Principles of exercise physiology: responses to acute exercise and long-term adaptations to training
Abstract
Physical activity and fitness are associated with a lower prevalence of chronic diseases, such as heart disease, cancer, high blood pressure, and diabetes. This review discusses the body's response to an acute bout of exercise and long-term physiological adaptations to exercise training with an emphasis on endurance exercise. An overview is provided of skeletal muscle actions, muscle fiber types, and the major metabolic pathways involved in energy production. The importance of adequate fluid intake during exercise sessions to prevent impairments induced by dehydration on endurance exercise, muscular power, and strength is discussed. Physiological adaptations that result from regular exercise training such as increases in cardiorespiratory capacity and strength are mentioned. The review emphasizes the cardiovascular and metabolic adaptations that lead to improvements in maximal oxygen capacity.
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A period of endurance training leads to improvements in blood flow, mitochondrial content and an improved ability to extract and utilise oxygen during exercise.
“At the level of the muscle a period of endurance training leads to improvements in blood flow, mitochondrial content and an improved ability to extract and utilise oxygen during exercise [7].”
From New strategies in sport nutrition to increase exercise performance (2016) · cites this paper as [7]
Structured endurance training leads to improvements in fatigue resistance partly by altering the phenotype of the skeletal muscle performing the work.
“Structured endurance training leads to improvements in fatigue resistance partly by altering the phenotype of the skeletal muscle performing the work [7].”
From New strategies in sport nutrition to increase exercise performance (2016) · cites this paper as [7]
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“Short periods of planned rest both between repetitions of exercises and between exercise sessions facilitate muscle benefit from exercise [12,13].”
BackgroundResearch advances in the application of metabolomics in exercise science
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Exercise and physical activity in cirrhosis: opportunities or perils
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“These factors are used to describe the decline in bodily function and the actual/perceived difficulties associated with tasks or increased exercise [4].”
BackgroundPadrão, A. I., Figueira, A. C., Faustino‐Rocha, A. I., Gama, A., Loureiro, M. M., Neuparth, M. J., Moreira‐Gonçalves, D., Vitorino, R. M. P., Amado, F. M. L., Santos, L. L., et al. (2016) · Acta Physiologica · doi:10.1111/apha.12721 · Cited by 27 · see citing works
“Published by John Wiley & Sons Ltd, doi: 10.1111/apha.12721 811 from arterial blood (Rivera-Brown & Frontera 2012), and to improved aerobic performance (Hindi et al. 2014).”
BackgroundInfluentialAndrade, D. C., Arce‐Álvarez, A., Parada, F., Uribe, S. M., Gordillo, P., Dupre, A., Ojeda, C., Palumbo, F., Castro, G., Vásquez-Muñoz, M., et al. (2020) · Physiological Reports · doi:10.14814/phy2.14455 · Cited by 25 · see citing works
“Also, EE may improve body composition, metabolic risk factors, cardiac autonomic control, and maximal aerobic capacity (Hottenrott, Ludyga, & Schulze, 2012; Rivera-Brown & Frontera, 2012).”
BackgroundTour de France Champions born or made: where do we take the genetics of performance?
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“Whilst many of these characteristics may be altered by training (Rivera-Brown & Frontera, 2012), several have also been shown to be influenced by genetics (see Wolfarth et al., 2014 for review).”
BackgroundChan, M. L. T., & Yu, D. S. F. (2021) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2021.104577 · Cited by 24 · see citing works
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Strategies for Skeletal Muscle Targeting in Drug Discovery
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Intestinal Microbiota Interventions to Enhance Athletic Performance—A Review
Patel, B. K., Patel, K. H., Lee, C. N., & Moochhala, S. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms251810076 · Cited by 25 · see citing works
“As humans engage in exercise at increasing intensities, oxygen consumption rises linearly to satisfy the requirements of the active skeletal muscles, ultimately attaining peak oxygen uptake [30].”
BackgroundAya, V., Pardo-Rodriguez, D., Vega, L. C., Cala, M. P., & Ramírez, J. D. (2025) · Scientific Reports · doi:10.1038/s41598-025-98973-2 · Cited by 28 · see citing works
“Most of the research in this field has focused on endurance training, particularly aerobic exercise 13,14 , which is key for energy production via the oxidative system 1,15 .”
Salomão, R. A. S., de Paula, T. G., Zanella, B. T. T., de Carvalho, P. L. P. F., Duran, B. O. D. S., Valente, J. S., Fantinatti, B. E. A., Fernandes, A. A. H., Barros, M. M., Mareco, E. A., et al. (2019) · Comparative Biochemistry and Physiology Part A Molecular & Integrative Physiology · doi:10.1016/j.cbpa.2019.05.002 · Cited by 21 · see citing works
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“These adaptations to IMT try to modulate homeostatic processes [46] that lead to changes in the oxidative energy metabolism of RMs, gaining in efficiency and causing a lower oxygen demand with respect to skeletal muscles [28,29], tissue remodeling of RMs (hypertrophy of the diaphragm, increase of type II fibers) that…”
BackgroundClinical impact of exercise in patients with peripheral arterial disease
Novaković, M., Jug, B., & Lenasi, H. (2016) · Vascular · doi:10.1177/1708538116678752 · Cited by 21 · see citing works
“preexercise, immediately post-exercise, after long-term exercise training or at rest) may therefore significantly influence blood levels of these markers.(52)”
BackgroundAerobic exercise-induced changes in fluid biomarkers in Parkinson’s disease
Luthra, N., Mehta, N., Munoz, M. J., Fantuzzi, G., Lamotte, G. J., Haus, J. M., McFarland, N. R., Tansey, M. G., González-Latapí, P., Caraveo, G., et al. (2025) · npj Parkinson s Disease · doi:10.1038/s41531-025-01042-8 · Cited by 20 · see citing works
“Chronicexerciseinducesmetabolicadaptations,particularlyinskeletal muscle, leading to reduced lactate production at a given intensity 165 .”
Swimming Exercise Promotes Post-injury Axon Regeneration and Functional Restoration through AMPK
Kumar, S., Behera, S., Basu, A., Dey, S., & Ghosh‐Roy, A. (2021) · eNeuro · doi:10.1523/eneuro.0414-20.2021 · Cited by 20 · see citing works
“Many of these phenomena share commonalities with the physical exercise in vertebrate models (Thompson et al., 2001; Rivera-Brown and Frontera, 2012; Vina et al., 2012).”
González, A., Ábrigo, J., Achiardi, O. A., Simón, F., & Cabello‐Verrugio, C. (2022) · European Journal of Translational Myology · doi:10.4081/ejtm.2022.10511 · Cited by 20 · see citing works
Resting sympatho-vagal balance is related to 10 km running performance in master endurance athletes
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Skeletal Muscle Aging Atrophy: Assessment and Exercise-Based Treatment
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“In most type of exercise, dynamic contractions consists of two distinct phases: concentric and eccentric (Rivera-Brown and Frontera, 2012).”
BackgroundCeylan, H. İ., Öztürk, M. E., Öztürk, D., Silva, A. F., Albayrak, M., Saygın, Ö., Eken, Ö., Clemente, F. M., & Nobarı, H. (2023) · Scientific Reports · doi:10.1038/s41598-023-34278-6 · Cited by 18 · see citing works
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Proteomic Analysis of Cardiac Adaptation to Exercise by High Resolution Mass Spectrometry
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Progression of aerobic exercise intensity in a cardiac rehabilitation program
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“Decrease in both HR and RPE per unit increase in exercise intensity is an indicator of functional, neurohumoral and cardiovascular improvement.(17) Of note, the main improvements in these parameters were seen in the first four weeks of treatment in those on a longer CR program, with less visible change after this peri…”
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“This is in agreement with the knowledge that regular aerobic exercise reduces the HR during submaximal workload due to decreased sympathetic drive and increased stroke volume, but does not change submaximal VO2 because of similar oxygen requirements for a fixed workload [32,33].”
BackgroundEffects of Aerobic and Resistance Exercise on Cardiovascular Parameters for People Living With HIV
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Introduction to Exercise Physiology
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Metabolic Adaptations to Exercise Training
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Heart failure with preserved ejection fraction and skeletal muscle physiology
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“Our the sports level of athletes [29, 30].”
The complex relationship between effort and heart rate: a hint from dynamic analysis
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Understanding Exercise Capacity: From Elite Athlete to HFpEF
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Sexual experience confers resilience to restraint stress in female rats
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“HPA and ANS activation, like exercise and skydiving (Masini et al., 2011; Meyer et al., 2015; Rivera-Brown and Frontera, 2012).”
The Exercise Rehabilitation Paradox: Less May Be More?
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“We are not in a position to know this LEAs’ specific training mandates, but we assumed that all the training programming was based on sound exercise related scientific principles, since it was performed by certified exercise specialists [17,80,83].”
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de Almeida, A. A., Correia, T. M. L., Pires, R. A., da Silva, D. A., Coqueiro, R. D. S., Machado, M., de Magalhães, A. C. M., Queiroz, R. F., Soares, T. D. J., & Pereira, R. (2022) · Brazilian Journal of Medical and Biological Research · doi:10.1590/1414-431x2022e12116 · Cited by 11 · see citing works
“Although well documented, the benefits of preconditioning depend on the exercise protocol (26).”
BackgroundSeffrin, A., Vivan, L., Souza, V. R. D. A., da Cunha, R. A., de Lira, C. A. B., Vancini, R. L., Weiss, K., Knechtle, B., & Andrade, M. S. (2023) · GeroScience · doi:10.1007/s11357-023-00828-z · Cited by 11 · see citing works
“This decline in absolute V̇O2max in aging individuals is anticipated because there is an undeniable reduction in maximal CO with age [26, 27], causing a reduction in V̇O2max.”
Background
- Authors
- Rivera‐Brown, A. M., & Frontera, W. R.
- Affiliations
- University of Puerto Rico, Medical Sciences Campus (PR)
- Corresponding author
- Rivera‐Brown, Anita M.
- Venue
- PM&R
- Publisher
- Wiley
- Published
- 2012-11
- Volume
- 4
- Issue
- 11
- Pages
- 797-804
- ISSN
- 1934-1482 (ISSN-L)
- 1934-1563
- OpenAlex
- W2092211000
- Cited by
- 228
- References
- 39
- Citations by year
- 2026: 7 · 2025: 20 · 2024: 27 · 2023: 19 · 2022: 21 · 2021: 32 · 2020: 27 · 2019: 21 · 2018: 13 · 2017: 9 · 2016: 10 · 2015: 12 · 2014: 9 · 2013: 1
- FWCI
- 1.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PM&R (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Sports Performance and Training
- Keywords
- acute exercise response, training effects, endurance exercise, skeletal muscle, muscle fiber type, energy metabolism, dehydration, fluid intake, cardiorespiratory capacity, muscle strength, cardiovascular adaptation, metabolic adaptation
- MeSH terms
- Adaptation, Physiological, Adenosine Triphosphate, Age Factors, Blood Pressure, Cardiac Output, Dehydration, Energy Metabolism, Glycolysis, Heart Rate, Humans, Mitochondria, Muscle, Muscle Contraction, Oxidative Phosphorylation, Oxygen Consumption, Phosphocreatine, Physical Education and Training, Physical Endurance, Physical Fitness, Plasma Volume, Sex Factors, Exercise, Practice Guidelines as Topic, Muscle, Skeletal, Muscle Fibers, Skeletal, Lactic Acid
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