Figure 2. Central (cardiovascular) and peripheral (skeletal muscle) adaptations to exercise training.

Cardiovascular adjustments to exercise (upper panel) require an intact autonomic nervous system and are driven by three major signals: (1) feedforward ‘central command’ related to motor output, which activates selected areas in the brainstem cardiovascular (and respiratory) centres to stimulate increases in heart rate, blood pressure and ventilation; (2) afferent feedback from thinly myelinated and unmyelinated type III and IV afferents in contracting muscles that increase sympathetic activation; and (3) baroreceptors in the carotid sinus and aortic arch that provide feedback on blood pressure to the brainstem cardiovascular centres. A common feature of the cardiovascular responses to exercise is the detection of motion‐related signals, such as the movement of blood (shear stress) and pressure in the heart and arteries (transmural pressure). Such haemodynamic signals transduce acute and chronic adaptation. Redundancy and compensatory regulation are key characteristics of these biological systems which act to preserve physiological homeostasis. Contraction‐induced adaptations to exercise training, and modulators of gene expression in skeletal muscle (lower panel), that ultimately lead to functional improvements in exercise capacity/performance and drive alterations in phenotype.