NASM CES Chapter 6: Integration Techniques

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Chapter Goals:

• Describe the function of the integration techniques in programs for corrective exercise.
• Find the techniques for integration that are used in corrective programming exercises. 
• Discuss the guidelines for the application of the integration techniques. 

Introduction

This is the fourth and final phase in the continuum of corrective exercise. It focuses on the techniques we use for the integration.

The integration techniques are used to re-educate the human movement system and make it a more functional synergistic movement pattern.

Using multiple joint actions and muscle synergies helps us reestablish this neuromuscular control and promotes coordinated movement in the muscles involved.

The first three phases worked on specific parts to do the fourth integration phase. 

During the initial client assessments, the specialist should have received valuable information about the goals and needs of the client.

A goal such as increasing their sprint speed may have been the initial desire.

And it was possibly found that the client has poor lower body mechanics, and the overall goal of increasing their sprint speed was found to be done while working on that. 

Integrated Dynamic Movement

When the right muscles have been inhibited and lengthened, and then others are activated by isolated strengthening, we implement this final component in the continuum: integrated dynamic movement.

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This involves using dynamic and total-body exercises where the lower body, the LPHC, and the upper body all have their own coordinated responsibilities.

Together, the integrated dynamic movement will work to enhance the functional capacity of the human movement system through increases in multiplanar neuromuscular control.

We achieve this by using exercises that will focus on the synergistic function of all the types of muscle. 

Scientific Rationale for Integrated Dynamic Movement

Slow, focused moves in controlled environments will allow us to practice and guide the ability for decelerating eccentrically, stabilizing, and concentric accelerated movement.

As the performance and control of the neuromuscular system improve, the movements change with more progressive dynamics like additions to speed, resistance, impacts, and multivariant directional patterns. 

To remind you, the agonist is the prime mover for all portions of the exercise.

The synergists support the agonists, and stabilizers are used to support the joints throughout the movement.

The antagonists work opposing the agonists; their job is to relax at the right times and amounts for the movements.

Multijoint movements are often used due to their promotion of and requirements for greater intermuscular coordination. 

Our multijoint movements in all the planes of motion, performed in both bilateral and unilateral stances, will help increase the coordination intramuscularly and reeducate the neuromuscular system for attaining proper postural alignments when doing these functional activities. 

The integrated dynamic movements involve higher load and controlled moves in the ideal postures.

We ensure the joints start and remain in ideal alignment, the muscles function in their proper length-tension relationships, and the synergistic muscle recruitment is optimal.

So, it really is a culmination of all the things we did in the other steps.

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We can use these as primer exercises for the more advanced ones to follow in the programming. 

Precautions and Contraindications of Integrated Dynamic Movement

Precautions for Integrated Dynamic Movement

• Special Populations
• Neuromuscular Disorders

Contraindications for Integrated Dynamic Movement

• Acute injuries or muscle strains and tears of the muscles that will be used
• Acute rheumatoid arthritis of the joints in the movements
• The position of the exercise is relevant to the condition of the patient, i.e., stomach and pregnancy
• Acute injuries to the joints that are involved in moving for the exercise
• Pain in the movements

Integration Considerations for Lower Extremities

Jumping tasks for the lower body may be done in progression phases.

It is important here that the clients are well prepared for the neuromuscular control at differing speeds and planes they will work in.

Not everyone can perform the jumping tasks during this phase of corrective exercise, so it is important to know the client and where they are in their progress.

Functional Movement Progressions

For clients unable to do the jumping exercises, basic functional movement progressions will incorporate total body exercises in multiple planes, which are used for integrated dynamic movements.

One progression would be something like starting with ball squats, then going to step ups, then to lunges, then to single leg squats.

Those show the proper difficulty progressions based on planes worked in and the skill to do them. 

Lower Extremity Progressions and Neuromuscular Control

Neuromuscular control imbalances are often found in adolescents during athletic movements, including ligament dominance, quadriceps dominance, and leg dominance.

In ligament dominance, we see the tissues as limiting someone’s ability to move in the end range of motion control.

In quadriceps dominance, we see decreases in strength or recruitment for the posterior chain muscles relative to that of the anterior chain.

And last, with leg dominance, we see limbs differing significantly in their strength, affecting the movements being done. 

Athletic Position

Before you teach dynamic movement exercises, clients need to know the proper athletic position.

This is a functionally stable position with the knees fixed comfortably, the shoulders back, eyes up, feet at shoulder width, and the body mass balanced onto the balls of the feet with the chest over the knees.

This is going to be the starting position for the client and the finish for most jump related tasks. 

Wall Jumps

These are another integrated dynamic movement exercise that targets our ligament dominance deficits.

Low to moderate intensity allows us to see the degree of valgus and Varus motions in the knee. 

Tuck Jump

This is an integrated dynamic movement that also targets ligament dominance in athletes.

It is sometimes also used for assessments, which can require high effort from the athlete. 

Horizontal Jump Test

This test allows the fitness professional to assess the person’s knee motion while progressing through the sagittal plane’s movements.

Performing dynamic knee control during tasks in all movement planes is critical to addressing deficits that transfer to competitive sports. 

Some other exercises to note and be familiar with from the book:

• 180 degree jump
• Single leg horizontal jump test
• Cutting maneuvers

Acute Training Variables for Integrated Dynamic Movement

• The frequency should be around 3 – 5 days every week.
• The sets should be 1 – 3 per exercise.
• The repetitions should be 10 – 15 per set. 
• The duration of the reps should be focused on controlling the movement.