Prescribing exercise interventions for patients with chronic conditions.

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Journal Article

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Hoffmann, T. C., Maher, C. G., Briffa, T., Sherrington, C., Bennell, K., Alison, J., Singh, F. M., & Glasziou, P. P. (2016). Prescribing exercise interventions for patients with chronic conditions. CMAJ, 188(7), 510-518.

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Exercise has been shown to be beneficial in the treatment of many chronic conditions. Mortality benefits from exercise are similar to pharmacologic interventions for secondary prevention of coronary heart disease, stroke rehabilitation, treatment for heart failure and prevention of diabetes. The morbidity benefits of exercise for diseases that are not life-threatening, such as back pain and osteoarthritis, are substantial. However, exercise is underprescribed and frequently overlooked, often in favour of a pharmacologic or surgical intervention.

Factors that contribute to underprescription of exercise interventions may include a lack of awareness among many clinicians and patients about the effectiveness of exercise interventions, poor knowledge about what comprises an effective exercise intervention, a lack of relevant training and educational opportunities available to medical practitioners and inadequate descriptions of exercise interventions in published trials and reviews. An analysis of 137 nonpharmacologic interventions from 133 trials found that 61% did not have sufficient information reported (e.g., procedural and intensity details) to enable replication in practice, thus preventing clinicians from being able to prescribe these interventions. An analysis of the reporting of the exercise component used in cardiac rehabilitation trials found that adequate descriptions of the exercise schedule were missing for 58% of the interventions.

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This document has been peer reviewed.