Is Exercise Enough? Evidence from Controlled Clinical Trials on Rehabilitation with and Without Adjunct Modalities
Bindiya Rawat1, Yajuvendra Singh Rajpoot2, Sohom Saha3
1Department of Liberal Arts and Social Sciences, Manipal University Jaipur, Jaipur 303007, Rajasthan, India.
Life (Basel, Switzerland)
|May 4, 2026
Summary
Exercise-based rehabilitation effectively treats musculoskeletal disorders. Adjunct modalities offer limited short-term benefits but do not significantly improve long-term outcomes compared to exercise alone.
Area of Science:
- Orthopedics and Rehabilitation
- Sports Medicine
- Physical Therapy
Background:
- Musculoskeletal disorders (MSDs) are a leading cause of global disability.
- Exercise-based rehabilitation is the standard first-line treatment for MSDs.
- The added value of adjunct therapies combined with exercise remains uncertain.
Purpose of the Study:
- To determine if adjunct modalities provide additional benefits beyond exercise-based rehabilitation for musculoskeletal disorders.
- To systematically review controlled clinical trials comparing exercise alone versus exercise plus adjunct modalities.
Main Methods:
- Systematic review adhering to PRISMA 2020 guidelines.
- Searches conducted in major databases (PubMed, Scopus, Web of Science, Cochrane).
- Included controlled clinical trials assessing various musculoskeletal conditions and outcomes (pain, function, performance).
Main Results:
- Twenty-one controlled trials were analyzed across conditions like tendinopathies, osteoarthritis, and spinal pain.
- Exercise-based rehabilitation consistently yielded clinically meaningful improvements in pain and function.
- Adjunct modalities showed transient benefits in some trials but lacked sustained long-term superiority over exercise alone.
Conclusions:
- Exercise-based rehabilitation is a highly effective primary intervention for diverse musculoskeletal conditions.
- Adjunct modalities may offer condition-specific or short-term advantages.
- Adjunct modalities do not consistently provide superior long-term outcomes compared to structured exercise programs.
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