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Br J Sports Med. 2019 Sep;53(18):1141-1153. doi: 10.1136/bjsports-2018-100328. Epub 2019 Mar 12.

Precision exercise medicine: understanding exercise response variability.

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School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada.
Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, Florida, USA.
Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio, USA.
Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA.
Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
Interventional Resources, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
School of Kinesiology, Louisiana State University, Baton Rouge, Louisiana, USA.
Department of Kinesiology, Indiana University, Bloomington, Indiana, USA.
Department of Physical Education, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
John S Mcilhenny Skeletal Muscle Physiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.
Kingston General Health Research Institute, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
Economics and Sociology of Sport, Saarland University, Saarbrücken, Saarland, Germany.
College of Sport and Exercise Science, Victoria University, Melbourne, Victoria, Australia.
Human Genomics Laboratory, Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA.


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

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