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Beyond 3 Sets of 10: A Critical Evaluation of the Dosage Parameters Prescribed for Exercise Interventions in Highly Influential Musculoskeletal and Sports Physiotherapy Research

This meta-research study reveals that highly influential musculoskeletal and sports physiotherapy trials frequently lack complete exercise dosage reporting and often prescribe parameters inconsistent with physiological rationale, thereby compromising the replicability and potential efficacy of these interventions.

Original authors: Lewis Anthony Ingram, Hunter Bennett

Published 2026-07-02

📖 3 min read☕ Coffee break read

CC BY 4.0

Original authors: Lewis Anthony Ingram, Hunter Bennett

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

Imagine you are trying to bake the perfect cake, but the recipe you found in a famous cookbook is missing half the instructions. It tells you to "mix some flour and sugar," but it doesn't say how much, how long to mix, or what temperature to set the oven. If you try to bake it, you might get a cake, but it probably won't taste like the one the author intended.

This paper is essentially a "recipe check" for the world of sports and injury rehabilitation. Here is what the researchers found, broken down simply:

The Big Problem
Physiotherapists (the experts who help people heal from injuries) rely on scientific studies to decide how to prescribe exercises. They need to know exactly how much weight to lift, how many times to do it, and how long to rest. However, the researchers looked at the 50 most famous and influential studies published in top journals between 2015 and 2025 and found a major issue: the "recipes" were often incomplete or wrong.

The Recipe Check (The Results)
The team used two special checklists to grade these studies:

The "Can You Copy This?" Check: They asked, "If I read this study, can I do the exact same exercise?"
- The Score: Only 24% of the studies (12 out of 50) gave enough detail to be copied perfectly.
- The Missing Ingredients: The most common thing left out was the rest time (how long to sit between sets). About 60% of the studies didn't say this. They also frequently forgot to mention how hard the exercise should be (intensity) or how fast to move (tempo).
The "Will This Actually Work?" Check: They asked, "Does the amount of exercise described actually make sense for the body's needs?"
- The Score: A staggering 72% of the studies (36 out of 50) were rated as "high risk" of being ineffective.
- The Reason: Even when they did list the numbers, the numbers often didn't match the goal. It's like telling someone to run a marathon to build muscle strength, or lifting a feather to fix a broken bone. The dosage didn't have a logical reason behind it to trigger the healing the study claimed it would.

The Bottom Line
The paper concludes that the "recipes" currently being used in top sports medicine research are often too vague to be copied and often lack a logical reason for why they should work.

The researchers are simply asking future scientists to do two things:

Write full recipes: Include every single detail (how long to rest, how heavy, how fast) so others can actually replicate the study.
Explain the logic: Make sure the numbers they choose actually make sense for the body's physiology, rather than just guessing.

They are not saying the exercises don't work; they are saying we don't have enough clear information to know how to make them work consistently.

Technical Summary: Beyond 3 Sets of 10

Problem Statement
Physiotherapists depend on empirical evidence from clinical trials to guide the selection and dosage of therapeutic exercises. However, a critical gap exists in the current literature: protocol descriptions in studies are frequently incomplete, hindering full replication. Furthermore, the dosage parameters that are reported often lack alignment with the physiological responses the exercises are intended to elicit. This disconnect raises concerns about the validity and reproducibility of exercise interventions in musculoskeletal and sports physiotherapy.

Methodology
This study employed a meta-research approach to evaluate the quality of reporting and the physiological rationale of exercise interventions in highly influential literature. The authors identified the 50 most highly cited randomized controlled trials (RCTs) published between 2015 and 2025 in Quartile 1 (Q1) journals within the "Physical Therapy, Sports Therapy and Rehabilitation" category. These studies were required to investigate specific exercise interventions for musculoskeletal or sports-related injuries.

Two primary assessment tools were utilized:

Consensus on Exercise Reporting Template (CERT): Used to evaluate the completeness of the reported exercise dosage parameters.
International Consensus on Therapeutic Exercise aNd Training (i-CONTENT): Used to assess whether the prescribed dosage parameters possessed a plausible physiological rationale sufficient to elicit the intended therapeutic response.

Key Contributions and Results
The analysis revealed significant deficiencies in both the reporting completeness and the physiological justification of exercise dosages in top-tier research:

Reporting Completeness: Only 24% of the studies ( $k=12$ ) provided sufficient detail in their dosage parameters to allow for full replication. The most frequently omitted parameter was the rest interval (time between sets), missing in 60% of the studies. Intensity and tempo were also frequently omitted, each missing in 34% of the studies.
Physiological Rationale: A substantial majority, 72% of the studies ( $k=36$ ), were classified as "high risk" of ineffectiveness. This classification stemmed from a lack of sound rationale justifying the specific dosage parameters selected for the interventions.

Significance and Claims
The paper concludes that there are substantial concerns regarding the completeness of reporting and the physiological rationale underpinning dosage parameters in influential musculoskeletal and sports physiotherapy research. The authors assert that these findings necessitate a shift in how prospective researchers design and report their studies. Specifically, the paper urges researchers to include comprehensive information on all key exercise parameters and to ensure that their exercise prescriptions are grounded in plausible physiological rationale to enhance the efficacy and replicability of future interventions.

Technical Summary: Beyond 3 Sets of 10

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