Essential Components of a Physical Therapy Prescription
A comprehensive physical therapy prescription should include the diagnosis, type of therapy, frequency, duration, specific goals, and safety precautions to ensure optimal patient outcomes and proper communication between healthcare providers. 1
Core Components
- Patient Information: Full name, date of birth, contact information, and relevant medical record numbers 2
- Diagnosis: Clear statement of the medical diagnosis or condition requiring physical therapy 1
- Type of Therapy: Specific interventions or modalities to be used (e.g., aerobic exercise, resistance training, flexibility exercises) 3
- FITT-PRO Parameters: Frequency, Intensity, Type, Time, and Progression specifications 3
- Frequency: Number of sessions per week (typically 2-5 days/week) 3
- Intensity: Target exertion level (e.g., using Borg RPE scale, percentage of maximum heart rate) 3
- Type: Specific exercises or activities 3
- Time: Duration of each session (typically 30-60 minutes) 3
- Progression: Guidelines for advancing the program 3
- Goals of Therapy: Specific, measurable outcomes to be achieved 1
- Duration: Total length of the physical therapy program 1
- Safety Precautions: Any restrictions, contraindications, or special considerations 1
- Prescriber Information: Name, signature, contact information, and date 2
Assessment Information to Include
- Functional Assessment Results: Baseline measurements of pain, fatigue, weakness, range of motion, balance, and walking ability 3
- Relevant Medical History: Comorbidities that may affect therapy (e.g., cardiovascular disease, diabetes, osteoporosis) 3
- Previous Physical Activity Level: Assessment of current capabilities and limitations 3
- Specific Limitations: Any restrictions on movement or activity 3
Disease-Specific Considerations
- Cardiovascular Conditions: Include exercise test results, target heart rate ranges, and any monitoring requirements 3
- Musculoskeletal Conditions: Specify weight-bearing restrictions, movement limitations, and pain management approaches 3
- Neurological Conditions: Include assessment of sensorimotor function and cognitive abilities 3
- Pulmonary Conditions: Note respiratory function parameters and oxygen requirements 3
Exercise Prescription Elements
- Aerobic Training: Specify mode (e.g., walking, cycling), intensity (e.g., 50-80% of exercise capacity), frequency (3-5 days/week), and duration (30-60 minutes) 3
- Resistance Training: Include frequency (2-3 days/week), intensity (e.g., 8-15 repetitions maximum), sets (1-3), and specific exercises for major muscle groups 3
- Flexibility Training: Detail frequency (2-3 times/week), duration of stretches (10-30 seconds), repetitions (3-4), and target muscle groups 3
- Balance and Functional Training: Specify exercises that address specific functional limitations 3
Communication Elements
- Interdisciplinary Coordination: Instructions for communication between the physical therapist and other healthcare team members 3
- Follow-up Plan: Timeline for reassessment and criteria for discharge or program modification 3
- Home Exercise Program: Guidelines for exercises to be performed outside of formal therapy sessions 3
Common Pitfalls to Avoid
- Vague Prescriptions: Avoid general statements like "evaluate and treat" without specific parameters 1
- Overlooking Contraindications: Failure to note activities that should be avoided based on the patient's condition 3
- Inadequate Progression Planning: Not providing guidelines for advancing the program as the patient improves 3
- Missing Safety Parameters: Failing to include vital signs monitoring requirements or exercise termination criteria 3
- Neglecting Functional Goals: Focusing only on impairments rather than functional outcomes 3
By including these essential components in a physical therapy prescription, healthcare providers can ensure effective communication and optimize patient outcomes through appropriate, targeted interventions.