A practical guide for exercise physiologists working with NDIS participants. Covers fitness assessments, capacity measures, exercise programming, and what NDIA planners expect.
Exercise physiology is a newer discipline in the NDIS landscape compared to OT, speech pathology, or physiotherapy. Many NDIA planners are less familiar with what EP looks like in practice, which means your report needs to be especially clear about what you did, why it matters, and how it connects to the participant's funded goals.
EP services are typically funded under Improved Daily Living (Category 07) or Improved Health and Wellbeing (Category 12). The distinction matters for your line item codes. Capacity building activities that directly relate to NDIS plan goals usually fall under Category 07. General health and fitness maintenance may fall under Category 12, but the justification needs to be stronger because planners sometimes question whether exercise is an NDIS responsibility or a mainstream health service.
Here is how to structure a report that answers those questions before the planner asks them.
Full participant name, NDIS number, date of birth, and primary diagnosis. Exercise physiologist full name, qualifications, ESSA (Exercise and Sports Science Australia) accreditation number, clinic name, and NDIS provider number. Report date and reporting period.
EP practitioners hold ESSA accreditation, not AHPRA registration. Make sure your accreditation number is current and correctly stated.
Relevant medical history, current physical activity levels, and the functional limitations that prompted EP involvement. State clearly why exercise physiology is the appropriate discipline: is the participant deconditioned due to their disability? Do they need supervised exercise because of a medical complexity? Are they working toward community participation goals that require improved physical capacity? The 'why EP and not a gym membership' question is one planners ask. Answer it in the background.
Number of sessions, total hours, and session format. EP sessions often take different forms: individual clinic sessions, small group exercise, hydrotherapy, community gym sessions, and home exercise programme reviews. List each format, the number of sessions in each, and the primary focus of each. Note the support category billed for each type.
Use repeatable, standardised measures wherever possible. Cardiorespiratory fitness: 6-Minute Walk Test distance (with age and gender norms), or submaximal cycle ergometry if appropriate. Strength: grip strength (dynamometry, in kg), sit-to-stand test (number of repetitions in 30 seconds), or estimated 1RM for key movements. Balance: Single Leg Stance time, or Berg Balance Scale if not already assessed by physiotherapy. Flexibility: sit-and-reach or specific joint range where relevant. Body composition: waist circumference, BMI (note that BMI has limitations for participants with mobility-related muscle atrophy). Include the tool name, date, and result for every measure.
Choose measures you can repeat at every review period. The power of EP reporting is showing objective change over time.
For each funded NDIS goal: quote the goal, assign a progress status, and write a specific summary. 'Participant's 6-Minute Walk Test distance increased from 280m to 340m. They can now walk to the bus stop (approximately 300m) without needing to stop and rest, which was not possible at the start of the period.' Connect the physical measure to a functional outcome the planner can understand.
Document the current exercise prescription with enough detail that another EP could reproduce it. Modality (resistance training, aerobic exercise, aquatic exercise, functional training), intensity (percentage of 1RM, RPE, heart rate zone), frequency, duration, and key exercises. Note any progressions made during the period and the rationale for each. Note any regressions and the reason (illness, injury, medication changes).
This section demonstrates that EP is a clinical service, not a gym programme. The specificity of your prescription and the clinical reasoning behind progressions are what distinguish EP from general fitness.
Factors that affected goal achievement: illness, pain flares, fatigue, motivation, transport, carer availability, seasonal weather affecting outdoor sessions. Be specific. 'Participant missed four sessions in June due to a respiratory infection and took three weeks to return to baseline exercise tolerance' is more useful than 'some sessions were missed due to illness.'
Specific frequency and total hours per year, NDIS support category and line item code. State whether you recommend individual or group sessions (or both) and why. Equipment recommendations if applicable (resistance bands, home exercise equipment) with specifications and costs. Suggested goals for the next plan period in functional language. If recommending a transition from individual to group sessions, or from supervised to independent exercise, explain the readiness criteria.
Signed declaration with full name, qualifications, ESSA accreditation number, and date. Sign and date every page.
Answer the 'why not a gym membership' question
Planners sometimes question whether exercise physiology is an NDIS support or a mainstream health activity. Your report needs to explain why this participant requires a qualified EP rather than a community gym. Medical complexity, safety risks, disability-specific exercise modifications, and the need for clinical progression are all valid reasons. State them.
Use repeatable outcome measures
6-Minute Walk Test, grip strength, sit-to-stand, and similar measures can be repeated at each review to show objective progress. Pick your measures at the initial assessment and use the same ones every time.
Connect fitness to function
'Improved cardiovascular fitness' is a clinical outcome. 'Can now walk to the local shops (400m) without rest breaks, which allows independent grocery shopping' is a functional outcome the NDIA funds. Always bridge the gap between the measure and the daily activity.
Document the programme in detail
A detailed exercise prescription demonstrates that EP is a clinical service with clinical reasoning behind every decision. 'Did some exercises' is not documentation. '3 sets of 10 bilateral squats at bodyweight, progressed to 5kg dumbbell hold in week 6 due to improved form and reduced compensatory trunk lean' is documentation.
Quantify your recommendations
'Ongoing EP' is not a recommendation. '24 x 60-minute individual sessions per year (fortnightly for 6 months, then monthly for 6 months as the participant transitions to independent gym attendance), under Improved Health and Wellbeing (12_004_0118_6_3)' is a recommendation with a transition plan.
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