Exercise Prescription

Exercise prescription is a major tool in the physiotherapist's repertoire of treatment techniques. Like other treatments, it must be carefully applied, continually assessed and re-assessed, and modified accordingly. Short and long-term goal setting is essential as is commitment from the patient and physiotherapist. Goals may range from simple activities of daily living tasks, such as holding a cup or utensils, working without discomfort or performing in a concert or sporting event. The role of exercise is not only a form of treatment or adjunct to treatment, but also a self-management and prevention approach.

Role of physiotherapy

Physiotherapists are experts in exercise prescription for both the fit, healthy person who requires specific fitness and injury prevention advice, and for the injured or disabled person who has specific needs and considerations. To ensure appropriate, effective and safe exercise it is important that exercise prescription is:
bullet supervised by a physiotherapist;
bullet used appropriately;
bullet performed with adequate initial assessment to identify the main problem and its cause;
bullet undertaken with ongoing reassessment and modification as appropriate.
The physiotherapist will perform a thorough assessment before prescribing specific exercises. Patient assessment can include consideration of:
bullet The presenting problem - pain, joint stiffness, muscle inflexibility, functional instability, muscle weakness, lack of coordination/balance, joint laxity. All may culminate in a loss of function activities of daily living.
bullet Cardiovascular fitness.
bullet General mobility, condition, health, age and effects of exercise on these e.g. diabetes, asthma, Chronic Obstructive Airways Disease (COAD), Cerebrovascular Accident (CVA), Osteoarthritis (OA), Rheumatiod Arthritis (RA), Acute Myocardial Infarction (AMI), pregnancy.
bullet Effects of immobilisation on isolated joints or the whole body.
bullet The exercise environment e.g. hospital, home, gym, including adequacy of lighting, floor surfaces, ventilation, temperature, and available equipment which can be anything from a can of food to a computerised Cybex/Kin Com.
bullet Previous exercise levels, skill, ability and preferred activities.
bullet Contraindications to exercise and movement.
bullet Patient's willingness to exercise.
bullet Pathology present.
bullet Individual learning (motor control learning).

Benefits of physiotherapy

Exercises may be prescribed either for the individual or in group situations e.g. hydrotherapy, ante/post natal classes, amputees, total hip/knee replacements, cardiac rehabilitation, post AMI/surgery.

Exercise prescription requires physiotherapists to have a detailed knowledge of:
bullet motor learning
bullet anatomy
bullet biomechanics/pathomechanics
bullet kinesiology
bullet pathology
bullet exercise physiology

Exercise prescription by a physiotherapist has many benefits and provides improvement in:
bullet cardiorespiratory fitness e.g. cardiac rehabilitation;
bullet strength, endurance, power, stability;
bullet mobilising, stretching;
bullet proprioception e.g. post ankle, knee, shoulder injury/surgery, neurology rehabilitation, and spinal conditions;
bullet functional rehabilitation - combine skill training, work conditioning, gait training;
bullet pain relief and function.

Finding a physiotherapist

Would you like the names of physiotherapists who have a special interest in Exercise Prescription? Call us on (03) 9527 7532 or contact us here.

APA
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Move well. Stay well.
By courtesy of the Australian Physiotherapy Association