Writing a physiotherapy exercise prescription that patients actually follow

Most home programmes fail at home, not in the clinic. The patient nodded along, took the sheet, and by day four could not remember whether it was ten repetitions or three sets of ten. A good exercise prescription is short, specific and easy to follow without you in the room. This is how to write one.

Choose fewer exercises

Pick the three to five exercises that matter most for this patient this week. A programme of twelve exercises is a programme of none. You can add or swap as they progress.

For each exercise, ask: what is it for, and will the patient be able to tell if they are doing it wrong? If you cannot answer both, choose a different one.

Dose every exercise

Every exercise needs all of these, written as numbers:

• sets and repetitions, for example 3 sets of 10

• hold, in seconds, for stretches and holds

• frequency, for example twice a day, or every other day

• rest between sets, if it matters

"Do some knee bends" is not a prescription. "Sit to stand from a dining chair, 2 sets of 8, once a day" is.

Say what it should feel like

Patients stop exercises that hurt and skip ones that feel like nothing. Tell them what to expect:

• "You should feel a stretch in the back of the thigh, not pain behind the knee."

• "Mild discomfort up to 3 out of 10 is fine. If it goes above that, or lasts until the next morning, do fewer."

Write instructions a family member could follow

Start position, the movement, the finish position, one sentence each. Avoid clinical terms on the patient's copy. Many patients will show the sheet to someone at home, so write for that person too.

Plan the progression

Note when and how you will make it harder: more repetitions, more load, a less stable surface, a longer hold. Tell the patient: "If this is easy for three days in a row, move to 3 sets of 12." Progression keeps the programme moving between visits.

Add the advice that goes with it

Activity advice is part of the prescription: posture at work, how long to sit, when to use ice or heat, what to avoid this week. Keep it to a few lines.

Check it before they leave

Ask the patient to do each exercise once in front of you. Correct it, then ask them to tell you the dose back. This takes two minutes and saves a week of doing it wrong.

Follow up

At the next session, ask how many days they did the programme, not whether they did it. People answer the first question honestly. If adherence is low, simplify rather than lecture.

Prescribing in PhysioDesk

In PhysioDesk the prescription lives on the patient's record, not on paper:

1. Every clinic starts with a library of exercises grouped by body part, written in plain patient-facing words. The owner can add the clinic's own.

2. On the patient's record, choose exercises by typing to search, and set sets, repetitions, hold and frequency for each.

3. The patient sees their home programme in the patient portal on their phone, exactly as you wrote it. In the PhysioDesk app (launching soon on Android and iPhone) they can tick off each exercise as done.

4. Stopping an exercise keeps it on the record, so you can see what has been tried.

5. Record progress measures, such as pain score or range of motion, as treatment goes on, so you and the patient can see whether the programme is working.

Try it in the 30-minute demo from the pricing page.