Listening Time — 15:44
Knowing the risk of harm associated with exercise can better inform safe dosing of exercise, clinical implementation, and replicability.
"Exercise is medicine, and understanding dose is really important," notes Maura Iversen, PT, DPT, MPH, SD, "[but] we'll never be able as a profession … to identify appropriate dose response if we don't [report] all the attributes of the exercise intervention." In Iversen's latest systematic review examining randomized controlled trials of therapeutic exercise for people with hip osteoarthritis, she and her colleagues found that reports of adverse events were inconsistent, adherence to exercise was not clearly defined, and main elements of exercise interventions often went unreported altogether. Only 40% of studies included a statement about adverse events. "If we're not reporting adverse events adequately, how do we really know what the risks are?" asks Editor-in-Chief Alan Jette, PT, PhD, FAPTA. Iversen believes that despite the lack of reporting, the overall low number of adverse events suggests that exercise-related risk of harm is minimal for people with hip OA: "The number of the adverse events we found are much less than the adverse events you see taking an NSAID, for example." But to really balance the benefits and the risks, researchers need to improve their reporting. Iversen and Jette offer strategies.
Alan M. Jette, PT, PhD, FAPTA, is editor-in-chief of PTJ: Physical Therapy & Rehabilitation Journal.
Maura D. Iversen, PT, DPT, MPH, SD, FAPTA, is dean of the College of Health Professions and professor of public health and human movement sciences at Sacred Heart University in Fairfield, Connecticut; is a professor in the Department of Physical Therapy, Movement and Rehabilitation Sciences, at Northeastern University in Boston; and is affiliated with the Department of Women' s and Children's Health, Karolinska Intitutet, in Stockholm, Sweden, and the Section of Clinical Sciences, Division of Rheumatology, Immunology & Allergy, at Brigham & Women's Hospital, Department of Medicine, Harvard Medical School, in Boston .