Management

Exercise Prescriptions

Editors: Patrick G. O'Malley MD, MPH, MACP; Zbigniew Fedorowicz PhD, MSc, DPH, BDS, LDSRCS; Dan Randall MD, MPH, FACP

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Background Information

Description

  • Exercise prescriptions refer to individualized exercise plans for patients that typically include:
    • Specific verbal or written instructions for physical activity to improve health outcomes
    • Recommendations for frequency, intensity, duration, and type of physical activity
  • Low level of physical activity is an important risk factor for all-cause mortality in both men and women, making exercise prescription an important consideration in many patients.
  • Sedentary lifestyles have become more common over recent years, and physical inactivity, low cardiorespiratory fitness, and prolonged sedentary periods are becoming a health concern, contributing to an increased risk of mortality.
  • > 60% of American adults are reported to not engage in regular physical activity (≥ 150 minutes/week of moderate-intensity aerobic activity), with 25% of adults reported to be completely sedentary.
  • The World Health Organization (WHO) reports that physical inactivity is the fourth leading risk of mortality worldwide, including increasing risk of diseases such as cardiovascular diseases, cancer, and diabetes.

Also Called

  • Supervised exercise programs
  • Exercise interventions
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DynaMed Levels of Evidence

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DynaMed provides easy-to-interpret Level of Evidence labels so users can quickly find and determine the quality of the best available evidence. Evidence may be labeled in one of three levels:

1Level 1 (likely reliable) Evidence
Representing research results addressing clinical outcomes and meeting an extensive set of quality criteria which minimizes bias.
There are two types of conclusions which can earn a Level 1 label: levels of evidence for conclusions derived from individual studies and levels of evidence for conclusions regarding a body of evidence.
2Level 2 (mid-level) Evidence
Representing research results addressing clinical outcomes, and using some method of scientific investigation, but not meeting the quality criteria to achieve Level 1 evidence labeling.
3Level 3 (lacking direct) Evidence
Representing reports that are not based on scientific analysis of clinical outcomes. Examples include case series, case reports, expert opinion, and conclusions extrapolated indirectly from scientific studies.

Grades of Recommendation

Guideline producers are now frequently using classification approaches for their evidence and recommendations, and these classifications are recognized and requested by guideline users. When summarizing guideline recommendations for DynaMed users, the DynaMed Editors are using the guideline-specific classifications and providing guideline classification approach when this is done.

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