Interventions and Treatment
What this domain tests
This domain tests exercise prescription, manual therapy, modalities, functional training, and education: selecting the intervention, dose, progression, and contraindications for the patient in front of you.
Core rules
- Overload and specificity drive adaptation. Prescribe frequency, intensity, time, and type (FITT); progress load, volume, or complexity when the patient tolerates it.
- Strength: roughly 60-70% of one-repetition maximum, 2-3 sets of 8-12 repetitions, 2-3 days per week for novices; endurance uses lower load and higher repetitions.
- Mobility interventions require enough force to affect tissue but not so much that they provoke inflammation. Manual therapy is an adjunct, not a substitute for active exercise.
- Modalities have specific contraindications: ultrasound over malignancy, pregnancy, growth plates, or infection; electrical stimulation in patients with pacemakers or over the carotid sinus; thermal agents over insensate skin.
- Measure response and function, not only pain.
Worked example
A patient with knee osteoarthritis has pain and quadriceps weakness. A reasonable plan combines supervised quadriceps strengthening (2-3 sets of 8-12 repetitions, 2-3 times weekly), low-impact aerobic walking, and manual therapy for short-term pain relief. The reasoning: strengthening addresses the impairment, aerobic exercise addresses function and cardiovascular health, and manual therapy is time-limited adjunctive care.
Traps
Applying one protocol to every patient. Using passive modalities as the main plan. Progressing load before tissue healing allows. Failing to reassess after an intervention.