What a 42-day protocol looks like when a clinician writes it as data
Published · 7 min read
Most published rehabilitation protocols describe phases. Weeks zero to two, weeks two to six, and so on, with goals and criteria for moving on. That is how clinicians think and how the literature is written.
It is not how a patient experiences it, and it is not something software can act on. A patient opens an app on day 11 and needs to know what to do today. Below is what the structure looks like when the protocol is written day by day instead.
The programme used here is the ACL conservative treatment programme published on our store, which is the same structure a hospital composes inside the rehabilitation module. The clinical content is the hospital's. The structure is what this post is about.
The shape of it
42 days. 606 exercises. 101 check-ins. 16 pieces of equipment the patient needs at home.
Four of the days are published as samples: day 1, day 11, day 26 and day 39. They are enough to show how a day is built and how it changes.
Day one is mostly assessment
Day 1 carries 23 entries. Five of them are questionnaires, covering four instruments:
- EQ-5D-5L, health related quality of life
- KOOS, the knee injury and osteoarthritis outcome score
- IKDC, the subjective knee assessment form
- VAS, the pain scale
That is the baseline. Every later measurement is read against it, so it has to be captured before anything therapeutic happens.
After day 1 the questionnaire load drops to one. Days 11, 26 and 39 each open and close with VAS and nothing else. None of the long instruments appears on the sample days from the middle of the programme. Asking a patient to fill in KOOS every day would produce worse data, not more.
The entries are not all exercises
A day holds six kinds of entry, and the mix is what makes it a programme rather than a workout:
| Entry type | What it carries |
|---|---|
| Exercise | A movement with dosage |
| Video | A demonstration |
| Survey | A questionnaire, including pain scales |
| Text | Instructions, precautions, encouragement |
| Medication | A dose the patient confirms |
| Image | A wound or posture photo for the care team |
Day 1 opens with text entries before the first exercise, and carries two medication check-ins. Day 39 has no text entries at all. By then the patient knows what they are doing.
How progression actually shows up
This is the part a phase diagram cannot express. Compare the same exercise across days:
| Exercise | Day 1 | Day 11 | Day 26 |
|---|---|---|---|
| Venous pump | 3 sets, 10 reps, 30 s rest | 4 sets, 12 reps, 30 s rest | not present |
| Knee exercises | 3 sets, 8 reps, 30 s rest | 4 sets, 10 reps, 30 s rest | not present |
| Single leg roller rolling | not present | 4 sets, 10 reps, 30 s rest | 4 sets, 12 reps, 20 s rest |
Three things are moving at once. Sets go up. Repetitions go up. Rest comes down. On the roller work between day 11 and day 26, rest drops from 30 seconds to 20 while repetitions rise, which is a harder session in two directions even though the exercise name has not changed.
A protocol written as prose would say "progress as tolerated". A protocol written as data says 4 by 12 with 20 seconds, and that is a number you can report on.
The day gets shorter and harder
Entry counts fall as the programme runs: 23 on day 1, 19 on day 11, 17 on day 26, 18 on day 39.
The content changes shape as well. Day 1 is cryotherapy, elevation, lymphatic drainage and passive movement. Day 26 introduces a stationary bike and lunge work. Day 39 has rollerblading, Copenhagen endurance holds, bosu ball and Pilates ball stabilisation.
Early days are many small entries, most of them passive. Late days are fewer entries that each take longer and demand more.
Two different dosage shapes
Not every exercise is counted in repetitions. From day 26 a second shape appears:
Single-leg trunk stabilization on the ground Series: 4 · 30 s rest
Copenhagen endurance (long lever) Series: 3 · 45 s rest
Core stabilization on a Pilates ball Series: 3 · 45 s restThese are holds. There is no repetition count because the set is a duration, not a number of movements. Any system that stores dosage as "sets and reps" cannot represent them and will quietly round them into something else.
That sounds like a small schema decision. It is the difference between a stabilisation exercise being reportable and being a free text note.
What this is not
This post describes structure, not treatment. Whether this protocol suits a particular patient, when to progress and when to stop are clinical decisions that belong to the treating clinician, and the content itself is written by the hospital that prescribes it.
What the platform contributes is that the decision survives as data instead of as a document.
See the rest of it
The full programme, including the equipment list and all four sample days, is published here. Nobody has to take our word for the depth.
If you want to compose one of these against your own protocols, request a demo.
Programme content is written and assigned by the treating hospital or clinic. Ormeda provides the platform and the content library. Clinical decisions, including whether a programme suits a patient, are made by the clinician responsible for that patient.