the initial and main source of motive power.
Superset—Set of two exercises that are performed back to back without any rest time between them.
Rate of force production—Ability of muscles to exert maximal force output in a minimal amount of time.