Association of Genetic Factors With Selected Measures of Physical Performance

• Angiotensin-converting enzyme (ACE)
• Genetics
• Rehabilitation

In the last 30 years, the field of genetics has proven to be a highly influential component of nearly all aspects of research and clinical science. Numerous important and interesting discoveries have been made since the Human Genome Project was launched. Among the first accomplishments were the identification of the genes responsible for cystic fibrosis, neurofibromatosis, Marfan syndrome, and xeroderma pigmentosum.¹ Several fields of medicine, such as psychiatry, embryology, and pulmonology, already have incorporated the use of genetics into their practices.^2–4 An individual’s genetic makeup may predispose him or her to a specific pathology, such as Alzheimer disease, cystic fibrosis, or diabetes, and influence the response to treatment.^5–7 The possible implications of the use of genetics in physical therapy are profound, and there are many examples in recent literature of genetic markers that are associated with performance and exercise intolerance.⁸ Recently, several studies identified an association between the presence of a specific allele of the gene encoding the angiotensin-converting enzyme (ACE) and an individual’s endurance or strength capacity.^9–12 Interestingly, some studies have refuted the relationship between the enzyme and increased endurance or strength.^13–15 Understanding the role of the ACE gene and other genes with respect to physical performance and how these genes may alter the ability of subjects to respond to therapeutic exercise may have important implications in designing studies for testing therapeutic interventions, which will in turn have an effect on clinical practice.