Exercise Therapy Is A Safe Intervention With A Low Risk For Adverse Events
Physical activity and exercise are regarded as integral components of physical therapy for most musculoskeletal disorders (eg, knee osteoarthritis, shoulder, neck, back pain, ankle sprains, etc.), as well as for losing weight and for treating various other conditions, such as depression, heart disease, and high blood pressure. These interventions are generally extremely safe, with reported adverse events—or side effects—expected to be less frequent and less severe than those associated with pharmaceutical or surgical interventions.
Nonetheless, it’s important to report on the severity, type, and frequency of adverse events that do occur from exercise interventions so that patients are aware of the potential risks involved and how these risks compare with other interventions. Therefore, a powerful study called a systematic review and meta-analysis was conducted to evaluate the relative risk of serious and non-serious adverse events from exercise therapy.
Researchers analyze 180 reviews that include 778 primary studies
Before discussing the details of the study, it’s important to state some key definitions:
- Physical activity: as any bodily movement produced by skeletal muscles that results in energy expenditure
- Exercise: a subset of physical activity that is planned, structured, and repetitive, and has a final or intermediate objective of improving or maintaining physical fitness
- Exercise therapy: a regimen or plan of physical activities designed and prescribed for specific therapeutic goals
- Adverse event: an undesirable or harmful outcome that occurs during or after the use of an intervention; can be serious (ie, leads to death, hospitalization, or serious risk of health deterioration) or non-serious (all other reported events)
Using these definitions, researchers performed a search of the Cochrane Library for Cochrane systematic reviews that investigated the effectiveness of exercise therapy for any condition. Exercise therapy had to be the main intervention of the study and each exercise session had to include active exercise therapy for at least 50% of the total time. The exercise also could not be combined with any pharmacological, surgical, or electrotherapeutic intervention.
Analysis of Top Quality Research (i.e. Cochrane Reviews) Shows Exercise Therapy Continues to be a Great Choice
This led to 180 Cochrane reviews being included, and 773 primary studies were identified from these reviews, with 378 reporting serious adverse events and 375 studies reporting non-serious adverse events. The main finding from these studies was that there was no increase in the risk of a serious adverse event from exercise therapy compared to a non-exercise intervention; however, there was an increase of 19% in the risk of a non-serious adverse event. This means that for every 6 people who participated in an exercise intervention, one additional non-serious adverse event occurred in the exercise group. The most common non-serious adverse events reported were pain, fatigue, bursitis, low back pain, and edema (swelling).
NOTE: this study examined exercise therapy prescribed by a number of different healthcare providers…not just physical therapists. Adverse events with our patients happen far less than 1 in 7 of our patients. Nevertheless, we wrote this post to let you know that non-serious adverse events in response to exercise therapy can happen, albeit, they are very rare at our practice.
Physical Therapist Directed Exercise Therapy is the Clear Winner for Natural/Conservative Care of Most Musculoskeletal Injuries
These results show that while there was an increase in the relative risk of non-serious adverse events associated with exercise therapy (provided by anyone), it was small. Therefore, exercise therapy can be regarded as a relatively safe intervention. Thus, physical therapists and other healthcare providers that prescribe exercise therapy are appropriately including it as an essential component of treatment for patients with various conditions.
If you’re dealing with pain of any sort, Bacci & Glinn Physical Therapy can help.
