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Multi‑omics approaches to decipher the molecular mechanisms of exercise‑mediated bone protection: From mechanistic insights to personalized exercise prescription (Review).

The global burden of bone metabolic disorders necessitates a shift from generic exercise recommendations toward personalized prescription strategies. Exercise confers skeletal protection through mechanotransduction, yet the underlying molecular networks remain incompletely understood. Multi‑omics technologies, including transcriptomics, proteomics, metabolomics and single‑cell spatial approaches, have revolutionized the capacity to decode exercise‑mediated bone adaptation at the systems level. The present review synthesizes current single‑omics landscapes and integrative multi‑omics analyses that elucidate the core regulatory networks, mechanobiological coupling mechanisms and multiorgan crosstalk that are implicated in the bone response to mechanical loading. Translational applications across clinical scenarios such as osteoporosis, osteoarthritis and disuse bone loss are evaluated, and the technical, analytical and translational challenges limiting clinical implementation are addressed. Finally, the present review provides a framework for translating multi‑omics molecular signatures into personalized exercise prescriptions for optimized skeletal health.

Humans

The Health Benefits of Exercise: Molecular and Cellular Mechanisms.

Exercise is a low-cost lifestyle intervention that can prevent and alleviate various diseases. It is a potent physiological stimulus that activates conserved molecular signaling pathways. Through the coordinated integration of multiple molecules, pathways, and systems, it leads to systemic health benefits. However, most studies focus on individual systems or molecular mechanisms, lacking systematic integration of the cross-system regulation induced by exercise. We summarize the molecular mechanisms of exercise in the musculoskeletal, cardiovascular, nervous systems, among others. Exercise induces the release of exerkines (e.g., irisin, interleukin-6, and brain-derived neurotrophic factor) and extracellular vesicles, which activate key signaling pathways to enhance mitochondrial function, metabolism and physiological adaptation, while suppressing inflammation and oxidative stress, thereby alleviating diseases and delaying aging through cross-system coordination. We further explore exercise-induced adaptive regulation in extreme environments, including microgravity, hyperbaria, and hypoxia, offering a multifaceted perspective on organismal health regulation. Finally, we outline the prospects and challenges of multiomics, artificial intelligence-driven precision medicine, personalized exercise prescriptions, and exercise mimetics. Overall, this review provides a more integrated perspective on the molecular basis of exercise and offers directions for future mechanistic and translational studies.

exercise

Exercise prescription--North American experience.

The principles of exercise prescription are reviewed with respect to North American experience. The required regimen must be safe, therapeutically effective, and ensure a high rate of compliance. Precautions to increase the safety of exercise are discussed. Cardiac emergencies are sufficiently rare events (less than 1 in 200,000 hours even in post-coronary classes) that the need for immediate medical supervision of a well-designed programme can be questioned. The prime determinant of the response to training is the intensity of effort relative to the individual's initial fitness. Post-coronary patients often have a great potential for training due to their previous inactivity, but this will not be realised if the prescribed exercise is of insufficient intensity. Exercise programmes are plagued by a high 'drop-out' rate; 50% of normal middle-aged volunteers are lost in 6 months, and even with post-coronary programmes losses can be 60--70% over 4 years. Simple suggestions are made for improving compliance with the required exercise prescription.

Adult

A new geriatric application of electrocardiographic treadmill testing in an office setting.

An accepted method of measuring exercise tolerance was applied exclusively to geriatric practice for the purpose of exercise prescription. This stress testing was performed to minimize the risks of introducing exercise in an elderly population, and to restore or maintain elderly persons at their own optimal level of function, for life. As no geriatric testing protocol was available, two standardized protocols were chiefly used to start the trial program in March, 1978. A geriatric modification devised by the author is described. During the first month of the study, in a physician's office, ECG-monitored treadmill testing was conducted without mishap in 175 patients (age range, 60--89 years). All but 4 of the subjects (98 percent) led habitually sedentary lives, and documented coronary heart disease was present in about one-fourth of the series. The initial test data in this proposed continuing study are summarized. The methods for candidate selection, the safety precautions, and the test procedure are outlined. The distinction is made between testing by functional grades and testing to maximal levels. Information obtained from this stress test is an integral part of the individualized exercise prescription for each geriatric subject.

Aged