Exercise Therapy and Rehabilitation
Exercise therapy tests prescription principles: choosing the right mode, dose, progression, and outcome measure for each impairment.
Core rules and concepts
- Use FITT: frequency, intensity, time, type. Match the dose to the goal-range, strength, endurance, power, balance, or function.
- Strength gains need progressive overload; hypertrophy programmes commonly use 60–80% of one-repetition maximum for 8–12 repetitions.
- Aerobic training improves cardiorespiratory fitness; prescribe moderate intensity with appropriate warm-up and cool-down.
- Balance training should be progressive, task-specific, and safe, with support reduced gradually.
- Monitor pain, fatigue, swelling, and adverse responses; distinguish delayed-onset muscle soreness from injury.
Worked example
A patient’s one-repetition maximum for knee extension is 40 kg. For hypertrophy, 60% is 24 kg. Prescribe 3 sets of 8–12 repetitions at 24 kg, with 1–2 minutes rest, two to three times weekly. Reasoning: 60% of 1RM is a moderate load that allows sufficient volume while limiting joint stress. Progression occurs by increasing load, repetitions, or sets, not all at once. Reassess strength after several weeks and adjust the percentage.
Traps that cost marks
- Prescribing strengthening without first checking joint range, pain, and stability.
- Confusing DOMS with a new musculoskeletal injury; DOMS usually begins 24–48 hours after unaccustomed exercise.
- Ignoring Valsalva manoeuvre and cardiovascular risk during heavy resistance work.
- Progressing too quickly and causing flare-up.