Elements of exercise prescription in Randomised controlled trials of musculoskeletal rehabilitation in a one–on–one setting. A scoping review

Abstract

BackgroundRandomised controlled trials (RCTs) are used by clinicians to inform evidence-based practice including when providing exercise programs. They should sufficiently report exercise interventions to permit accurate replication and incorporation into clinical practice. ObjectivesThe aim of this scoping review was to describe the elements used within the exercise prescription process for musculoskeletal rehabilitation in a one-on-one setting reported in RCTs including their methods and prescription in intervention or control groups. MethodsThe databases CINHAL, COCHRANE, EMBASE, MEDLINE and PUBMED were searched using a predefined strategy. Articles were reviewed according to detailed inclusion/exclusion criteria which included whether they were RCTs prescribing exercises for musculoskeletal rehabilitation in a one-on-one setting published within the last 5 years. For studies retained following screening, data extracted included year of publication, musculoskeletal condition and interventions studied. A pre-determined checklist ascertained the elements of the exercise prescription process reported in each study. Data obtained were analysed descriptively and summarised. ResultsAfter screening, 153 studies were retained for data extraction. The two most reported items included ‘specific dosages provided’ (75%, n = 115), and ‘observe the patient performing the exercises’ (71%. n = 108). Over half of studies reported basing their exercise intervention on existing evidence-based protocols (61%, n = 93). Elements considering biomechanical principles were the most ‘unclear’. Most of the checklist items received an ‘unclear’ score due to inadequate descriptions of interventions. ConclusionMany RCTs under report the development and prescription of exercise interventions, limiting replication of findings in clinical practice. A comprehensive framework is needed to ensure exercise prescription is adequately reported.