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Periodization for the Clinical Practitioner

Schilero, Jessica M.S., H.F.S.; Swank, Ann M. Ph.D., FACSM

doi: 10.1249/01.FIT.0000422570.32612.d4
COLUMNS: Clinical Applications

Periodization for the Clinical Practitioner.

Jessica Schilero, M.S., H.F.S., earned a B.S. in exercise physiology from Ohio University in 2008 and an M.S. in exercise physiology, with a concentration in strength and conditioning, from the University of Louisville in 2011. She currently is a full-time instructor at the University of Louisville, teaching at both the undergraduate and graduate levels. She is ACSM Health Fitness SpecialistSM certified and is a part-time personal trainer at a wellness center in Louisville, KY.

Ann M. Swank, Ph.D., FACSM, is a professor of exercise physiology, co-chair of the Health and Sport Science Department, and director of the Exercise Physiology Laboratory at the University of Louisville. Her research interests are exercise testing and prescription for special populations, with an emphasis on chronic heart failure. She is ACSM Program Director certified, ACSM Clinical Exercise SpecialistSM certified, and a fellow of ACSM.

Staying with an exercise program is a difficult task, and lack of compliance is often related to an individual experiencing a plateau in health and fitness gains. One strategy to address this concern is to use the method of periodization to prescribe exercise. A critical factor often overlooked in exercise programming is the concept of planned rest. Structuring the exercise program to incorporate rest is an important underlying concept of periodization. The most common use of periodization has been for the sport athlete, who uses it to minimize fatigue and maximize performance by varying training intensity and training volume throughout the sport season. However, varying training volume over time in a planned manner also can be adapted or applied to individuals with stable health problems who plan to undertake a long-term training program. This column presents a brief overview of periodization and provides an example of how this model of exercise prescription can be used by the clinical practitioner. There are many variations to applying a periodized program, and this column will focus on the linear model.

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Periodization was developed in the 1960s by the Russian physiologist Leo Matveyev (8,15) and is defined as an organized cyclic program that uses planned variations in intensity, volume, and specificity to minimize fatigue and maximize performance outcomes (8,9,14,15). Periodized programs are composed of macrocycles, mesocycles, and microcycles. The largest cycle or macrocycle is 1 year in length, corresponding to the duration of the competition cycle. Each macrocycle is then broken into mesocycles, traditionally 1 to 3 months in length. Finally, each mesocycle is broken into individual microcycles, typically 1 week in length (Table 1) (14,15). Although this is the traditional model, durations of each cycle vary greatly depending on the sport in which the athlete participates. For example, among Olympic athletes, the macrocycle would be 4 years in length because this is the duration of their competition cycle; therefore, the mesocycle and microcycle lengths also would differ from the traditional model (14,15). Within each cycle, the training load progresses from high volume to high intensity. Volume is manipulated through variations in repetitions, sets, duration, and frequency, whereas intensity is primarily manipulated through changes in load, typically a percentage of the individual’s one-repetition maximum (1-RM). Variation in exercise specificity is accomplished by progressing from general movement patterns to sport-specific movements (8,14,15)

As previously stated, the largest division of the linear model is a macrocycle, corresponding to the duration of the competition cycle. Linear periodization then divides the macrocycle into training periods, each with a different training focus (2,6,9,10,14,15). Matveyev (8) and Wathen et al. (16) first defined the major training periods as preparatory, transition, and competition. Later, Stone et al. (10) and Wathen et al. (15) added an additional transition period following competition (Table 1). Each training period promotes specific outcomes by manipulating three primary variables: intensity, volume, and specificity (11,12,14,15). Salient characteristics of each of these training periods are presented below.

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The preparatory period corresponds to when the athlete is not participating in competition or sport-specific skilled practices. The major focus of this period is to build a strong base of conditioning so the individual can tolerate more intense training. The preparatory period includes three subphases termed (a) hypertrophy/endurance, (b) basic strength, and (c) strength/power; each typically one mesocycle in length (3–5,14,15). The hypertrophy/endurance phase provides a training load of high volume with relatively low intensity. The training outcomes expected are an increase in lean body mass and metabolic endurance. The goal of the basic strength phase is to develop sport-specific muscular strength. Intensity of training load will increase and volume will decrease during this phase. The final phase of the preparatory period is strength/power, in which the individual will be performing powerful sport-specific movements at high loads and low volumes (3–5, 11,12,14,15). This phase proceeds to the competitive season and should begin to lead the athlete to his or her peak levels of performance.

The first transition period defines the break between higher volume training to higher intensity training. Typically, this period is 1 week in length and allows a planned recovery before the start of competition. During this period, athletes will train at low-intensity, low-volume workloads, ultimately resulting in stimulation of exercise adaptations and prevention of overtraining (3–5,14,15). After the planned recovery, the athlete enters the competition period. During this period, goals shift to maximizing strength and power through further decreases in volume with additional increases in intensity. In addition, athletes will participate in highly skilled and specific training to prepare for competition. Duration of this period is typically one mesocycle; however, the time frame is completely dependent on the type of sport for which the athlete is involved (3–5,14,15). On completion of the competition season, the athlete is allowed a second transition or planned recovery period. This period is often referred to as active rest and can last anywhere from 1 to 4 weeks. Goals of this period are rehabilitation and both physical and mental rest. As in the first transition period, intensity and volume are both dramatically decreased. In addition, the athlete is encouraged to participate in general non-sport-specific movement patterns. This final planned recovery period is imperative for the athlete’s long-term progress and is used as a beneficial transition into the following macrocycle or training season (3–5,14,15).

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The resistance training (RT) program presented in Table 2 was the basis for a previous research project that evaluated the safety and efficacy of high-intensity RT for individuals with heart failure. For the purposes of this column, the same model is now being applied to patients with stable heart diseases. (1,7,13). The program uses standard circuit weight training protocols currently used in cardiac rehabilitation (6). Circuit weight training programs consist of a series of RT exercises performed in sequence with minimal rest (30 to 60 seconds) between exercises. Exercise intensity is based on a 1-RM method (6) performed at frequent intervals during the training to maintain appropriate exercise intensity and provide a “competition” goal for the subject. Initially, 1-RM testing is performed after 2 weeks of training to accommodate for a learning effect.

The RT exercise is a whole-body progressive workload program based on periodization. The program is 24 weeks long (the macrocycle) and divided into two 12-week mesocycles. Within each of the mesocycles are several microcycles, in which the intensity is increased and the volume is decreased over time. Exercises consist of the leg press, horizontal squat, shoulder press, leg extension, latpulldown, and cable biceps curl exercises for weeks 1 through 12 (the first mesocycle). At week 12, an active rest of 1 week is incorporated, after which the exercise challenge is changed to address the issue of specificity and activities of daily living (analogous to an athlete shifting to sport-specific movements to improve competitive performance).

Dumbbell lunges, dumbbell shoulder press, and dumbbell curl are substituted for the leg extension, the machine shoulder press, and cable biceps curl, respectively, and the program is continued for an additional 12 weeks (the second mesocycle). The addition of the dynamic free weight program after the first 12 weeks is beneficial for several reasons. First, it has been shown that the subject’s neuromuscular system is optimally challenged by activities that affect activities of daily living (6) in a manner that is similar to the athlete performing exercises that mimic his or her sport. Second, the free weight program is reproducible outside of the clinic environment and thus provides the subjects with RT techniques that can be performed at home. Finally, the dynamic free weight program mimics the balance and strength requirements of activities such as walking and climbing stairs, facilitating transfer of muscular strength gains to activities of daily life.

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Identifying strategies that facilitate compliance with exercise is important for both individuals and public health. Periodizing an exercise program to incorporate planned rest periods may be one strategy to enhance compliance. The next column in this series will address adding variety to the training program by incorporating “implement training.”

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© 2012 American College of Sports Medicine