Exercise is an important part of all physical therapy treatment. Exercise has the ability to aggravate symptoms if chosen incorrectly or dosed too high (too many repetitions) or to improve symptoms by improving mobility, motor control, or increasing strength and endurance. Exercise under the prescription of a physical therapist is different than just physical activity. The therapist has the ability to choose appropriate exercise based on the dysfunction, the patient's other medical issues, and the desired functional improvement. Generalized exercise has not been shown to be effective in all conditions. Specific exercises have been shown to have efficacy. Often, treatment may include transferring forces to proximal or distal segments. Specific strengthening is utilized to prepare target muscles for the movement re-education that is to follow. Strengthening in these non-painful areas also serves to improve general function and decrease a patient's fear of pain as the treatment does not initially focus on the painful region. Exercise serves to improve motor control and coordination, decreases stress, improves mood, and improves cardiovascular performance. Physical therapists dose exercise based on frequency, intensity (load, number of repetitions, rest time), and speed that the exercise is performed (Brosseau et al. 2008b, Kulig et al. 2009, Hayden et al. 2005, French et al. 2006).
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