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Consensus statement
Precision exercise medicine: understanding exercise response variability
  1. Robert Ross1,
  2. Bret H Goodpaster2,
  3. Lauren G Koch3,
  4. Mark A Sarzynski4,
  5. Wendy M Kohrt5,
  6. Neil M Johannsen6,7,
  7. James S Skinner8,
  8. Alex Castro9,
  9. Brian A Irving7,10,
  10. Robert C Noland11,
  11. Lauren M Sparks2,
  12. Guillaume Spielmann7,10,
  13. Andrew G Day12,
  14. Werner Pitsch13,
  15. William G Hopkins14,
  16. Claude Bouchard15
  1. 1 School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada
  2. 2 Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, Florida, USA
  3. 3 Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA
  4. 4 Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
  5. 5 Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
  6. 6 Interventional Resources, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
  7. 7 School of Kinesiology, Louisiana State University, Baton Rouge, Louisiana, USA
  8. 8 Department of Kinesiology, Indiana University, Bloomington, Indiana, USA
  9. 9 Department of Physical Education, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
  10. 10 Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
  11. 11 John S Mcilhenny Skeletal Muscle Physiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
  12. 12 Kingston General Health Research Institute, Kingston Health Sciences Centre, Kingston, Ontario, Canada
  13. 13 Economics and Sociology of Sport, Saarland University, Saarbrücken, Saarland, Germany
  14. 14 College of Sport and Exercise Science, Victoria University, Melbourne, Victoria, Australia
  15. 15 Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
  1. Correspondence to Dr Claude Bouchard, Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana 70808, USA; claude.bouchard{at}pbrc.edu

Abstract

There is evidence from human twin and family studies as well as mouse and rat selection experiments that there are considerable interindividual differences in the response of cardiorespiratory fitness (CRF) and other cardiometabolic traits to a given exercise programme dose. We developed this consensus statement on exercise response variability following a symposium dedicated to this topic. There is strong evidence from both animal and human studies that exercise training doses lead to variable responses. A genetic component contributes to exercise training response variability.

In this consensus statement, we (1) briefly review the literature on exercise response variability and the various sources of variations in CRF response to an exercise programme, (2) introduce the key research designs and corresponding statistical models with an emphasis on randomised controlled designs with or without multiple pretests and post-tests, crossover designs and repeated measures designs, (3) discuss advantages and disadvantages of multiple methods of categorising exercise response levels—a topic that is of particular interest for personalised exercise medicine and (4) outline approaches that may identify determinants and modifiers of CRF exercise response. We also summarise gaps in knowledge and recommend future research to better understand exercise response variability.

  • exercise testing

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bjsports-2018-100328

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    Footnotes

    • Contributors RR and CB were responsible for the development of the scientific content of the symposium and for writing the first draft of the manuscript. The original draft was circulated to all coauthors for critical revision of intellectual content. Final approval of the revised manuscript as edited by RR and CB was obtained from all coauthors.

    • Funding The consensus meeting that led to the writing of this manuscript was held with the financial support of the Pennington Biomedical Research Foundation, the Pennington Biomedical Research Center Division of Education, the LSU Boyd Professorship and the John W. Barton, Sr. Chair in Genetics and Nutrition. No funding and/or honorarium was provided to any member of the writing group for the production of this manuscript.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Not required.