Leadership Message: Evolution of exercise—from competitive sport to precision digital medicine

Dear Colleagues,

As we recognize National Wellness Month this August, it is a great time to reflect on how movement, community, and evidence-based exercise can support lifelong well-being.

Physical activity, then and now

For most of human history, physical activity was a necessity for survival, work, and daily life.  Ancient civilizations, particularly Greece, later formalized exercise through athletic competitions such as the Olympic Games.  Today, exercise is recognized as an evidence-based medical intervention that helps prevent chronic disease, improves mental and cognitive health, and supports treatment and recovery. This evolution further creates an opportunity to integrate exercise into routine healthcare through digital technologies and artificial intelligence (AI).

The World Health Organization recommends that adults engage in 150 to 300 minutes of moderate-intensity aerobic activity each week, along with muscle-strengthening activities on two or more days per week (WHO, 2020).

Regular physical activity also reduces depression and anxiety while improving memory, executive function, and overall well-being (Singh et al., 2024; Stillman et al., 2020).  These benefits are supported by biological mechanisms, including increased production of brain-derived neurotrophic factor, which promotes neuroplasticity, learning, and cognitive health.

One of the most significant changes has occurred in cancer care.  Patients undergoing treatment were once advised to rest, but research now demonstrates that appropriately prescribed exercise is safe and beneficial.  The American College of Sports Medicine concluded that exercise improves physical function, reduces treatment-related side effects, and enhances quality of life for cancer survivors (Campbell et al., 2019).  The American Society of Clinical Oncology also recommends exercise as part of supportive cancer care during treatment (Ligibel et al., 2022).  Furthermore, emerging evidence suggests that exercise may also have direct anticancer effects through multiple mechanisms, including enhancing the body's immune response.

AI integration

The COVID-19 pandemic accelerated the adoption of digital exercise.  Virtual platforms, wearable sensors, smartphones, and AI-powered motion analysis now enable personalized exercise programs regardless of location.  However, technology alone is not enough.

When the pandemic made in-person classes impossible, I transitioned my Zumba classes to a live virtual format.  What began as a way to help people stay active during a difficult time evolved into a supportive online community.  Participants encouraged one another, celebrated milestones, and maintained social connections while exercising from home (Ahumada-Newhart et al., 2024). 

Even after in-person activities resumed, many continued attending virtually because of the friendships, accountability, and sense of belonging they had developed.  This fall, we will celebrate our 1,000^th  virtual class – a milestone demonstrating that meaningful human connections can thrive in digital environments.

As a physician-scientist and exercise instructor, I believe the future of exercise lies at the intersection of medicine, technology, and community. AI can personalize exercise prescriptions, while group-based programs foster social connections that help sustain healthy behaviors. By combining evidence-based exercise with digital innovation and community support, we can make wellness more accessible and create healthier lives for everyone.

National Wellness Month reminds us to prioritize self-care, stress management, and healthy routines in our daily lives.  By viewing exercise as both preventive medicine and a shared community practice, we can transform wellness from a short-term goal into an integral part of everyday life.

The next evolution of healthcare is not simply delivering exercise digitally – it is creating intelligent, evidence-based communities that bring people together to improve health wherever they live.

Yours in health,

Noriko Satake, MD
Professor
Department of Pediatrics