Physio Program Design

Mandatory first reads

Read safety core and program design framework. A program starts only after safety, scope, restrictions, baseline capacity, goals, and outcome measures are sufficiently clear. Invoke $physio-clinical-reasoning first when they are not.

Workflow

1. Confirm the decision envelope. Record diagnosis/working classification, stage, irritability, medical stability, protocol/restrictions, medications/devices, contraindications, precautions, supervision, environment, and patient priorities.
2. Map each target. Use ICF problem → meaningful goal → intervention mechanism → outcome measure → reassessment date.
3. Gather dose-relevant evidence. Invoke $physio-evidence-search; extract the actual intervention using CERT/TIDieR fields. Distinguish guideline dose, trial dose, consensus, and clinician-titrated starting dose.
4. Choose the minimum sufficient components. Prioritize active, goal-linked elements. Add education, task/environment modification, assistive technology, manual/device intervention, or referral only when justified.
5. Specify every component. Mode/type, frequency, intensity/load, time per bout, repetitions/sets, total volume, rest, session order, program duration, supervision, provider competence, setting, equipment, adherence strategy, and co-interventions.
6. Use the assistive-technology pathway when relevant. Define the participation problem, user/environment fit, alternatives, trial, qualified fitting/configuration, training, skin/pressure/fall checks, maintenance, follow-up, and abandonment risk. Do not fabricate dimensions, alignment, pressure, or device settings.
7. Individualize the start. Use baseline performance and symptom/vital response. Never copy a study dose directly when eligibility, setting, or monitoring differs.
8. Write progression and regression rules. Base decisions on technique, target performance, symptoms, recovery, confidence, function, and safety—not calendar time alone.
9. Write stop/escalation rules. Separate expected exertion, acceptable temporary response, modify/hold criteria, and urgent/emergency features. Do not invent universal pain, heart-rate, SpO₂, or swelling thresholds.
10. Design the home version. Use the fewest exercises/tasks that cover priorities; include setup, assistance, equipment, exact clinician-approved dose, common errors, tracking, and safety-net.
11. Build reassessment logic. Define adherence, exposure, outcome change, adverse events, goal attainment, and criteria to continue, progress, change, refer, or discharge.
12. Check feasibility and equity. Cost, transport, caregiver burden, culture/language, digital access, cognitive/sensory needs, fatigue, space, and patient preference.
13. Create a transparent final plan. Mark every unknown as unknown. Label extrapolation and evidence certainty.

Phase design

Each phase must state:

• entry criteria;
• objectives and components;
• dose provenance and starting range;
• progression/regression rules;
• exit criteria;
• reassessment measures;
• adverse-response and escalation plan.

Return to activity, sport, work, or driving must be criteria-based and jurisdiction-aware. Do not issue clearance.

High-risk boundaries

Do not provide unsupervised or do-it-yourself instructions for invasive procedures, high-velocity manipulation, blood-flow restriction, internal pelvic procedures, maximal/exertional testing, or device settings when training, authority, medical stability, manufacturer instructions, and emergency support are unverified.

Output

1. Eligibility, restrictions, and unresolved safety data
2. Goals and baseline measures
3. Evidence and dose-provenance summary
4. Phase plan
5. Session template
6. Home program
7. Assistive technology/equipment trial, fitting, training, maintenance, and follow-up when relevant
8. Progression, regression, hold, stop, and escalation rules
9. Monitoring and reassessment schedule
10. Adherence, feasibility, and accessibility plan
11. Uncertainty and sources

Always label research numbers as study dose—not an individual prescription until individualized and approved within a real clinical assessment.