Indicate the strengths and weaknesses of the educational experience:
What feelings did you experience?
What did you learn about good or bad teaching?
What did you learn about yourself as a student?
Semester and Course . | Content . |
---|---|
Semester 1: Ethics and Professionalism | Students learn narrative approach to ethical decision making. They practice analyzing cases for "narrative gaps." Students learn the questions to ask to complete the story from the perspectives of multiple stakeholders. |
Semester 2: Teaching and Learning | Students are introduced to concepts of reflection and narrative for learning. They practice writing reflective narratives about a previous educational experience. They are given the following narrative prompts: Indicate the strengths and weaknesses of the educational experience: What feelings did you experience? What did you learn about good or bad teaching? What did you learn about yourself as a student? |
Semesters 3, 4, and 5: Clinical courses in Acute Care, Musculoskeletal, and Neurological Rehabilitation | During the students' 2-week clinical rotations in each course, they are instructed to write a narrative about a clinical experience based on the following objective: Given an issue of interaction in the clinic involving patients/clients, family members/caregivers, other health professionals, students, and other consumers or payers, the student will effectively deal with a positive and negative outcome resulting from self-assessment/reflection activities by writing a short summary of the experience based on the following questions: (Narrative Prompts ) What was the central issue you encountered? What confuses you about the issue/case? What feelings did you experience during this issue? How did you and/or others address the issue? What did you learn about yourself from this issue/case/encounter? What would you do differently if you encountered this situation again? Unbundling session |
Semester 6: Internship I | Students write 2 clinical narratives early and late during their first long-term clinical placement using Gibbs' model as a guide and based on the following narrative prompts: Prompts as noted above Unbundling session |
Resident Program | Residents in our orthopedic and neurologic resident program are asked to write narratives early, during, and at the end of their residency program using Gibbs' model as a guide and based on the following narrative prompts: Prompts as noted above Unbundling session |
In both of these examples of teaching, narrative models are used to facilitate deeper levels of reflection. 56 – 59 For example, Gibbs' model 56 provides students with the framework to move from describing their experience (using a first-person account) to describing their thoughts and feelings as the experience unfolds. At Emory University, students are encouraged to write narratives guided by prompt questions from Gibbs' model during their initial 2-week clinical experiences and during their first 10-week clinical internships ( Tab. 4 ). Students are asked to follow the 6 circular phases of Gibbs' model. The first 2 phases encourage them to describe their experience using first-person accounts. Students are asked to place themselves into the action and avoid using abstraction to describe what occurred, using concrete examples instead. These phases are followed by evaluative phases (where they judge the value and meaning of the experience and discuss their thoughts and feeling in response to the experience). The final phases involve analysis of what went right or wrong and finally how they would address a similar situation in the future. Gibbs' model appears to guide students to move between a description of an experience and an explanatory framework that explains its meaning, providing the student increased insight into practice. During their 10-week clinical internships, the students progress to writing 2 reflective narratives—the first after 3 weeks of the clinical experience and the second at the end.
Narrative theory suggests that the meaning of a story or narrative is always co-constructed and exists in the coming together of storyteller and listener (author and reader). Rather than being confident that they know the author's intended meaning, readers bring their own meaning-making ability to bear in understanding what the narrative means to them. According to Shulman, 55 narratives are second-order experiences—the interpretation of the first-order experience (the actual case or event). In the written narrative, the first co-construction of meaning occurs between the clinician who experienced the situation and, through the benefit of time and language, the same clinician who reflects on that experience and writes the story. Narratives also invite third-order experiences—additional layers of interpretation and meaning making. Through their sharing, narratives afford the opportunity to engage in collaborative, rather than individualistic, reflection. A structure is provided within which students and clinicians can work together to develop a shared meaning of an experience. The eFigure (available at ptjournal.apta.org ) illustrates the progression and interconnection of how shared meaning is created from a writer's original engagement in an experience through personal to group reflection.
In our teaching, we emphasize the primacy of group discussion, deliberation, and debate in the examination of the narrative. The process is dialogic; different members of the group explore different perspectives on the nature of the problem, the available elective actions, or the import of the consequences. Narratives almost always reveal more than the author was aware of or intended to reveal in the telling of the story. 60 , 61 The interaction with a group helps the writer unbundle additional meaning and understanding. Because of this, however, it is critical that the discussion occurs in a safe environment for all involved. An attitude of genuine curiosity about the experience, wanting to understand rather than trying to judge the rightness or wrongness of the author's actions or decisions, helps to create this safe space. 39
At Emory University, we have integrated narrative unbundling activities during the students' short-term and long-term clinical internships (semesters 3, 4, and 5) ( Tab. 4 ). During these initial unbundling activities, students meet in smaller groups and read their narratives to each other. A faculty member guides students to ask probing questions and discussions of each narrative for themes and meaning based on the prompts listed in Table 5 .
Prompts Used to Facilitate Group Discussions About a Narrative
What is this a story about? |
Are there ethical issues involved? If so, what are they? |
How can the issue(s) be framed? |
What were your priorities during the situation? |
Did your priorities change during this clinical episode? If so, how? |
What were your major expectations in this clinical situation? Where do you think those expectations came from? |
Did anything take you by surprise during the clinical situation? |
As the situation unfolded, what were you feeling? |
How did you know to take that action (or respond in that way) in the moment? Were there interpersonal, clinical, or environmental cues you were responding to? |
Can you identify any rules, principles, concepts, or theories that guided you during this situation? |
How did you know to take that action (or respond in that way) in the moment? Were there interpersonal, clinical, or environmental cues you were responding to? |
Do you think your perspective about patient care has changed as a result of this clinical encounter? If so, how? |
What is this a story about? |
Are there ethical issues involved? If so, what are they? |
How can the issue(s) be framed? |
What were your priorities during the situation? |
Did your priorities change during this clinical episode? If so, how? |
What were your major expectations in this clinical situation? Where do you think those expectations came from? |
Did anything take you by surprise during the clinical situation? |
As the situation unfolded, what were you feeling? |
How did you know to take that action (or respond in that way) in the moment? Were there interpersonal, clinical, or environmental cues you were responding to? |
Can you identify any rules, principles, concepts, or theories that guided you during this situation? |
How did you know to take that action (or respond in that way) in the moment? Were there interpersonal, clinical, or environmental cues you were responding to? |
Do you think your perspective about patient care has changed as a result of this clinical encounter? If so, how? |
For the students' long-term clinical affiliation, a course was created on the Emory Blackboard educational site. After writing their narratives, students used Blackboard (Blackboard Inc, Washington, DC) to participate in an online group discussion. Groups consisted of 6 or 7 students (from a cohort of 70 students). The purpose of small groups was to facilitate follow-up discussion and ultimately develop a shared meaning of each group member's experience. Each group member uploaded his or her narrative, and the other members provided in-depth responses (1 to 3 paragraphs offering their reflections on the narrative). Group members, including the narrative's author, were asked to pose questions and make comments on others' posts in order to further probe meaning and sharpen understanding of the narrative.
Based on our experiences of integrating narrative tools to enhance physical therapist students' clinical learning, we have instituted a program of narrative writing for our physical therapy residents at Creighton University and Emory University. The residents were trained in the theory and skills of narrative writing and reflection and were asked to write narratives during their 1-year residency in orthopedics and neurology ( Tab. 4 ). Each student wrote narratives across 3 time placements. As is the case with physical therapist students, our goals of narrative training for residents are to help them develop tools of reflection and reflexivity for expert practice.
At MGH, narratives are part of a hospital-based interprofessional development program. 39 As they move through each defined level, clinicians write a first-person description of a clinical experience or situation that was meaningful to them. That narrative is read by one or more department leaders, who meet with the clinician to further discuss and “unbundle” the experience. This process facilitates the therapist's deeper reflection on the meaning of the clinical experience and applications it may have for their practice. For example, questions may be directed to specific words the clinician chose to describe the situation: “You write that the patient interview felt like a ‘battle.’ Tell me more about that.” Or questions may probe thoughts and feeling underlying the written statement: “You describe that you were seeing this patient immediately after they had been given an unexpected prognosis. How did this change your thinking about the session?” The content of these discussions differs from the department's traditional case presentation.
Over time, the use of narrative as a vehicle for reflection and learning from experience has expanded to other role groups. For example, clinical instructors share and discuss narratives of student/patient/clinical instructor interactions related to teaching strategies and student learning challenges. This group unbundling is facilitated by the center coordinators of clinical education, who bring expertise in both narrative interpretation and clinical education. Table 6 provides a summary of narrative experiences across education, residency, and clinical care.
Summary of Experiences Using Narrative Across Professional Education, Residency Program, and Clinical Development Program
Students learn narrative approach to ethical decision making. |
Students are introduced to concepts of narrative for reflection and learning. They practice writing a narrative about a learning experience. |
Students are instructed to write a narrative about a clinical experience during their short-term clinical rotations using narrative prompts as a guide. |
Students practice unbundling narrative meaning in small groups. |
Students are instructed to write 2 clinical narratives early and late during their first long-term clinical placement using Gibbs' model as a guide and narrative prompts. |
Residents are instructed in how to write narratives and asked to write them early, in the middle of, and later during their residency programs using Gibbs' model to guide narrative writing and narrative prompts. |
Residents and resident mentors unbundle and explore narrative meanings and types and levels of reflection. |
Clinicians write a first-person description of a clinical experience or situation that was meaningful to them. |
Clinicians share their narratives with the center coordinator of clinical education through a process of unbundling. |
Students learn narrative approach to ethical decision making. |
Students are introduced to concepts of narrative for reflection and learning. They practice writing a narrative about a learning experience. |
Students are instructed to write a narrative about a clinical experience during their short-term clinical rotations using narrative prompts as a guide. |
Students practice unbundling narrative meaning in small groups. |
Students are instructed to write 2 clinical narratives early and late during their first long-term clinical placement using Gibbs' model as a guide and narrative prompts. |
Residents are instructed in how to write narratives and asked to write them early, in the middle of, and later during their residency programs using Gibbs' model to guide narrative writing and narrative prompts. |
Residents and resident mentors unbundle and explore narrative meanings and types and levels of reflection. |
Clinicians write a first-person description of a clinical experience or situation that was meaningful to them. |
Clinicians share their narratives with the center coordinator of clinical education through a process of unbundling. |
In summary, we have integrated narratives throughout our curricula, residency programs, and clinical practices. Based on our experiences, we have learned several lessons to effectively help our physical therapist students, residents, and clinicians learn to write and interpret reflective narratives about their clinical experiences.
Not all narratives are created equal; reflective writing is a skill that needs to be taught, learned, and practiced. Writing good narratives requires time and opportunities to develop this skill.
Stories need to be shared; faculty, clinical instructors, and clinical mentors need to create narrative friends and a safe environment for sharing stories. Narrative theory suggests that the meaning of a story is always co-constructed between the storyteller and listener (author and reader).
Reflective narratives can be both a learning process and outcome measures. Narrative provides a powerful tool for educators and clinicians to gain more insight into the thinking of their learners. Recent studies have focused on evaluating narratives for themes and categories and levels of reflection across clinical experiences. 13 , 22 , 30 , 53
There is increasing recognition of the need for greater balance between the humanistic and the technical aspects of physical therapist practice. This increased recognition has contributed to an interest in education methods to promote and help students and clinicians to incorporate the qualitative and quantitative aspects of their practice. In this article, we suggest that narrative methodology is an appropriate pedagogical tool to assist students in exploring their own development and experiences and, most importantly, those of their patients.
In this article, we have highlighted how narrative provides a powerful framework for educators to assist students to engage in reflective and reflexive practice. Narratives and the questions that prompt narrative reflection provide a vehicle for uncovering the broader aspects of a patient's context. They work to support clinical reasoning, which incorporates psychosocial and sociocultural elements of patient care. Importantly, narratives assist in redefining dominant conceptions of what counts as physical therapist practice and expand clinical thinking and practice to include not only the use of epistemic technical knowledge but also the use of phronetic and ethics-based knowledge. We believe such an expansion in knowledge use and reflection is vital for the physical therapy profession to respond to the contextual complexities of clinical practice.
In this article, we have described our strategies with specific examples of integrating narrative experiences throughout different levels of professional education and development. Through our own reflection of the successes and shortcomings of these experiences, we continue to experiment with and modify our approach. We encounter skeptical students and clinicians who need to be convinced that the story is an important construct in the delivery of high-quality, patient-centered care and who need to be reassured that their reflective writing is not assessed according to the stance or viewpoints they take but rather according to their degree of engagement in the process of critical reflection. Our experiences have taught us the importance of incrementally and consistently integrating narrative throughout curriculum and clinical practice. Our challenge is to find ways to see our knowledge generation and construction in its broadest sense with evidence from multiple sources.
Harrison M . Evidence based practice: Practice based evidence . Physiother Theory Pract . 1996 ; 12 : 129 – 130 .
Google Scholar
Herbert RD , Sherrington C , Maher C , Moseley AM . Evidence-based practice: imperfect but necessary . Physiother Theory Pract . 2001 ; 17 : 201 – 211 .
Hooked on Evidence . Alexandria, VA : American Physical Therapy Association ; 2013 . Available at: http://www.hookedonevidence.org . Accessed August 27, 2013 .
Jensen GM . 42nd Mary McMillan Lecture. Learning: what matters most . Phys Ther . 2011 ; 91 : 1674 – 1689 .
French S , Sim J , eds. Physiotherapy: A Psychosocial Approach . 3rd ed. New York, NY : Elsevier Butterworth Heinemann ; 2004 .
Google Preview
Schön D . The Reflective Practitioner: How Professionals Think in Action . New York, NY : Basic Books ; 1983 .
Hislop HJ . Tenth Mary McMillan Lecture: The not-so-impossible dream . Phys Ther . 1975 ; 55 : 1069 – 1080 .
Mostrom E . 16th Annual Pauline Cerasoli Lecture. Life lessons: teaching for learning that lasts . J Phys Ther Educ . 2013 ; 27 : 112 – 119 .
Purtilo RB . Thirty-First Mary McMillan lecture. A time to harvest, a time to sow: ethics for a shifting landscape . Phys Ther . 2000 ; 80 : 1112 – 1119 .
Shepard KF . Thirty-Eighth Mary McMillan Lecture. Are you waving or drowning? Phys Ther . 2007 ; 11 : 1543 – 1554 .
Greenfield B , Jensen GM . Phenomenology: a powerful tool for patient-centered rehabilitation . Phys Ther Rev . 2012 ; 17 : 417 – 424 .
Jensen GM , Mostrom E , Shepard KF . Teaching and learning in academic settings . In: Jensen GM , Mostrom E , eds. Handbook of Teaching and Learning for Physical Therapists . 3rd ed. St Louis, MO : Elsevier ; 2013 : 32 – 60 .
Levett-Jones TL . Facilitating reflective practice and self-assessment of competence through the use of narratives . Nurse Educ Prac . 2007 ; 7 : 112 – 119 .
Bruner J . Actual Minds, Possible Worlds . Cambridge, MA ; Harvard University Press : 1986 .
Charon R . Narrative Medicine: Honoring the Stories of Illness . New York, NY : Oxford University Press ; 2006 .
Benner P , Tanner C , Chesla C , eds. Expertise in Nursing Practice: Caring, Clinical Judgment, and Ethics . New York, NY : Springer Publishing Co ; 1996 .
Frank AW . At the Will of the Body: Reflections on Illness . Boston, MA ; Houghton Mills : 2002 .
Polkinghorne DE . Narrative Knowing and the Human Sciences . New York, NY : State University of New York Press ; 1988 .
Dewey J . Democracy and Education: An Introduction to the Philosophy of Education . New York, NY : The Free Press ; 1944 .
Boyd EM , Fales AW . Reflective learning key to learning from experience . J Humanistic Psychol . 1983 ; 23 : 99 – 117 .
Johns C . Becoming a Reflective Practitioner . 3rd ed. Oxford, United Kingdom : Wiley-Blackwell ; 2009 .
Hatton N , Smith D . Reflection in teacher education: towards definitions and implementation . Teaching Teaching Educ . 1995 ; 11 : 33 – 49 .
Boud D , Keogh R , Walker D . Reflection: Turning Experience Into Learning . New York, NY : Nichols Publishing Co ; 2005 .
Buchmann M . Beyond the lonely, choosing will: professional development in teacher thinking . Teach Coll Rec . 1990 ; 91 : 482 – 508 .
Wald HS , Borkan JM , Taylor JS , Anthony D , Reis SP . Fostering and evaluating reflective capacity in medical education: developing the REFLECT rubric for assessing reflective writing . Acad Med . 2012 ; 87 : 41 – 50 .
Charon R , Hermann N . A sense of story, or why teach reflective writing? Acad Med . 2012 ; 87 : 5 – 7 .
Mezirow J . Fostering Critical Reflection in Adulthood: A Guide to Transformative and Emancipatory Learning . San Francisco, CA : Jossey-Bass ; 1990 .
Donaghy M , Morss K . Guided reflection: a framework to facilitate and assess reflective practice within the discipline of physiotherapy . Physiother Theory Pract . 2000 ; 16 : 3 – 14 .
Delaney C , Watkins D . A study of critical reflection in health professional education: “learning where others are coming from.” Adv Health Sci Educ . 2009 ; 14 : 411 – 429 .
Delany C , Molloy E . Critical reflection in clinical education: beyond the “swampy lowlands.” In: Delany C , Molloy E , eds. Clinical Education in the Health Professions . Sydney, New South Wales, Australia : Elsevier ; 2009 : 3 – 24 .
Patton MQ . Qualitative Research and Evaluation Methods . 3rd ed. Thousand Oaks, CA ; Sage Publications : 2002 .
Aristotle . Nichomachean Ethics . Thomson JAK , trans. Middlesex, United Kingdom : Penguin Classics ; 1953 : 197 – 222 .
Sackett DL , Rosenberg WMC , Gray JAM , et al. . Evidence-based medicine: what it is and what it isn't . BMJ . 1996 ; 312 : 71 – 72 .
Flyvbjerg B . Making Social Science Matter: Why Social Inquiry Fails and How It Can Succeed Again . Cambridge, United Kingdom : Cambridge University Press ; 2001 .
Jensen GM , Resnik L , Haddad A . Expertise and clinical reasoning . In: Higgs J , Jones M , Loftus S , Christensen N , eds. Clinical Reasoning in the Health Professions . Boston, MA : Elsevier ; 2008 : 123 – 136 .
Jensen GM , Gwyer J , Shepard KF . Expert practice in physical therapy . Phys Ther . 2000 ; 80 : 28 – 43 .
Resnik L , Jensen GM . Using clinical outcomes to explore the theory of expert practice in physical therapy . Phys Ther . 2003 ; 83 : 1090 – 1106 .
Edwards I , Jones M . Clinical reasoning and expert practice . In: Jensen GM , Gwyer J , Hack LM , Shepard KF , eds. Expertise in Physical Therapy Practice . St Louis, MO : Elsevier Saunders ; 2007 : 192 – 213 .
Clinical recognition program. Massachusetts General Hospital website . Available at: http://www.mghpcs.org/ipc/programs/Recognition/Index.asp .
Purtilo R , Doherty RA . Ethical Dimensions in the Health Professions . 5th ed. St Louis, MO : Elsevier Saunders ; 2013 .
Jensen GM . Mindfulness: Applications for teaching and learning in ethics education . In: Purtilo RB , Jensen GM , Royeen CB , eds. Educating for Moral Action: A Sourcebook in Health and Rehabilitation . Philadelphia, PA : FA Davis ; 2005 : 191 – 201 .
Mylopoulos M , Lohfeld L , Norman GR , et al. . Renowned physicians' perceptions of expert diagnostic practice . Acad Med . 2012 ; 87 : 1413 – 1417 .
Mamede S , Schmidt HG , Penaforte JC . Effects of reflective practice on the accuracy of medical diagnoses . Med Educ . 2008 ; 42 : 468 – 474 .
Plack MM , Greenberg L . The reflective practitioner: reaching for excellence in practice . Pediatrics . 2005 ; 116 : 1546 – 1552 .
Greenhalgh T . Narrative based medicine in an evidence-based world . BMJ . 1999 ; 318 : 323 – 325 .
Mishler EG . The Discourse of Medicine: The Dialectics of Medical Interviews . Norwood, NJ : Ablex ; 1984 .
Coles R . A Call of Stories. Teaching and the Moral Imagination . Boston, MA : Houghton Mifflin Co ; 1990 .
Kleinman A . The Illness Narrative. Suffering, Healing & the Human Condition . New York, NY : Basic Books ; 1988 .
Nowacyk MJ . Narrative medicine in clinical genetics practice . Am J Med Genet A . 2012 ; 158 : 1941 – 1947 .
Hatem D , Rider EA . Sharing stories: narrative medicine in an evidence-based world . Patient Educ Couns . 2004 ; 54 : 251 – 243 .
Mattingly C . The narrative nature of clinical reasoning . In: Mattingly C , Fleming MH , eds. Clinical Reasoning: Forms of Inquiry in a Therapeutic Practice . Philadelphia, PA : FA Davis Co ; 1994 .
Royeen C , Kramer P . Professional preparation for practice . In: Higgs J , Sheehan D , Currens JB , Letts W , Jensen GM , eds. Realising Exemplary Practice-Based Education . Rotterdam, the Netherlands : Sense Publishers ; 2013 : 25 – 32 .
Plack MM , Driscoll M , Blissett S , et al. . A method for assessing reflective journal writing . J Allied Health . 2005 ; 34 : 199 – 208 .
Greenfield B , Swisher LL . The role of narrative in professional formation for students . In: Higgs J , Sheehan D , Currens JB , et al. , eds. Realising Exemplary Practice-Based Education . Rotterdam, the Netherlands : Sense Publishers ; 2013 : 163 – 170 .
Shulman LS . The Wisdom of Practice: Essays on Teaching, Learning and Learning to Teach . San Francisco, CA : Jossey-Bass ; 2004 .
Gibbs G . Learning by Doing: A Guide to Teaching and Learning Methods . Oxford, United Kingdom : Further Education Unit, Oxford Brookes University ; 1988 .
Atkins S , Murphy K . Reflective practice (continuing education credit) . Nurs Stand . 1994 ; 8 : 49 – 56 .
Johns C , Graham J . Using a reflective model of nursing and guided reflection . Nurs Stand . 1996 ; 11 : 34 – 38 .
Kolb DA . Experiential Learning: Experience as the Source of Learning and Development . Englewood Cliffs, NJ : Prentice-Hall ; 1984 .
Guignon C . Becoming a person: hermeneutic phenomenology's contribution . New Ideas Psychol . 2012 ; 30 : 97 – 106 .
Mishler EG . Models of narrative analysis: a typology . J Narr Life Hist . 1995 ; 5 : 87 – 123 .
Supplementary data.
Process of narrative unbundling.
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Over the past several decades, periodization has been widely accepted as the gold standard of training theory. Within the literature, there are numerous definitions for periodization, which makes it difficult to study. When examining the proposed definitions and related studies on periodization, problems arise in the following domains: (1) periodization has been proposed to serve as the macro-management of the training process concerning the annual plan, yet research on long-term effects is scarce; (2) periodization and programming are being used interchangeably in research; and (3) training is not periodized alongside other stressors such as sport (i.e., only resistance training is being performed without the inclusion of sport). Overall, the state of the literature suggests that the inability to define periodization makes the statement of its superiority difficult to experimentally test. This paper discusses the proposed definitions of periodization and the study designs which have been employed to examine the concept.
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Development of a skill acquisition periodisation framework for high-performance sport.
Matveyev LP. Problem of periodization the sport training. Moscow: FiS Publisher; 1964.
Google Scholar
Stone MH, O’Bryant H, Garhammer J. A hypothetical model for strength training. J Sports Med Phys Fitness. 1981;21(4):342–51.
CAS PubMed Google Scholar
Prestes J, De Lima C, Frollini AB, Donatto FF, Conte M. Comparison of linear and reverse linear periodization effects on maximal strength and body composition. J Strength Cond Res. 2009;23(1):266–74.
PubMed Google Scholar
Bartolomei S, Hoffman JR, Merni F, Stout JR. A comparison of traditional and block periodized strength training programs in trained athletes. J Strength Cond Res. 2014;28(4):990–7.
Apel JM, Lacey RM, Kell RT. A comparison of traditional and weekly undulating periodized strength training programs with total volume and intensity equated. J Strength Cond Res. 2011;25(3):694–703.
Selye H. Experimental evidence supporting the conception of “adaptation energy.” Am J Physiol. 1938;123(3):758–65.
Buckner SL, Mouser JG, Dankel SJ, Jessee MB, Mattocks KT, Loenneke JP. The general adaptation syndrome: potential misapplications to resistance exercise. J Sci Med Sport. 2017;20(11):1015–7.
Cunanan AJ, DeWeese BH, Wagle JP, Hornsby WG III, Carroll KM, Sausaman R, et al. The general adaptation syndrome: a foundation for the concept of periodization. Sports Med. 2018;4:787.
Buckner SL, Jessee MB, Dankel SJ, Mouser JG, Mattocks KT, Loenneke JP. Comment on: “the general adaptation syndrome: a foundation for the concept of periodization.” Sports Med. 2018;48(7):1751–3.
Cunanan AJ, DeWeese BH, Wagle JP, Carroll KM, Sausaman R, Hornsby WG, et al. Authors’ reply to Buckner et al.: ‘comment on: “the general adaptation syndrome: a foundation for the concept of periodization.” Sports Med. 2018;48(7):1755–7.
Stone MH, O’Bryant H, Garhammer J, McMillan J, Rozenek R. A theoretical model of strength training. Strength Cond J. 1982;4(4):36–9.
Buckner SL, Jessee MB, Mouser JG, Dankel SJ, Mattocks KT, Bell ZW, et al. The basics of training for muscle size and strength: a brief review on the theory. Med Sci Sports Exerc. 2020;52(3):645–53.
Williams TD, Tolusso DV, Fedewa MV, Esco MR. Comparison of periodized and non-periodized resistance training on maximal strength: a meta-analysis. Sports Med. 2017;47(10):2083–100.
Kiely J. Periodization paradigms in the 21st century: evidence-led or tradition-driven? Int J Sports Physiol Perform. 2012;7(3):242–50.
Plisk SS, Stone MH. Periodization strategies. Strength Cond J. 2003;25(6):19–37.
Harries SK, Lubans DR, Callister R. Systematic review and meta-analysis of linear and undulating periodized resistance training programs on muscular strength. J Strength Cond Res. 2015;29(4):1113–25.
DeWeese BH, Hornsby GW, Stone MH, Stone MH. The training process: planning for strength—power training in track and field. part 1: theoretical aspects. J Sport Health Sci. 2015;4:308–17.
Fleck SJ, Kraemer WJ, Kraemer PHDW. Designing resistance training programs. 3rd ed. Human Kinetics; 2004.
Brown LE, Bradley-Popovich G, Haff G. Nonlinear versus linear periodization models. Strength Cond J. 2001;23(1):42–4.
Buford TW, Rossi SJ, Smith DB, Warren AJ. A comparison of periodization models during nine weeks with equated volume and intensity for strength. J Strength Cond Res. 2007;21(4):1245–50.
Suchomel TJ, Nimphius S, Bellon CR, Stone MH. The importance of muscular strength: training considerations. Sports Med. 2018;48(4):765–85.
Hoffman JR, National S, Conditioning A. NSCA’s guide to program design. Champaign: Human Kinetics; 2012.
Bompa T. Primer on periodization. Olympic Coach. 2004;16(2):4–7.
Zatsiorsky V, Kraemer W. Science and practice of strength training. 2nd Ed. Human Kinetics; 2006.
Haff G, Triplett NT, National Strength & Conditioning Association. Essentials of strength training and conditioning. 4th Ed. Human Kinetics; 2016.
DeWeese BH, Hornsby GW, Stone MH, Stone MH. The training process: planning for strength–power training in track and field. Part 2: practical and applied aspects. J Sport Health Sci. 2015;4:318–24.
Zaryski C, Smith DJ. Training principles and issues for ultra-endurance athletes. Curr Sports Med Rep. 2005;4(3):165–70.
Painter KB, Haff GG, Ramsey MW, McBride J, Triplett T, Sands WA, et al. Strength gains: block versus daily undulating periodization weight training among track and field athletes. Int J Sports Physiol Perform. 2012;7(2):161–9.
Chandler TJ, Brown LE. Conditioning for strength and human performance. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins; 2013.
Issurin VB. New horizons for the methodology and physiology of training periodization. Sports Med. 2010;40(3):189–206.
Tonnessen E, Svendsen IS, Ronnestad BR, Hisdal J, Haugen TA, Seiler S. The annual training periodization of 8 world champions in orienteering. Int J Sports Physiol Perform. 2015;10(1):29–38.
Kiely J. Periodization theory: confronting an inconvenient truth. Sports Med. 2017;48(4):753–64.
PubMed Central Google Scholar
Grgic J, Mikulic P, Podnar H, Pedisic Z. Effects of linear and daily undulating periodized resistance training programs on measures of muscle hypertrophy: a systematic review and meta-analysis. PeerJ. 2017;5:e3695.
PubMed PubMed Central Google Scholar
Willoughby DS. The Effects of mesocycle-length weight training programs involving periodization and partially equated volumes on upper and lower body strength. J Strength Cond Res. 1993;7(1):2–8.
Stone MH, Potteiger JA, Pierce KC, Proulx CM, O’Bryant HS, Johnson RL, et al. Comparison of the effects of three different weight-training programs on the one repetition maximum squat. J Strength Cond Res. 2000;14(3):332–7.
Pinto R, Angarten V, Santos V, Melo X, Santa-Clara H. The effect of an expanded long-term periodization exercise training on physical fitness in patients with coronary artery disease: study protocol for a randomized controlled trial. Trials. 2019;20(1):208.
Kibler WB, Chandler TJ. Sport-specific conditioning. Am J Sports Med. 1994;22(3):424–32.
Haff GG. Roundtable discussion: periodization of training—part 1. Strength Cond J. 2004;26(1):50–69.
Fisher PJ, Steele J, Smith D, Gentil P. Periodization for optimizing strength and hypertrophy; the forgotten variables. J Trainol. 2018;7(1):10–5.
Marx JO, Ratamess NA, Nindl BC, Gotshalk LA, Volek JS, Dohi K, et al. Low-volume circuit versus high-volume periodized resistance training in women. Med Sci Sports Exerc. 2001;33(4):635–43.
Herrick AB, Stone WJ. The effects of periodization versus progressive resistance exercise on upper and lower body strength in women. J Strength Cond Res. 1996;10(2):72–6.
DeBeliso M, Harris C, Spitzer-Gibson T, Adams KJ. A comparison of periodised and fixed repetition training protocol on strength in older adults. J Sci Med Sport. 2005;8(2):190–9.
Prestes J, Frollini AB, de Lima C, Donatto FF, Foschini D, de Cassia MR, et al. Comparison between linear and daily undulating periodized resistance training to increase strength. J Strength Cond Res. 2009;23(9):2437–42.
Foschini D, Araujo RC, Bacurau RF, De Piano A, De Almeida SS, Carnier J, et al. Treatment of obese adolescents: the influence of periodization models and ACE genotype. Obesity. 2010;18(4):766–72.
Mann JB, Thyfault JP, Ivey PA, Sayers SP. The effect of autoregulatory progressive resistance exercise vs. linear periodization on strength improvement in college athletes. J Strength Cond Res. 2010;24(7):1718–23.
Fleck SJ. Non-linear periodization for general fitness & athletes. J Hum Kinet. 2011;29a:41–5.
Lorenz D, Morrison S. Current concepts in periodization of strength and conditioning for the sports physical therapist. Int J Sports Phys Ther. 2015;10(6):734–47.
Ullrich B, Holzinger S, Soleimani M, Pelzer T, Stening J, Pfeiffer M. Neuromuscular responses to 14 weeks of traditional and daily undulating resistance training. Int J Sports Med. 2015;36(7):554–62.
Bradbury DG, Landers GJ, Benjanuvatra N, Goods PSR. Comparison of linear and reverse linear periodized programs with equated volume and intensity for endurance running performance. J Strength Cond Res. 2018;34(5):1345–53.
Fleck SJ, Kraemer WJ. Periodization breakthrough!: the ultimate training system. 1st Ed. Advanced Research Press; 1996.
Schiotz MK, Potteiger JA, Huntsinger PG, Donald C, Denmark LC. The short-term effects of periodized and constant-intensity training on body composition, strength, and performance. J Strength Cond Res. 1998;12(3):173–8.
Graham J. Periodization research and an example application. Strength Cond J. 2002;24:62–70.
Kraemer WJ, Hakkinen K, Triplett-Mcbride NT, Fry AC, Koziris LP, Ratamess NA, et al. Physiological changes with periodized resistance training in women tennis players. Med Sci Sports Exerc. 2003;35(1):157–68.
Plisk S. Periodization: fancy name for a basic concept. Olympic Coach. 2004;16(2):14–7.
Jiménez A. Undulating periodization models for strength training & conditioning. Motricidade. 2009;5:1–5.
Tammam A, Hashem E. Comparison between daily and weekly undulating periodized resistance training to increase muscular strength for volleyball players. J Appl Sports Sci. 2015;5(3):27–36.
Klemp A, Dolan C, Quiles JM, Blanco R, Zoeller RF, Graves BS, et al. Volume-equated high- and low-repetition daily undulating programming strategies produce similar hypertrophy and strength adaptations. Appl Physiol Nutr Metab. 2016;41(7):699–705.
Housh TJ, Housh DJ, deVries HA. Applied exercise and sport physiology, with labs. 3rd Ed. Taylor & Francis; 2011.
Vargas A. Tiered vs. traditional daily undulating periodization for improving powerlifting performance in trained males. Graduate Theses and Dissertations, University of South Florida; 2017. https://scholarcommons.usf.edu/etd/6770 .
Stowers T, McMillan J, Scala D, Davis V, Wilson D, Stone M. The short-term effects of three different strength-power training methods. Strength Cond J. 1983;5(3):24–7.
Harries SK, Lubans DR, Callister R. Comparison of resistance training progression models on maximal strength in sub-elite adolescent rugby union players. J Sci Med Sport. 2016;19(2):163–9.
Hoffman JR, Wendell M, Cooper J, Kang J. Comparison between linear and nonlinear in-season training programs in freshman football players. J Strength Cond Res. 2003;17(3):561–5.
Kok LY, Hamer PW, Bishop DJ. Enhancing muscular qualities in untrained women: linear versus undulating periodization. Med Sci Sports Exerc. 2009;41(9):1797–807.
Rhea MR, Ball SD, Phillips WT, Burkett LN. A comparison of linear and daily undulating periodized programs with equated volume and intensity for strength. J Strength Cond Res. 2002;16(2):250–5.
Bartolomei S, Stout JR, Fukuda DH, Hoffman JR, Merni F. Block vs. weekly undulating periodized resistance training programs in women. J Strength Cond Res. 2015;29(10):2679–87.
O’Bryant HS, Byrd R, Stone MH. Cycle ergometer performance and maximum leg and hip strength adaptations to two different methods of weight-training. J Strength Cond Res. 1988;2(2):27–30.
Monteiro AG, Aoki MS, Evangelista AL, Alveno DA, Monteiro GA, Picarro Ida C, et al. Nonlinear periodization maximizes strength gains in split resistance training routines. J Strength Cond Res. 2009;23(4):1321–6.
McNamara JM, Stearne DJ. Flexible nonlinear periodization in a beginner college weight training class. J Strength Cond Res. 2010;24(1):17–22.
Miranda F, Simao R, Rhea M, Bunker D, Prestes J, Leite RD, et al. Effects of linear vs. daily undulatory periodized resistance training on maximal and submaximal strength gains. J Strength Cond Res. 2011;25(7):1824–30.
Simao R, Spineti J, de Salles BF, Matta T, Fernandes L, Fleck SJ, et al. Comparison between nonlinear and linear periodized resistance training: hypertrophic and strength effects. J Strength Cond Res. 2012;26(5):1389–95.
de Lima C, Boullosa DA, Frollini AB, Donatto FF, Leite RD, Gonelli PR, et al. Linear and daily undulating resistance training periodizations have differential beneficial effects in young sedentary women. Int J Sports Med. 2012;33(9):723–7.
Bakken TA. Effects of block periodization training versus traditional periodization training in trained cross country skiers. Student thesis, Swedish School of Sport and Health Sciences; 2013.
Ahmadizad S, Ghorbani S, Ghasemikaram M, Bahmanzadeh M. Effects of short-term nonperiodized, linear periodized and daily undulating periodized resistance training on plasma adiponectin, leptin and insulin resistance. Clin Biochem. 2014;47(6):417–22.
Zourdos MC, Jo E, Khamoui AV, Lee SR, Park BS, Ormsbee MJ, et al. Modified daily undulating periodization model produces greater performance than a traditional configuration in powerlifters. J Strength Cond Res. 2016;30(3):784–91.
Colquhoun RJ, Gai CM, Walters J, Brannon AR, Kilpatrick MW, D’Agostino DP, et al. Comparison of powerlifting performance in trained men using traditional and flexible daily undulating periodization. J Strength Cond Res. 2017;31(2):283–91.
Pelzer T, Ullrich B, Pfeiffer M. Periodization effects during short-term resistance training with equated exercise variables in females. Eur J Appl Physiol. 2017;117(3):441–54.
Bartolomei S, Hoffman J, Stout J, Zini M, Stefanelli C, Merni F. Comparison of block versus weekly undulating periodization models on endocrine and strength changes in male athletes. Kinesiology. 2016;48:71–8.
Spineti J, Figueiredo T, de Salles B, Barbosa M, Oliveira L, Novaes J, et al. Comparison between different periodization models on muscular strength and thickness in a muscle group increasing sequence. Rev Bras Med Esporte. 2013;19:280–6.
Kenney WL, Wilmore JH, Costill DL. Physiology of sport and exercise. 7th Ed. Human kinetics, Incorporated; 2019.
Hartmann H, Wirth K, Keiner M, Mickel C, Sander A, Szilvas E. Short-term periodization models: effects on strength and speed-strength performance. Sports Med. 2015;45(10):1373–86.
Conlon JA, Newton RU, Tufano JJ, Banyard HG, Hopper AJ, Ridge AJ, et al. Periodization strategies in older adults: impact on physical function and health. Med Sci Sports Exerc. 2016;48(12):2426–36.
Meeusen R, Duclos M, Foster C, Fry A, Gleeson M, Nieman D, et al. Prevention, diagnosis, and treatment of the overtraining syndrome: joint consensus statement of the European College of Sport Science and the American College of Sports Medicine. Med Sci Sports Exerc. 2013;45(1):186–205.
Kentta G, Hassmen P, Raglin JS. Training practices and overtraining syndrome in Swedish age-group athletes. Int J Sports Med. 2001;22(6):460–5.
Matos NF, Winsley RJ, Williams CA. Prevalence of nonfunctional overreaching/overtraining in young English athletes. Med Sci Sports Exerc. 2011;43(7):1287–94.
Matveev LP. Fundamentals of sports training. Moscow: Progress Publishers; 1981.
Stults-Kolehmainen MA, Bartholomew JB, Sinha R. Chronic psychological stress impairs recovery of muscular function and somatic sensations over a 96-hour period. J Strength Cond Res. 2014;28(7):2007–17.
Kraemer WJ, Ratamess N, Fry AC, Triplett-McBride T, Koziris LP, Bauer JA, et al. Influence of resistance training volume and periodization on physiological and performance adaptations in collegiate women tennis players. Am J Sports Med. 2000;28(5):626–33.
Painter KB, Haff GG, Triplett NT, Stuart C, Hornsby G, Ramsey MW, et al. Resting hormone alterations and injuries: block vs. DUP weight-training among D-1 track and field athletes. Sports. 2018;6(1):3.
Pedemonte J. Updated acquisitions about training periodization: part one. Strength Cond J. 1982;4(5):56–60.
Freeman WH. Peak when it counts: periodization for American track and field. 4th Ed. Tafnews Press; 2001.
Smith DJ. A framework for understanding the training process leading to elite performance. Sports Med. 2003;33(15):1103–26.
Gambetta V. Periodization and the systematic sport development process. Olympic Coach. 2004;16(2):8–13.
Cissik J, Hedrick A, Barnes M. Challenges applying the research on periodization. Strength Cond J. 2008;30(1):45–51.
Issurin V. Block periodization versus traditional training theory: a review. J Sports Med Phys Fitness. 2008;48(1):65–75.
Peterson MD, Dodd DJ, Alvar BA, Rhea MR, Favre M. Undulation training for development of hierarchical fitness and improved firefighter job performance. J Strength Cond Res. 2008;22(5):1683–95.
Ratamess N, Alvar B, Evetoch TK, Housh TJ, Kibler WB, Kraemer W. Progression models in resistance training for healthy adults [ACSM position stand]. Med Sci Sports Exerc. 2009;41:687–708.
Kell RT. The influence of periodized resistance training on strength changes in men and women. J Strength Cond Res. 2011;25(3):735–44.
Turner A. The science and practice of periodization: a brief review. Strength Cond J. 2011;33(1):34–46.
Naclerio F, Moody J, Chapman M. Applied periodization: a methodological approach. J Hum Sport Exerc. 2013;8(2):S350–66.
DeWeese BH, Gray H, Sams M, Scruggs S, Serrano AJ. Revising the definition of periodization: merging historical principles with modern concern. Olympic Coach. 2013;24:5–18.
Horschig AD, Neff TE, Serrano AJ. Utilization of autoregulatory progressive resistance exercise in transitional rehabilitation periodization of a high school football-player following anterior cruciate ligament reconstruction: a case report. Int J Sports Phys Ther. 2014;9(5):691–8.
Carter J, Potter A, Brooks K. Overtraining syndrome: causes, consequences, and methods for prevention. J Sport Human Perf. 2014;2:1–4.
Hoover DL, VanWye WR, Judge LW. Periodization and physical therapy: bridging the gap between training and rehabilitation. Phys Ther Sport. 2016;18:1–20.
Eifler C. Short-term effects of different loading schemes in fitness-related resistance training. J Strength Cond Res. 2016;30(7):1880–9.
Loturco I, Nakamura F. Training periodisation: an obsolete methodology? Aspetar Sports Med J. 2016.
Fairman CM, Zourdos MC, Helms ER, Focht BC. A scientific rationale to improve resistance training prescription in exercise oncology. Sports Med. 2017;47(8):1457–65.
Conlon JA, Newton RU, Tufano JJ, Penailillo LE, Banyard HG, Hopper AJ, et al. The efficacy of periodised resistance training on neuromuscular adaptation in older adults. Eur J Appl Physiol. 2017;117(6):1181–94.
Mujika I, Halson S, Burke LM, Balague G, Farrow D. An integrated, multifactorial approach to periodization for optimal performance in individual and team sports. Int J Sports Physiol Perform. 2018;13(5):538–61.
Boggenpoel BY, Nel S, Hanekom S. The use of periodized exercise prescription in rehabilitation: a systematic scoping review of literature. Clin Rehabil. 2018;32(9):1235–48.
Afonso J, Rocha T, Nikolaidis PT, Clemente FM, Rosemann T, Knechtle B. A systematic review of meta-analyses comparing periodized and non-periodized exercise programs: why we should go back to original research. Front Physiol. 2019;10:1023.
Evans JW. Periodized resistance training for enhancing skeletal muscle hypertrophy and strength: a mini-review. Front Physiol. 2019;10:13.
Hellard P, Avalos-Fernandes M, Lefort G, Pla R, Mujika I, Toussaint J-F, et al. Elite swimmers’ training patterns in the 25 weeks prior to their season’s best performances: insights into periodization from a 20-years cohort. Front Physiol. 2019;10:363.
Myakinchenko EB, Kriuchkov AS, Adodin NV, Feofilaktov V. The annual periodization of training volumes of international-level cross-country skiers and biathletes. Int J Sports Physiol Perform. 2020;1:1–8.
Baker D, Wilson G, Carlyon R. Periodization: the effect on strength of manipulating volume and intensity. J Strength Cond Res. 1994;8(4):235–42.
Hoffman JR, Ratamess NA, Klatt M, Faigenbaum AD, Ross RE, Tranchina NM, et al. Comparison between different off-season resistance training programs in Division III American college football players. J Strength Cond Res. 2009;23(1):11–9.
Reiman MP, Lorenz DS. Integration of strength and conditioning principles into a rehabilitation program. Int J Sports Phys Ther. 2011;6(3):241–53.
Moraes E, Fleck SJ, Ricardo Dias M, Simao R. Effects on strength, power, and flexibility in adolescents of nonperiodized vs. daily nonlinear periodized weight training. J Strength Cond Res. 2013;27(12):3310–21.
Souza EO, Ugrinowitsch C, Tricoli V, Roschel H, Lowery RP, Aihara AY, et al. Early adaptations to six weeks of non-periodized and periodized strength training regimens in recreational males. J Sports Sci Med. 2014;13(3):604–9.
Smith RA, Martin GJ, Szivak TK, Comstock BA, Dunn-Lewis C, Hooper DR, et al. The effects of resistance training prioritization in NCAA Division I Football summer training. J Strength Cond Res. 2014;28(1):14–22.
Inoue DS, De Mello MT, Foschini D, Lira FS, De Piano GA, Da Silveira Campos RM, et al. Linear and undulating periodized strength plus aerobic training promote similar benefits and lead to improvement of insulin resistance on obese adolescents. J Diabetes Complicat. 2015;29(2):258–64.
Androulakis-Korakakis P, Fisher JP, Kolokotronis P, Gentil P, Steele J. Reduced volume ‘daily max’’ training compared to higher volume periodized training in powerlifters preparing for competition-a pilot study.’ Sports (Basel). 2018;6(3):86.
Issurin VB. Biological background of block periodized endurance training: a review. Sports Med. 2019;49(1):31–9.
Ronnestad BR, Hansen J, Ellefsen S. Block periodization of high-intensity aerobic intervals provides superior training effects in trained cyclists. Scand J Med Sci Sports. 2014;24(1):34–42.
Ronnestad BR, Hansen J, Thyli V, Bakken TA, Sandbakk O. 5-week block periodization increases aerobic power in elite cross-country skiers. Scand J Med Sci Sports. 2016;26(2):140–6.
Caldwell AM. A comparison of linear and daily undulating periodizied strength training programs [Student thesis]; 2004.
Loturco I, Nakamura FY, Kobal R, Gil S, Pivetti B, Pereira LA, et al. Traditional periodization versus optimum training load applied to soccer players: effects on neuromuscular abilities. Int J Sports Med. 2016;37(13):1051–9.
Ronnestad BR, Ofsteng SJ, Ellefsen S. Block periodization of strength and endurance training is superior to traditional periodization in ice hockey players. Scand J Med Sci Sports. 2019;29(2):180–8.
Ullrich B, Pelzer T, Pfeiffer M. Neuromuscular effects to 6 weeks of loaded countermovement jumping with traditional and daily undulating periodization. J Strength Cond Res. 2018;32(3):660–74.
Gonelli P, Braz T, Verlengia R, Pellegrinotti Í, Cesar M, Sindorf M, et al. Effect of linear and undulating training periodization models on the repeated sprint ability and strength of soccer players. Motriz Revista de Educação Física. 2018;24:1–7.
McGee D, Jessee TC, Stone MH, Blessing D. Leg and hip endurance adaptations to three weight-training programs. J Strength Cond Res. 1992;6(2):92–5.
Sabido R, Hernández-Davó J, Botella Ruiz J, Jiménez-Leiva A, Fernandez-Fernandez J. Effects of block and daily undulating periodization on neuromuscular performance in young male handball players. Kinesiology. 2018;50:97–103.
Fink J, Kikuchi N, Yoshida S, Terada K, Nakazato K. Impact of high versus low fixed loads and non-linear training loads on muscle hypertrophy, strength and force development. Springerplus. 2016;5(1):698.
Franchini E, Branco BM, Agostinho MF, Calmet M, Candau R. Influence of linear and undulating strength periodization on physical fitness, physiological, and performance responses to simulated judo matches. J Strength Cond Res. 2015;29(2):358–67.
Marques M, Casimiro F, Marinho D, Costa A. Training and detraining effects on strength parameters in young volleyball players: volume distribution implications. Motriz. 2011;17:235–43.
Schoenfeld BJ, Contreras B, Ogborn D, Galpin A, Krieger J, Sonmez GT. Effects of varied versus constant loading zones on muscular adaptations in trained men. Int J Sports Med. 2016;37(6):442–7.
Pliauga V, Lukonaitiene I, Kamandulis S, Skurvydas A, Sakalauskas R, Scanlan AT, et al. The effect of block and traditional periodization training models on jump and sprint performance in collegiate basketball players. Biol Sport. 2018;35(4):373–82.
Javaloyes A, Sarabia JM, Lamberts RP, Plews D, Moya-Ramon M. Training prescription guided by heart rate variability vs. block periodization in well-trained cyclists. J Strength Cond Res. 2019;34(6):1511–8.
Harris GR, Stone MH, O’bryant HS, Proulx CM, Johnson RL. Short-term performance effects of high power, high force, or combined weight-training methods. J Strength Cond Res. 2000;14(1):14–20.
Clemente-Suarez VJ, Ramos-Campo DJ. Effectiveness of reverse vs. traditional linear training periodization in triathlon. Int J Environ Res Public Health. 2019;16(15):2807.
CAS PubMed Central Google Scholar
Medeiros LHL, Sandbakk SB, Bertazone TMA, Bueno Junior CR. Comparison of periodization models of concurrent training in recreationally active postmenopausal women. J Strength Cond Res. 2020. https://doi.org/10.1519/JSC.0000000000003559 ( Epub ahead of print ).
Article PubMed Google Scholar
Pacobahyba N, Vale R, Legey S, Simão R, Santos E, Dantas E. Muscle strength, serum basal levels of testosterone and urea in soccer athletes submitted to non-linear periodization program. Rev Bras Med Esporte. 2012;18:130–3.
Storer TW, Dolezal BA, Berenc MN, Timmins JE, Cooper CB. Effect of supervised, periodized exercise training vs self-Directed training on lean body mass and other fitness variables in health club members. J Strength Cond Res. 2014;28(7):1995–2006.
Garcia-Pallares J, Sanchez-Medina L, Carrasco L, Diaz A, Izquierdo M. Endurance and neuromuscular changes in world-class level kayakers during a periodized training cycle. Eur J Appl Physiol. 2009;106(4):629–38.
Ronnestad BR, Ellefsen S, Nygaard H, Zacharoff EE, Vikmoen O, Hansen J, et al. Effects of 12 weeks of block periodization on performance and performance indices in well-trained cyclists. Scand J Med Sci Sports. 2014;24(2):327–35.
Sylta Ø, Tønnessen E, Hammarström D, Danielsen J, Skovereng K, Ravn T, et al. The effect of different high-intensity periodization models on endurance adaptations. Med Sci Sports Exerc. 2016;48(11):2165–74.
De Souza EO, Tricoli V, Rauch J, Alvarez MR, Laurentino G, Aihara AY, et al. Different patterns in muscular strength and hypertrophy adaptations in untrained individuals undergoing nonperiodized and periodized strength regimens. J Strength Cond Res. 2018;32(5):1238–44.
Gavanda S, Geisler S, Quittmann OJ, Schiffer T. The effect of block versus daily undulating periodization on strength and performance in adolescent football players. Int J Sports Physiol Perform. 2019;14(6):814–21.
Harries SK, Lubans DR, Buxton A, MacDougall THJ, Callister R. Effects of 12-week resistance training on sprint and jump performances in mompetitive adolescent rugby union players. J Strength Cond Res. 2018;32(10):2762–9.
Rodrigues JAL, Santos BC, Medeiros LH, Goncalves TCP, Junior CRB. Effects of different periodization strategies of combined aerobic and strength training on heart rate variability in older women. J Strength Cond Res. 2019. https://doi.org/10.1519/JSC.0000000000003013 ( Epub ahead of print ).
Boidin M, Trachsel LD, Nigam A, Juneau M, Tremblay J, Gayda M. Non-linear is not superior to linear aerobic training periodization in coronary heart disease patients. Eur J Prev Cardiol. 2019. https://doi.org/10.1177/2047487319891778 .
Tjønna AE, Sandbakk Ø, Skovereng K. The effects of systematic block versus traditional periodization on physiological and performance indicators of well-trained cyclists [Master Thesis]: NTNU; 2019.
Buskard A, Zalma B, Cherup N, Armitage C, Dent C, Signorile JF. Effects of linear periodization versus daily undulating periodization on neuromuscular performance and activities of daily living in an elderly population. Exp Gerontol. 2018;113:199–208.
Barjaste A, Mirzaei B. The periodization of resistance training in soccer players: changes in maximal strength, lower extremity power, body composition and muscle volume. J Sports Med Phys Fitness. 2018;58(9):1218–25.
Bessa A, Sposito-Araujo C, Senna G, Lopes T, Godoy E, Scudese E, et al. Comparison of the Matveev periodization model and the Verkhoshansky periodization model. J Exerc Physiol Online. 2018;21:60–7.
Hartmann H, Bob A, Wirth K, Schmidtbleicher D. Effects of different periodization models on rate of force development and power ability of the upper extremity. J Strength Cond Res. 2009;23(7):1921–32.
Kramer JB, Stone MH, O’Bryant HS, Conley MS, Johnson RL, Nieman DC, et al. Effects of single vs. multiple sets of weight training: impact of volume, intensity, and variation. J Strength Cond Res. 1997;11(3):143–7.
Rhea MR, Phillips WT, Burkett LN, Stone WJ, Ball SD, Alvar BA, et al. A comparison of linear and daily undulating periodized programs with equated volume and intensity for local muscular endurance. J Strength Cond Res. 2003;17(1):82–7.
Bezerra ES, Orssatto LBR, de Moura BM, Willardson JM, Simão R, Moro ARP. Mixed session periodization as a new approach for strength, power, functional performance, and body composition enhancement in aging adults. J Strength Cond Res. 2018;32(10):2795–806.
de Freitas MC, de Souza Pereira CG, Batista VC, Rossi FE, Ribeiro AS, Cyrino ES, et al. Effects of linear versus nonperiodized resistance training on isometric force and skeletal muscle mass adaptations in sarcopenic older adults. J Exerc Rehabil. 2019;15(1):148–54.
Jaimes DAR, Contreras D, Jimenez AMF, Orcioli-Silva D, Barbieri FA, Gobbi LTB. Effects of linear and undulating periodization of strength training in the acceleration of skater children. Motriz Revista de Educação Física. 2019;25(1):e101955.
de Assis LA, Werneck FZ, Junior DBR, Vianna JM. Effect of periodization on the physical capacities of basketball players of a military school. Rev Bras Cineantropom Desempenho Hum. 2019;21:59818.
Ullrich B, Pelzer T, Oliveira S, Pfeiffer M. Neuromuscular responses to short-term resistance training with traditional and daily undulating periodization in adolescent elite judoka. J Strength Cond Res. 2016;30(8):2083–99.
Manchado C, Cortell-Tormo JM, Tortosa-Martinez J. Effects of two different training periodization models on physical and physiological aspects of elite female team handball players. J Strength Cond Res. 2018;32(1):280–7.
Kraemer WJ, Nindl BC, Ratamess NA, Gotshalk LA, Volek JS, Fleck SJ, et al. Changes in muscle hypertrophy in women with periodized resistance training. Med Sci Sports Exerc. 2004;36(4):697–708.
Hunter GR, Wetzstein CJ, McLafferty CL Jr, Zuckerman PA, Landers KA, Bamman MM. High-resistance versus variable-resistance training in older adults. Med Sci Sports Exerc. 2001;33(10):1759–64.
Vanni AC, Meyer F, da Veiga AD, Zanardo VP. Comparison of the effects of two resistance training regimens on muscular and bone responses in premenopausal women. Osteoporos Int. 2010;21(9):1537–44.
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USF Muscle Lab, Exercise Science Program, University of South Florida, Tampa, FL, USA
Ryo Kataoka, Ecaterina Vasenina & Samuel L. Buckner
Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, University, MS, USA
Jeremy Loenneke
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Correspondence to Samuel L. Buckner .
No external sources of funding were used in the preparation of this article.
Ryo Kataoka, Ecaterina Vasenina, Jeremy Loenneke, and Samuel Buckner declare that they have no conflicts of interest that are relevant to the content of this article.
RK, EV, SLB, and JPL wrote the manuscript. All authors read and approved the final manuscript.
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Kataoka, R., Vasenina, E., Loenneke, J. et al. Periodization: Variation in the Definition and Discrepancies in Study Design. Sports Med 51 , 625–651 (2021). https://doi.org/10.1007/s40279-020-01414-5
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Accepted : 20 December 2020
Published : 06 January 2021
Issue Date : April 2021
DOI : https://doi.org/10.1007/s40279-020-01414-5
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PTCAS Personal Statement prompts can vary in topics, but ultimately they touch on the physical therapy profession. It's important that you answer the PTCAS question in your essay. But you should also view this as an opportunity to describe yourself to the admissions committees. Keep in mind that these committees are reviewing hundreds, or ...
The prompt for the PTCAS personal statement essay for the 2024-25 cycle is: "Every applicant is unique in their own way, possessing individual qualities, abilities, and backgrounds. What unique traits will you bring to the physical therapy profession that will help you to be successful? "
PTCAS Essay Prompt: Every person has a story that has led them to a career. Since there are a variety of health professions that "help" others, please go beyond your initial interaction or experiences with physical therapy, and share the deeper story that has confirmed your decision to specifically pursue physical therapy as your career.
Here are some pointers for writing essays when you apply to physical therapy school. Please know that there isn't a single best way to write your essays and everyone will answer each prompt d…
The following essay question is required for the PTCAS application: Every applicant is unique in their own way, possessing individual qualities, abilities, and backgrounds. What unique traits will you bring to the physical therapy profession that will help you to be successful?
This will give you time to start brainstorming and drafting your essay before the application even opens! Past PTCAS Prompts: 2016-2017, 2017-2018: "What is professionalism in the context of being a student in a doctor of physical therapy program?". 2018-2019, 2019-2020: "Describe a meaningful experience in your life.
The Essay is the main opportunity to tie activities and experiences together and connect with the people who read your application. Ultimately, you want to write an essay that makes the reader want to become your future professor or colleague. The PTCAS application requires one 4500-character, or about 550-word, essay.
What Is The 2024-2025 PTCAS Application Essay Prompt? The next PTCAS application cycle officially opened on June 17, 2024. During an APTA virtual fair in 2024, they stated that the essay prompts stay the same for 2-3 years. For 2024-25, the spirit of the prompt will stay the same as last year, although the wording is changing slightly.
PTCAS changes the personal statement essay prompt every 2-3 years. On April 24, 2024, APTA confirmed that the prompt for the 2024-25 cycle will be: Every applicant is unique in their own way, possessing individual qualities, abilities, and backgrounds. What unique traits will you bring to the physical therapy profession that will help you to.
OTCAS (Occupational Therapy): "Your Personal Statement should address why you selected OT as a career and how an Occupational Therapy degree relates to your immediate and long-term professional goals. Describe how your personal, educational, and professional background will help you achieve your goals." -No character limit specified.
The physical therapy prompt is a sassy one this year. And full of possibility for writing a memorable personal statement that will connect with your reader.
The positive impact that physical therapy can have on patients is one of the most compelling reasons why I want to become a physical therapist. Physical therapy can help alleviate pain, improve range of motion, increase strength and flexibility, and prevent future injuries. It can also enhance the overall quality of life by promoting ...
Physical therapy is a medical treatment that relieves us from pain and maintains our fitness. Physical therapy helps to increase the mobility and flexibility of our bodies. A physical therapist offers restorative types of assistance to their patients who have transitory or constant states of being that were caused by injury or illness.
Physical Therapy as a Career Essay Good Essays 1115 Words 5 Pages 3 Works Cited Open Document A Detailed Description of the Job/Position The job I plan on pursuing with kinesiology as my major is to become a physical therapist, which is also known as PT.
Physical Therapy Essay: Describe your decision making process my volunteer experience [2] ~ 2012 - Graduate 'Focus on my health' - Choosing Physical Therapy - My PTCAS Physical Therapy School [2] ~ 2012 - Graduate Physical Therapy School Personal Statement: Goals in pursuit of physical therapy [3] ~ 2013 - Graduate
The PT Application Essay Course. As a physical therapist, writer, and editor, I've helped hundreds of future physical therapists get into over 175 PT schools. I'm so excited to combine all my experience and advice into a new video that will guide you in writing a physical therapy essay that will help you stand out from the crowd! This ...
Physical Therapy school personal statement. Currently applying to Doctor of Physical Therapy programs! Any help with my essay would be appreciated. This is my 3rd draft. Thanks in advance. Essay Prompt: Describe your decision making process in choosing physical therapy as a career choice versus other health care careers.
An initial goal of introducing narrative, therefore, is to demonstrate how narrative can be meaningful and relevant to physical therapy practitioners. The following section describes the authors' experiences with integrating the tools of narrative into an educational program, into physical therapist residency programs, and into a clinical practice.
Integrated Physical Therapy Care for the Best Possible Orthopedic Outcome. Our team of highly-skilled physical and occupational therapists brings decades of experience and knowledge to help you heal, restore functionality and get back to living life to the fullest. Whether you are undergoing a procedure for a fracture, ligament damage or are ...
Periodization has been proposed to serve as the macro-management of the training process concerning the annual plan, yet research on long-term effects is scarce. The terms 'periodization' and 'programming' are being used interchangeably in research leading to confusion over a proper definition.
Reactiv Physical Therapy boasts a team of seasoned therapists committed to optimize your physical well-being. With extensive experience, our experts deliver tailored solutions, ensuring a swift and effective path to optimal health.
It is the mission of Moscow Mountain Sport & Physical Therapy to assist our patients in reaching their full neuromuscular potential through the application of advanced orthopedic and manual therapy techniques.