Clinical Reasoning for Therapeutic Exercise and Physical Activity in Musculoskeletal Care: A Scoping Review of Qualitative Studies and a Qualitative Interview Study

Physical therapists and physical therapist assistants who prescribe, progress, or carry out therapeutic exercise and physical activity programs for people with musculoskeletal conditions in outpatient, hospital, home care, and community settings.

Physical therapists and physical therapist assistants. Physical therapist assistants may enroll; the course describes their part as work carried out under the direction and supervision of the physical therapist, who holds responsibility for evaluation, diagnosis, and the plan of care.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course reports the findings of two published qualitative papers and adds no claims beyond them.

Cooper S, Ghanem C, Yamali M, Anderson J, Gillis H, Wong JJ, Kowalski K. Factors That Inform Clinical Reasoning for Therapeutic Exercise and Physical Activity Prescription in Musculoskeletal Physiotherapy: A Scoping Review of Qualitative Studies. JOSPT Open. 2026:1-49. doi:10.2519/josptopen.2026.0240

Stead A, Vishnubala D, Marino KR, Iqbal A, Pringle A, Nykjaer C. UK physiotherapists delivering physical activity advice: what are the challenges and possible solutions? A qualitative study. BMJ Open. 2023;13(4):e069372. doi:10.1136/bmjopen-2022-069372

After completing this course, you will be able to:

1. Describe the four categories of factors that the JOSPT Open scoping review found informed physical therapists' clinical reasoning for therapeutic exercise and physical activity prescription in musculoskeletal populations, and state which of those categories the review found were not captured by the International Classification of Functioning, Disability and Health.
2. Name the barriers and the proposed solutions to delivering physical activity advice that the BMJ Open interview study reported among physical therapists practicing in the United Kingdom.
3. Explain where the two papers agree and where they diverge on what shapes exercise and physical activity prescription, and state what qualitative evidence of this kind can and cannot establish.

1. Start Here: How This Course Works
2. Part One: What Informs Clinical Reasoning for Exercise and Physical Activity Prescription
3. What the Scoping Review Set Out to Map and Which Studies It Drew On
4. How the Evidence Was Searched, Screened, and Analyzed
5. The Twenty-Three Factors and the Four Categories They Formed
6. Mapping to the ICF, and What the Authors Said It Means for Education and Practice
7. Part Two: Delivering Physical Activity Advice in United Kingdom Practice
8. Who Was Interviewed and What the Study Wanted to Know
9. How the Interviews Were Conducted and Analyzed
10. Barriers Reported: Knowledge, Confidence, Priority, Time, and Patient Factors
11. Solutions the Participants Proposed, and the Study's Acknowledged Limits
12. Bringing It Together
13. Where the Two Papers Point in the Same Direction
14. Where They Diverge, and Which Paper Reported What
15. Toward More Deliberate and Patient-Centered Exercise and Physical Activity Prescription
16. What Qualitative Evidence Cannot Settle, and What the Authors Left Open
17. Key Takeaways
18. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 1.0 contact hour (60 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. Cooper S, Ghanem C, Yamali M, Anderson J, Gillis H, Wong JJ, Kowalski K. Factors That Inform Clinical Reasoning for Therapeutic Exercise and Physical Activity Prescription in Musculoskeletal Physiotherapy: A Scoping Review of Qualitative Studies. JOSPT Open. 2026:1-49. doi:10.2519/josptopen.2026.0240
2. Stead A, Vishnubala D, Marino KR, Iqbal A, Pringle A, Nykjaer C. UK physiotherapists delivering physical activity advice: what are the challenges and possible solutions? A qualitative study. BMJ Open. 2023;13(4):e069372. doi:10.1136/bmjopen-2022-069372