Findings from a metaanalysis of 305 randomized controlled trials with 339,274 participants comparing the effectiveness of exercise and drug interventions on mortality outcomes found no statistical difference between the two treatments for preventing mortality associated with coronary heart disease and pre diabetes and for mortality associated with stroke, exercise was found to be more effective than medications.2

“The art of exercise prescription is the successful integration of exercise science with behavioral techniques that result in long-term program compliance and attainment of the individual’s goals,” said Dr. Mignosa. 


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How to Write an Exercise Rx

In order to write an effective exercise prescription, healthcare practitioners first must assess patients current level of activity, and identify patient risk factors that must be addressed using a process he called ART Rx (activity/inactivity, risk stratification, and testing).

Clinicians should first assess patients and calculate a physical activity score based on the amount of time a patient reports engaging in physical activity per week — 0-60 minutes is considered sedentary; 61-149 is considered moderate; more than 150 minutes is considered adequate.

“Gauge physical inactivity as a vital sign,” said Dr. Mignosa. “Fewer than 3 hours of physical inactivity per day indicates adequate physical activity, 3 to 5 hours is considered moderate, and 6 or more hours of inactivity indicates a sedentary lifestyle.”

Several useful forms can aid clinicians in this process, including the Physical Activity Readiness Questionnaire (PAR-Q) from the National Academy of Sports Medicine, the American College of Sports Medicine (ACSM) Risk Stratification Screening Questionnaire , the Exercise Prescription and Referral Form.