Patient exercise classes during Covid-19

Physiotherapists are beginning to think about restarting patient exercise classes. Whether these classes are offered from a gym, a community hall or your clinic, there are many things that you will need to consider.


In the first instance, we would direct you to our guidance about seven key factors for face-to-face consultations, since much of this is as relevant for classes as it is for one-to-one treatments. However, there are additional considerations for those wishing to deliver classes.

Please review  national guidance:

At this time this is the guidance that should be followed in all four countries.

With regard to risk assessments, (factor two in the seven-factor guidance), you will have to risk-assess the venue and the activity you plan to deliver. Careful consideration must be given to the following.

Can I continue with my exercise class in an area of lockdown?

  • As lockdown restrictions begin to ease and indoor exercise classes in gyms resume, so too can physiotherapy-led classes aimed at general fitness and wellbeing. All classes must be risk assessed, including the risk of asking patients to travel, to exercise indoors and to mix with others. This risk must be weighed up with the intended health benefit to the patient, and clearly documented in case your decision-making is called into question. 
  • The easing of restrictions in some countries means that outdoor classes are now allowed. Again, where this is the case the same applies to physiotherapy-led classes.


Social distancing

  • Maximum capacity should be based on the government requirement for social distancing. When considering the space and capacity needed, you should take account of the nature of the intended activities –  i.e. if the activity is relatively static vs. requiring considerable movement, equipment layout and the configuration of facilities.
  • Particular attention should be given to ventilation and sufficient circulation space, especially around equipment and between classes. There is no government guidance on the type of ventilation required beyond the fact that ventilation is necessary, and that systems should provide 100 per cent fresh air and not recirculate air from one space to another. There is further information available from the Health and Safety Executive.
  • The maximum occupancy of each indoor facility should be limited by providing a minimum of 100 square feet per person (approximately 9 square metres). For this figure, the area is the net useable indoor facility space available per person using that space, including changing rooms, toilets and washing facilities. This figure is about the capacity of the building and is not a measure of the space required in the individual class.
  • Within your risk assessment of the environment, consider what clients are able to bring into that space and subsequent issues around space, cleaning and potential spread. For example, is it more sensible that the client brings their own mat and towel, rather than you cleaning these items? Should you limit any bags that clients normally bring into the exercise space?
  • Consider how participants enter and leave the venue. For example, can you implement a flow system to ensure social distancing, where will clients wait and so on? Again, for those working in gyms or community halls, you should liaise with the centre managers.


Read the infection prevention and control (IPC) measures in our guidance and ensure that cleaning of the venue and equipment are in accordance with the venue protocols where appropriate.


PPE is required when you are not able to maintain social distancing, and are working within 2m of the patient / client. By wearing the advised  PPE you are protecting yourself from having to self-isolate should a client test positive and you are contacted by Test and Trace.

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