therapeutic exercise

In recent years physiotherapists have claimed our competence in the ability to prescribe a therapeutic exercise program to our patients. But the truth is that many professionals do not use this tool either for lack of time, space or because it simply does not take into account the functional nature of a good recovery.

We do not need a world confederation to enumerate the virtues of exercise. We know that exercise can heal, but in physical therapy, healing is synonymous with functionality.

Implementing a good exercise protocol tailored to the needs of your patients will redirect their recovery, make them feel supported in their treatment and most importantly, prepare and educate them to prevent future injury.

You don’t even need to have space for them to do it at your center and if they adhere to the treatment they will generate an exercise routine at home and will be motivated to adapt their day-to-day life to a healthier lifestyle.

 

Basic principles for a good exercise protocol

Developing a good exercise protocol is not an easy task, especially when we are dealing with a patient who does not engage in regular physical activity.

Adherence to treatment is the biggest complication we are going to encounter and, in this case, we do not have the typical “burn calories” motivation that can be used in a gym because we are not prescribing physical exercise.

To get our patient to decide to train at home, we are going to recite the multiple benefits of therapeutic exercise for his injury, that is, we are going to “sell” the treatment.

We are going to talk to you about how essential this exercise is for you to return to that activity that you liked so much and can no longer do.

In physiotherapy, empathy is fundamental and we must connect with our patient. So, rather than a set of rules, these basic principles for developing a training routine are patient-centered tips.

  • Assess the patient: it does not matter if he/she is referred or has come on his/her own. Without assessment there is no action plan. What type of patient is he/she? Is there a nervous system involvement?
  • Define a goal: both for the patient and for you.
  • Adapt to the patient: according to the phase he/she is in, his/her ADLs, his/her occupation, etc. Adaptive exercise will reduce the risk of worsening.
  • Evaluate and re-evaluate your protocol: it is essential to periodically review the patient’s progress, strength, range of motion or functional capacity.

 

Once the roadmap has been made, we choose the type of exercise to prescribe. For this we will take into account:

  • Dosage: how many times, how long.
  • Position and load.
  • The technique and complexity of the exercise: Make the patient see that they are not a series of body movements, they must be done correctly and respect the capabilities of each person to perform them.

What material do I implement in my protocol?

In general, we should prescribe to the patient the exercise program thinking that the exercises should be as accessible and easy to do as possible.

For this reason, we will normally think of exercises that can be done with objects that the patient would find at home: a chair, towels, the wall, the floor, a milk carton, etc.

We can always ask the patient about the equipment they have and that they can make use of that exercise bike they bought during confinement and never used again. You would be surprised how many patients have a fitball at home or even a stepper.

Likewise, we always recommend that in the clinic we have a roll of elastic bands to give to the patient when prescribing the protocol. If we also have several rolls of different resistance, so much the better.

In summary, the answer to the question of this post is very simple: When should we prescribe therapeutic exercise to our patients? Well, as long as we adapt to the needs of each case and monitor its progression properly.

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