This Research Topic is part of the Precision Physical Activity and Exercise Prescriptions for Disease Prevention: The Effect of Interindividual Variability Under Different Training Approaches series:
Precision Physical Activity and Exercise Prescriptions for Disease Prevention: The Effect of Interindividual Variability Under Different Training ApproachesPrecision/personalized medicine is an emerging approach for prevention as well as more effective diagnosis and disease treatment that takes into account variability in genes, environment, and lifestyle for each individual. Precision medicine will enable health care providers to more accurately define the optimal treatment and prevention strategies for a particular disease phenotype and if widely implemented may lead to large clinical and public health improvements both in the US and globally. Despite an initial focus on “genes, drugs and disease”, aspects related to social, environmental and behavioral disease determinants are increasingly being emphasized.
Physical activity (PA) and is a very promising intervention for the modulation of both health span and lifespan in a number of species. Substantial evidence already exists in support of multipronged PA and exercise counselling, prescription and referral strategies. Evidence shows that PA has a significant role, in many cases comparable or superior to drug interventions, in the prevention and treatment of more than 40 non-communicable chronic diseases such as obesity, heart disease, diabetes, hypertension, cancer, depression, Alzheimer’s, arthritis, and osteoporosis. Physical activity, as an intervention, is one of the most important components in improving the functional capacity of frail seniors. Accordingly, an important conceptual idea for frailty is that the focus should be on functionality and not on the diagnosis of disease for older patients.
Despite the overwhelming scientific evidence that PA improves the health of the population, society in general and health professionals in particular are not yet clear on how to approach this matter. Although an initial good step, PA and exercise prescriptions as a form of medicine are much more than just walking. Unfortunately, exercise programs are typically developed for the average person controlling relative intensity efforts, (i.e "one-size-fits-all" approach), with less consideration for the differences between individuals. This would necessarily involve an individualized prescription according to the functional capacity of the person, with specific recommendations about the dose (intensity, volume, and frequency), similar to those of other medications. Indeed, researchers have recognized the substantial variability in patient response to physical exercise interventions and have sought to understand these differences. Precision PA and exercise prescriptions can help address the substantial variability in individual patient response to health-related fitness outcomes and tailoring of exercise program to the individual phenotype of each patient. In this context, there are two main components: a short-term focus on improving chronic disease-related declines in functional capacity and a longer-term aim to generate knowledge applicable to the whole range of maintaining optimal health and preventing diseases. For example, in cancer disease there is increasing interest in health-related fitness outcomes by exercise researchers makes the application of precision medicine (i.e., the focus on genetic and molecular subgroups) much more relevant. Nevertheless, there are some differences between exercise and medical interventions that may have implications for the application of precision medicine to exercise oncology. Several reports pertain to ‘average data’, and there is a wide interindividual variability in response to exercise training (IVRET), which has mainly been explored in endurance-based studies.
The IVRET implies that under the same stimulus, some subjects may achieve benefits, who are considered responders (R), whereas others may exhibit a worsened or unchanged response after training, termed non-responders (NRs). In the era of precision medicine, IVRET in the magnitude of response to supervised exercise training (subject-by-training interaction; ‘individual response’) has received increasing scientific interest. This Research Topic will afford the broad-based benefits of PA while targeting exercise prescriptions and programs using precision behavioral and lifestyle medicine approaches to help patients combat the increasingly recognized impact of aging as well as non-communicable diseases on health and quality of life.