exercise prescription and the FITT framework
/ FITT, rhymes with "fit" /
When a doctor writes you a prescription for a medicine, it does not just say "take pills" — it says which pill, how much, how often, and for how long. Exercise in rehabilitation works the same way. "Go and exercise" is almost useless advice; what helps is a precise, personalized recipe — this exercise, this hard, this long, this often. A therapist who hands a stroke survivor a vague "do some walking" has prescribed nothing. The skill is in the details.
FITT is the simple memory hook for those details: Frequency (how many times a week), Intensity (how hard — how heavy the weight, how fast the walk, often expressed as a percentage of someone's maximum), Time (how long each session lasts), and Type (which mode — strengthening, stretching, walking, balance work, and so on). A real prescription pins down all four and then changes them over weeks as the person gets stronger. For example, a heart-attack survivor might begin with brisk walking (Type) at a comfortable, conversational pace (Intensity) for ten minutes (Time) three days a week (Frequency), and only later add minutes and speed as the body adapts.
Why this matters: rehabilitation is not about exercising in general but about giving the right dose to the right person for the right goal, and then progressing it. Too little dose and nothing changes; too much, too soon, and the person is injured, exhausted, or frightened off. The same FITT logic underlies strengthening, aerobic conditioning, stretching, and balance work alike — it is the grammar of every exercise plan. It rests on the training principles (overload, specificity, progression) borrowed from exercise physiology, but here it is bent toward a clinical goal rather than athletic performance.
A therapist's note reads: "Stationary cycling, 3x/week, 20 min, at a level where the patient can still talk but not sing; progress by 5 min every 2 weeks as tolerated." Type, Frequency, Time, and Intensity are all there, plus a progression rule.
The "talk-test" is a low-tech way to set Intensity without any equipment.
FITT is a checklist, not the whole story — modern versions add a fifth term for Volume and Progression (FITT-VP), because the recipe must change over time, not stay fixed.