Abstract
Precision medicine is being discussed and incorporated at all levels of health care and disease prevention, management, and treatment. Key components include new taxonomies of disease classification, the measurement and incorporation of genetics and “omics” data, biomarkers, and health care professionals who can optimize this information for a precision approach to treatment. The study and treatment of Duchenne Muscular Dystrophy is making rapid advances in these areas in addition to rapid advances in new gene and cell-based therapies. New therapies will increase the variability in disease severity, furthering a need for a precision-based approach. An area of therapy that is rarely considered in this approach is how the physiology of muscle contractions will interact with these therapies and a precision approach. As muscle pathology improves, physical activity levels will increase, which will likely be very beneficial to some patients but likely not to all. Physical activity is likely to synergistically improve these therapies and can be used to enhance muscle health and quality of life after these therapies are delivered using the tools of precision medicine.
Highlights
The idea of personalized medicine has been gaining significant interest since the sequencing of the human genome
The basic concepts of precision medicine will be examined in relation to Duchenne Muscular Dystrophy (DMD), with a special emphasis on how therapeutic exercise programs might interact with each of these concepts
The goal is to highlight the likely interactions of precision DMD medicine with therapeutic exercise, and how this should be considered an integral part of these treatments
Summary
The idea of personalized medicine has been gaining significant interest since the sequencing of the human genome. With a slightly modified and updated approach, the National Research Council used the term “precision” medicine instead of personalized medicine [5] Precision medicine, they suggest, relies on the ability to subcategorize individuals within a disease into those who will respond to specific targeted therapies and those who would not respond, or for whom the treatment might even be detrimental. To ignore the importance of the physiologic effect of increased muscle contractions (i.e., physical activity) in this disease is missing important opportunities to improve these treatments but to be ready to optimize the entire intervention program In this perspective paper, the basic concepts of precision medicine will be examined in relation to DMD, with a special emphasis on how therapeutic exercise programs might interact with each of these concepts. The goal is to highlight the likely interactions of precision DMD medicine with therapeutic exercise, and how this should be considered an integral part of these treatments
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