What elements of the exercise prescription process should clinicians consider when prescribing exercise for musculoskeletal rehabilitation in a one on one setting? A review of the literature and primer for exercise prescription

Abstract

Background

Despite exercise being a fundamental component of musculoskeletal rehabilitation, there is a lack concise, evidence-based recommendations to inform the clinician’s development of rehabilitative exercise programs for patients in a one-on-one rehabilitation setting. Current evidence is widely dispersed throughout the literature, with each paper addressing one element of the exercise prescription process in isolation.

Objectives

The aim of this review is to draw together current and available literature to summarise the elements of the exercise prescription process that a clinician should consider when prescribing exercises programs for musculoskeletal rehabilitation in a one-on-one setting.

Methods

Literature was first obtained by database searches, then hand searches were performed based on the reference lists from papers from the original search. Literature was then summarised and synthesised to create a collation of the elements of the exercise prescription process a clinician should consider for musculoskeletal rehabilitation in a one-on-one setting.

Major Findings

The reviewed literature was categorised into two main themes: the clinical considerations and decision making underpinning the exercise prescription and the physical implementation of the exercise prescription to the patient. Each theme contained key elements and sub-elements that may systematically guide a clinician through the exercise prescription process.

Conclusion

Whilst much evidence on exercise prescription in musculoskeletal rehabilitation is present in the literature, there is a lack of concise collated evidence that explores the elements of the exercise prescription process that could inform a clinicians clinical practice. The summary of these elements provides clinicians with a succinct summary that could aid in improving their exercise prescription process and potentially improve patient outcomes. Further research into the efficacy and importance of each element in clinical practice is needed.

Keywords:

• Exercise prescription
• musculoskeletal
• therapeutic exercise
• clinical decision making
• rehabilitation

Disclosure statement

No potential conflict of interest has been reported by the authors.

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Additional information

Notes on contributors

Samantha S. Smith

Samantha Smith is a PhD candidate researching exercise prescription within musculoskeletal rehabilitation and has a Bachelor of Physiotherapy degree with Honours. She works clinically in private practice.

Peter G. Osmotherly

Dr Peter Osmotherly is Senior Lecturer in Physiotherapy at University of Newcastle, Australia His research focusses on diagnosis and management of musculoskeletal disorders.

Darren A. Rivett

Honorary Professor Darren Rivett is Honorary Professor Darren A. Rivett, PhD was the foundation Professor of Physiotherapy and former Head of School of Health Sciences at The University of Newcastle, Australia. His research interests include clinical reasoning and the effectiveness of manual therapy and exercise for musculoskeletal disorders.