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Exercise Based Rehabilitative Practice

 PrioritiesLeadership CommitteeClinical GuidelinesPosition Statements

Exercise based rehabilitation is a unique focus in osteopathy. It uses movement and movement instruction, often with minimal hands on manual therapy, specifically to enhance physical capacity or movement in patients who:

  • Have sustained an injury
  • Have undergone recent surgery
  • Have a chronic illness or injury
  • Are seeking recovery and improvement to their general health and wellbeing
  • Have experienced loss of normal functional ability.

Exercise rehabilitative osteopaths develop programs either for individuals or groups. These aim to restore patient functionality to pre-injury capacity wherever possible, or to adjust to life with a chronic illness or injury. The focus in exercise rehabilitative practice is ‘fit for purpose’ exercise, which builds cognitive and physical resilience, suited to clinical presentations, their limitations and any  expected changes over time.  Exercise rehabilitative osteopaths may provide exercise based interventions in private practice, healthcare setting or within communities.

Assessment and treatment 

There are clinical processes and requirements that all osteopaths follow, regardless of their clinical focus, before they provide treatment. These include performing a physical assessment, a thorough health history, discussion of a proposed treatment plan, provision of advice and information on the risks and benefits of any proposed treatment; and confirmation of your willingness to proceed – otherwise known as informed consent.

An assessment performed by an exercise rehabilitative osteopath may include the following additional and specific clinical components: 

  • Identification of your lifestyle and functional goals and requirements in partnership with you
  • Movement based assessment using physical tests. This involves assessment of your body and how it moves, to identify your strengths or imbalances that may impact your ability to perform daily activities, live your preferred lifestyle, or meet your functional goals
  • Assessment of resting blood pressure and heart rate, body composition, strength, control, balance, cardiorespiratory fitness, muscular fitness and ability to perform specific functional tasks
  • Identification of factors that may have contributed to any loss of your normal function through a discussion of your history.

Exercise rehabilitative practice is patient-centred and empowering. An exercise rehabilitative osteopath will involve you in developing an exercise program that meets your assessed needs and assists in building your physical and mental resilience. This means you will: 

  • Be involved in selecting an exercise setting or settings that meet your individual requirements
  • Be involved in selecting exercise techniques from a range of appropriate exercises determined by the exercise rehabilitative osteopath
  • Receive advice about how to apply prescribed exercises with correct technique in order to avoid aggravation or exposure to further injury.

After you start an exercise program, an exercise rehabilitative osteopath will review how well your program has been working toward meeting your needs. They will reassess changes to your function before, during and after an exercise program has been applied. Adjustments to your exercise program may be recommended.

Exercise rehabilitative osteopaths understand alternative treatment options and treatments that may work in combination with exercise based programs. They have links with other health practitioners, as well as with wellbeing program providers. They regularly give referrals to and work with medical practitioners, psychologists, exercise physiologists and other health professionals, as well as fitness programs, such as personal training, cross fit, yoga and pilates. Osteopaths also receive regular referrals from other health professionals.

Special considerations of exercise rehabilitative osteopaths

Exercise rehabilitative osteopaths have in depth knowledge of: 

  • Pre and post-surgical functional issues across a range of age and patient groups
  • Approaches used to develop and evaluate individual and group based exercise programs
  • Individual goal setting and coaching approaches, including managing  barriers to behaviour change and motivation
  • Exercise dynamics, motivation and coaching
  • Exercise interventions and approaches that may prevent or manage issues in patients that decrease their ability to perform daily activities
  • Rehabilitation transition points and supports that may be required by patients to meet key transition points
  • Combinations between hands on manual therapy and exercise prescription that may be effective.

Note: there are no specialisations within osteopathy. However many osteopaths choose to work with a specific patient group or groups and undertake further study and/or training to support their clinical focus.