Thomas Gwendolyn A
Department of Kinesiology, The Pennsylvania State University, University Park, PA, United States.
Front Netw Physiol. 2022 May 12;2:877676. doi: 10.3389/fnetp.2022.877676. eCollection 2022.
Current American College of Sports Medicine (ACSM) exercise guidelines for exercise oncology survivors are generic one-size fits all recommendations, which assume ideal or prototypic health and fitness state in order to prescribe. Individualization is based on the objective evaluation of the patient's baseline physiological status based on a linear dose response relationship of endpoints. This is only a partial snapshot of both the acute and chronic responses exercise can provide. Each acute exercise session represents a unique challenge to whole-body homeostasis and complex acute and adaptive responses occur at the cellular and systemic levels. Additionally, external factors must be considered when prescribing exercise. Network physiology views the human organism in terms of physiological and organ systems, each with structural organization and functional complexity. This organizational approach leads to complex, transient, fluctuating and nonlinear output dynamics which should be utilized in exercise prescription across health states. Targeting health outcomes requires a multi-system approach as change doesn't happen in only one system at a time or in one direction Utilizing a multi-system or person-centered approach, allows for targeting and personalization and understands and targets non-linear dynamics of change. Therefore, the aims of this review are to propose a paradigm shift towards a Network Physiology approach for exercise prescription for cancer survivors. Cancer treatment affects multiple systems that interact to create symptoms and disruptions across these and therefore, prescribing exercise utilizing both external daily factors and internal physiological networks is of the highest order.
美国运动医学学院（ACSM）目前针对肿瘤康复者的运动指南是通用的一刀切式建议，这些建议为了给出运动处方，假定处于理想或典型的健康和体能状态。个体化是基于对患者基线生理状态的客观评估，这种评估基于终点的线性剂量反应关系。这只是运动所能提供的急性和慢性反应的部分情况。每次急性运动对全身的内环境稳定都是一次独特的挑战，细胞和全身水平会发生复杂的急性和适应性反应。此外，在开具运动处方时必须考虑外部因素。网络生理学从生理和器官系统的角度看待人体，每个系统都有结构组织和功能复杂性。这种组织方式会导致复杂、短暂、波动和非线性的输出动态，在针对不同健康状态的运动处方中应加以利用。针对健康结果需要采用多系统方法，因为变化不会只在一个系统中或只朝一个方向发生。采用多系统或以人为本的方法能够实现针对性和个性化，并理解和针对变化的非线性动态。因此，本综述的目的是提议在为癌症幸存者开具运动处方时向网络生理学方法转变。癌症治疗会影响多个相互作用的系统，从而在这些系统中产生症状和干扰，因此，结合外部日常因素和内部生理网络来开具运动处方至关重要。
