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Fig. 9 Gene-based personalisation of exercise rehabilitation

Composite figure emphasising interaction effects of nature and

nurture on the muscle phenotype. Natural constitution and

conditioning by environmental stimuli activate a genomic

programme that instructs plastic changes of the muscle

phenotype. It involves the production of diffusible gene

messengers that act as actuators of performance by instructing

the making of proteins. Polymorphisms in multiple fitness genes

are understood to influence gains in endurance and strength

performance by affecting gene expression. ACE, angiotensin-

converting enzyme; EPO-R, erythropoietin receptor; HIF-1



hypoxia-induced factor 1-alpha; MSTN, myostatin; VEGF, vascular

endothelial growth factor; PGC-1


, peroxisome proliferator-

activated receptor gamma coactivator 1-alpha

re-establishing musculoskeletal function. In a last, larger

research project, we have therefore initiated studies into the

mechanism underlying variability in muscle plasticity. In this

context, we assess the extent to which muscular adaptations

are associated with genomic determinants. We thereby focus

on selected gene polymorphisms which affect the muscle

phenotype in animals and which encode regulators of muscle

plasticity (Fig. 9). The aim being to disentangle the

mechanism underlying the responsiveness in healthy subjects

to mechanical (i.e. strength-type) and metabolic (i.e.

endurance-type) stimuli interventions and to translate this

knowledge to the patient.


The laboratory for muscle plasticity will continue research in

this area at Balgrist campus, which provides a unique

combination of dry and wetlabs in an open space landscape

that fosters interactions between academic, industrial and

medical partners on questions driven by the orthopaedic

patient (Fig. 10). Towards this end we call for interactions with

academic and industrial partners who are interested in

developing our research areas in a joint venture.


1. Booth F W, Chakravarthy M V, Gordon S E, Spangenburg E E (2002): Waging war on

physical inactivity: using modern molecular ammunition against an ancient enemy.

J Appl Physiol

93(1): 3-30

2. Dean E (2009): Physical therapy in the 21st century (Part I): toward practice

informed by epidemiology and the crisis of lifestyle conditions.

Physiother Theory


25(5-6): 330-53

3. (2014): Statistical Yearbook of Switzerland, Swiss Federal Statistical Office,



ISBN 978-3-03823-874-4

4. Griffin L Y (2008): Noncontact Anterior Cruciate Ligament Injuries: Risk factors and

prevention strategies,

Journal of the American Academy of Orthopaedic Surgeons

8: 141-150

5. Glazebrook M A (March 2010): New guidelines to address acute Achilles tendon





Additional information:

Webpages: Education/Orthopaedics/Muskelplastizitaet.aspx

Fig. 10 Virtual view of the Balgrist campus. More information is available at

for further information consult: