Toward an Equity-Based Response to Endometriosis.

Physical exercise has played a central role in human health since early civilization. Evidence from 3000 BCE indicates that nomadic societies relied on movement for survival, and over time, activity evolved into culturally embedded practices such as games, rituals, and dance []. Classical physicians, including Hippocrates and Galen, emphasized exercise as a vital component of health maintenance and coined concepts such as “exercise is medicine” []. In modern society, structured exercise remains essential, with the COVID-19 pandemic further highlighting its role in immune function and overall well-being []. Caspersen distinguished “physical activity” as any energy-expenditure movement and “exercise” as structured, planned, and repetitive activity aimed at improving fitness []. This distinction is particularly relevant for intervention-based research, as “exercise” denotes controlled, fitness-oriented training widely used in experimental and clinical studies (e.g., over 19,882 citations on Google Scholar). Despite global recommendations, physical inactivity remains a major public health challenge. The WHO Global Action Plan on Physical Activity (GAPPA 2018–2030) targets a 15% reduction by 2030; however, worldwide inactivity increased from 27.5% in 2016 to 31.3% in 2022, particularly among women and older adults [,]. Exercise confers benefits across the lifespan. In older adults, it mitigates frailty [], sarcopenia [], cardiovascular dysfunction [], and enhances cognitive function []; accordingly, WHO guidelines emphasize aerobic, resistance, and balance training to preserve muscle mass, mobility, and independence [,]. In children and young adults, ≥60 min of daily moderate-to-vigorous physical activity supports cardiometabolic health, bone development, cognition, and overall well-being [,]. Athletes and tactical populations engage in high levels of physical activity and require substantial physical and psychological capacity for optimal performance and public safety [,]. Training is periodized into pre-season conditioning, in-season maintenance, and off-season recovery phases to optimize adaptation and minimize injury and fatigue [].