Exercise prescription

Exercise prescription commonly refers to the specific plan of fitness-related activities that are designed for a specified purpose, which is often developed by a fitness or rehabilitation, or Exercise medicine specialist for the client or patient. Due to the specific and unique needs and interests of the client/patient, the goal of exercise prescription should focus on motivation and customization, thus making achieving goals more likely to become successful. Exercise prescription should take into account the patient's medical history, and a pre-examination of a patient's physical fitness to make sure a person has the capacity to perform the exercises.

In the United Kingdom there is a scheme called "Exercise on prescription" or "Exercise Referral" in which doctors are able to prescribe exercise to those with conditions that benefit from it, such as asthma, depression, or obesity. The initiative particularly aimed to lower the rate of heart disease. National standards for such initiatives from doctors were established by the Department of Health in 2001. Exercise on prescription aims to prevent deterioration of conditions, and views exercise as a preventative health measure. Fitness classes or a course at the local gym are available on prescription at a reduced rate to people who might benefit from them. It aims to make it easier for people to follow their doctors' advice about taking more exercise or losing weight. Such preventative measures hope to lead to savings for the National Health Service.

Researchers in New Zealand have also discussed the benefits of exercise referral by medical practitioners there. In New Zealand it is known as a green prescription, while in the United States a similar initiative is known as Exercise is Medicine. A green prescription is a referral given by a doctor or nurse to a patient, with exercise and lifestyle goals written on them. The term, used by health practitioners in New Zealand draws parallel to the usual prescriptions given to patients for medications, and emphasizes the importance of exercise in improving their condition, and not relying on drugs. The green prescription is written after discussing the issues and goals in the consultation. Studies have shown that an increase in exercise, better sense of well-being, and a decrease in blood pressure results from using the method. A decreased risk of coronary heart disease has not been shown. This was shown in two studies, one that surveyed patients in Auckland and Dunedin, and another that was done in 42 practices in the same region of New Zealand.

General practitioners like the idea as it formalizes what they are telling the patient about how their lifestyle changes are necessary. There has previously not been sufficient education of general practitioners on Exercise Prescription, compared to drug and procedural education, although the need to confidently prescribe exercise increases as the evidence shows of its benefits. If not confident or in difficult cases, General practitioners can refer on to Exercise physiologists, Physiotherapists or Sport & Exercise medicine specialists.

Research in Australia has suggested that an exercise prescription program would be very beneficial and many ICU physiotherapists are already performing this practice, however there is no national standards to govern how this practice is administered so there is great variety in the ways this is administered therefore more research is needed.

Studies show that exercise prescription aids in both preventing and minimizing the effects of joint disorders such as osteoarthritis. Evidence shows that in addition to the general physiological, psychological and functional benefits gained from exercise, greater quadriceps strength has a mitigating effect on knee joint pain.

A large body of research indicates that exercise prescription has beneficial effects for patients with depression. One study shows a significant improvement for a randomized group of women with major depressive disorder engaging in a twice-weekly resistance training program compared to a control group. The reasons for this marked change is thought to have biochemical, physiological and psychosocial aspects.

Although routine physical activity could be an aggravating factor for migraine, physical exercise is considered to be part of a non-pharmacological strategy for migraine prevention. Migraine patients tend to have less pleasure in physical activity due to fear-avoidance and anxiety sensitivity.