Doctors should be prescribing more exercise for common chronic problems, including knee osteoarthritis, heart disease, diabetes, and chronic obstructive pulmonary disease, says a review in CMAJ (Canadian Medical Journal Association), yet it's often overlooked as a treatment.

Part of the reason doctors don't prescribe exercise is that they simply don't understand how effective exercise can be, and haven't a clue how to advise patients.

"Many doctors and their patients aren't aware that exercise is a treatment for these chronic conditions and can provide as much benefit as drugs or surgery, and typically with fewer harms," said the study's lead author Dr. Tammy Hoffmann of Bond University, Australia.

The study found that exercise is often under-prescribed in favor of pharmaceutical or surgical solutions, despite exercise having similar results. Both physicians and patients aren't aware of how effective different types of exercise can be. In addition, poor descriptions of exercises in studies and a lack of training for healthcare workers are also factors affecting the lack of exercise "prescriptions."

The new study includes a how-to guide that lists step-by-step effective exercises for a variety of health problems including:

• Osteoarthritis of the knee and hip: muscle strengthening, aerobic and range-of-motion exercises to help alleviate pain and improve function in people of all ages

• Low back pain: individually supervised exercise sessions by a physiotherapist over 8-12 weeks with both a supervised component and home-based exercises

• Prevention of falls: supervised group or individual exercises by a physiotherapist or trained health professional with home exercises to improve balance, strength and coordination

The how-to guide also includes exercises for COPD, diabetes, chronic fatigue syndrome, heart disease and heart failure. The guide details specifics for each condition, such as materials needed, and the number and length of exercise sessions.

"Exercise is an effective but neglected treatment for many chronic conditions," the authors wrote. "However, similar to surgery, exercise is not a single entity but must be tailored to the condition."