ISO/TS 16569:2026

Technical
Specification
ISO/TS 16569
First edition
Health informatics — Standardized
2026-10
data set for exchanging exercise
therapy recommendations for
degenerative arthritis and backpain
Informatique de santé — Jeu de données normalisé pour
l'échange de recommandations concernant la thérapie par
l'exercice dans les cas d'arthrite dégénérative et de douleurs
dorsales
Reference number
© ISO 2026
All rights reserved. Unless otherwise specified, or required in the context of its implementation, no part of this publication may
be reproduced or utilized otherwise in any form or by any means, electronic or mechanical, including photocopying, or posting on
the internet or an intranet, without prior written permission. Permission can be requested from either ISO at the address below
or ISO’s member body in the country of the requester.
ISO copyright office
CP 401 • Ch. de Blandonnet 8
CH-1214 Vernier, Geneva
Phone: +41 22 749 01 11
Email: copyright@iso.org
Website: www.iso.org
Published in Switzerland
ii
Contents Page
Foreword .iv
Introduction .v
1 Scope . 1
2 Normative references . 1
3 Terms and definitions . 1
4 Symbols and abbreviated terms. 2
5 Data structure . 2
5.1 General .2
5.2 Overview of exercise therapy recommendation .2
5.3 Object Period .3
5.4 Object Exercise Program .4
5.4.1 General .4
5.4.2 Object Session within the object Exercise Program .5
5.5 Object Healthcare Provider .6
5.6 Object Subject of Care .7
Annex A (informative) Examples of exercise recommendations . 9
Annex B (informative) Applicable codes for codable data elements .15
Bibliography .18

iii
Foreword
ISO (the International Organization for Standardization) is a worldwide federation of national standards
bodies (ISO member bodies). The work of preparing International Standards is normally carried out through
ISO technical committees. Each member body interested in a subject for which a technical committee
has been established has the right to be represented on that committee. International organizations,
governmental and non-governmental, in liaison with ISO, also take part in the work. ISO collaborates closely
with the International Electrotechnical Commission (IEC) on all matters of electrotechnical standardization.
The procedures used to develop this document and those intended for its further maintenance are described
in the ISO/IEC Directives, Part 1. In particular, the different approval criteria needed for the different types
of ISO documents should be noted. This document was drafted in accordance with the editorial rules of the
ISO/IEC Directives, Part 2 (see www.iso.org/directives).
ISO draws attention to the possibility that the implementation of this document may involve the use of (a)
patent(s). ISO takes no position concerning the evidence, validity or applicability of any claimed patent
rights in respect thereof. As of the date of publication of this document, ISO had not received notice of (a)
patent(s) which may be required to implement this document. However, implementers are cautioned that
this may not represent the latest information, which may be obtained from the patent database available at
www.iso.org/patents. ISO shall not be held responsible for identifying any or all such patent rights.
Any trade name used in this document is information given for the convenience of users and does not
constitute an endorsement.
For an explanation of the voluntary nature of standards, the meaning of ISO specific terms and expressions
related to conformity assessment, as well as information about ISO’s adherence to the World Trade
Organization (WTO) principles in the Technical Barriers to Trade (TBT), see www.iso.org/iso/foreword.html.
This document was prepared by Technical Committee ISO/TC 215, Health informatics.
Any feedback or questions on this document should be directed to the user’s national standards body. A
complete listing of these bodies can be found at www.iso.org/members.html.

iv
Introduction
Numerous people have musculoskeletal disorders related to chronic diseases and need steady and long-
term exercise therapy. In rehabilitation medicine, appropriate and clinically validated exercises are as
important as medication prescriptions or medical procedures for symptom relief. Therefore, patients
receive personalized exercise therapy recommendations from their physicians or physiotherapists, and
carry out rehabilitation activity at home, which can also include supervised or semi-supervised session
where applicable. For example, in order to treat backache or degenerative arthritis, combining long-term
exercise therapy at home with medical treatment is significantly efficient.
However, there are no widely adopted technical documents that provide guidelines on how to electronically
exchange data and how to represent exercise therapy recommendation for patients with degenerative
arthritis and back pain.
A standardized data set to deliver exercise recommendations can contribute to support interoperability
and consistent electronic exchange in the context of long-term exercise management at home. Additionally,
information collected in accordance with the data definition in this document can be included in patient’s
records such as the international patient summary (IPS), personal health record (PHR) or patient-generated
health data (PGHD).
The purpose of this document is to define a standardized data set of exercise recommendations for data
exchange between healthcare providers and patients with degenerative arthritis and back pain. Using the
data set, patients can receive their exercise recommendations on electronic devices such as smartphones
or tablets and perform their exercises for long-term therapy in various settings and with different types of
instruments.
v
Technical Specification ISO/TS 16569:2026(en)
Health informatics — Standardized data set for exchanging
exercise therapy recommendations for degenerative arthritis
and backpain
1 Scope
This document specifies a standardized data set for exercise recommendations to facilitate data exchange
between healthcare providers and patients.
This document specifically focuses on degenerative arthritis and backpain because these conditions
commonly require long-term structured rehabilitation exercise exchange.
This document defines the structure of exercise recommendation data for electronic exchange between
healthcare providers and patients with degenerative arthritis and back pain.
This document focuses on data exchange of exercise recommendations for backache and degenerative
arthritis; other musculoskeletal disorders are outside the scope of this document.
This document is not intended to provide a data set for symptoms of other musculoskeletal disorders, or for
the patient’s pain intensity.
This document does not cover medication orders, observation data measured by personal health devices,
or other information that can be relevant in the context of recommendations for musculoskeletal disorders.
2 Normative references
There are no normative references in this document.
3 Terms and definitions
For the purposes of this document, the following terms and definitions apply.
ISO and IEC maintain terminology databases for use in standardization at the following addresses:
— ISO Online browsing platform: available at https:// www .iso .org/ obp
— IEC Electropedia: available at https:// www .electropedia .org/
3.1
disorder
alterations or attributes of the health status of an individual which might lead to distress, interference with
daily activities, or contact with health
[SOURCE: ISO/TR 21835:2020, 3.4]
3.2
musculoskeletal disorders
set of diverse conditions affecting bones, joints, muscles and connective tissues
Note 1 to entry: Adapted from Reference [7].

3.3
exercise therapy
regimen or plan of physical activities designed and prescribed to facilitate the recovery of patients from
diseases and any conditions which disturb their movement and activity of daily life, or to maintain a state of
well-being
Note 1 to entry: Adapted from Reference [8].
4 Symbols and abbreviated terms
FHIR Fast Healthcare Interoperability Resources
HL7 Health Level Seven
SNOMED CT Systematized Nomenclature of Medicine – Clinical Terms
5 Data structure
5.1 General
In order to electronically exchange exercise recommendations for musculoskeletal disorders such as
degenerative arthritis and back pain, it is necessary to define a standardized data structure that supports
communication from healthcare providers to patients.
The information necessary for delivering exercise therapy recommendations consists of period, exercise
program, healthcare provider and subject of care. The exercise program consists of exercise type, session
(which refers to unit of a specific physical activity within an exercise program), and number of sessions. Each
session consists of the body part primarily targeted in exercise, repetition (that indicates how many times
the exercise is repeated), and the equipment used in exercise. For examples of exercise recommendations,
see Annex A.
5.2 Overview of exercise therapy recommendation
The exercise therapy recommendation is composed of the following objects:
— Period: this object represents the period during which the subject of care performs the exercise program.
It includes the start time, end time, consecutive days and rest time.
— Exercise Program: this object consists of details of the exercise to be performed by the subject of care. It
includes category, type, session, number of sessions and equipment.
— Healthcare Provider: this object represents the role of the person making exercise recommendations
and providing them to the subject of care. These can primarily be doctors or physiotherapists.
— Subject of Care: this object is intended to represent the subject who receives exercise therapy
recommendations and performs them. It can primarily be patients with degenerative arthritis and back
pain.
The relationship between the objects that make up the exercise therapy recommendation is shown in
Figure 1. The exercise therapy recommendations delivered from healthcare providers to subjects of care
can be structured with a Period object, a Healthcare Provider object, a Subject of Care object, and more than
one of the Exercise Program objects.

Figure 1 — Data structure and components of exercise therapy recommendation
5.3 Object Period
The Period object represents the period during which the subject of care performs the exercise therapy
recommendations given by healthcare providers.
The Start and End data elements are required in this object; the ConsecutiveDays and RestDays data
elements are optional depending on the characteristics of the exercise therapy recommendation.
Both the Start and End data elements can be expressed in the DateTime data type; the ConsecutiveDays and
RestDays can be expressed in an Integer data type.
The data elements which make up the Period object are shown in Figure 2, and the data types and
descriptions of characteristics for each data element are shown in Table 1.
Figure 2 — Data elements of the object Period

Table 1 — Data fields of the object Period
Data
No. Cardinality Datatype Description Example
elements
Starting time for recommended
1 Start 1.1 DateTime exercise program with inclusive 2022-04-01
boundary
End time for recommended
2 End 1.1 DateTime exercise program with inclusive 2022-04-30
boundary
Con- It describes how many days a
3 secu-tive- 0.1 Integer subject of care performs exercise 3
Days in a row.
It describes how many days the
4 RestDays 0.1 Integer subject of care should rest after 2
exercising in a row.
EXAMPLE Start = 2022-04-01, End = 2022-04-30, ConsecutiveDays = 3, RestDays = 2. This means the
subject exercises for 3 consecutive days followed by 2 days of rest.
5.4 Object Exercise Program
5.4.1 General
The object Exercise Program represents the types and methods of the exercise program recommended by
healthcare providers for subjects of care to relieve or treat degenerative arthritis and back pain. The Exercise
Program object includes the category of exercise, type of exercise, the number of sessions, equipment to be
utilized during the exercise, and one or more sessions.
The Category, Type and Session data elements are required in this object. One or more Session object can
be contained in the Exercise program object. The Number of sessions and Equipment data elements are
optional.
The Number of session data element can be expressed in the Integer data type; the Category, Type and
Equipment data element should be represented in Enumeration data type.
The data elements that make up the Exercise program object are shown in Figure 3, and the data types and
descriptions of characteristics for each data element are shown in Table 2.
Figure 3 — Data elements of the object Exercise Program

Table 2 — Data fields of the object Exercise Program
Data
No. Cardinality Datatype Description Example
element
Classification of the general type of exer-
cise
The recommended codes defined in this
document. SNOMED CT codes are recom-
mended as well.
1 Category 1.1 Code STRET
Each organization may utilize its pre-
ferred coding system for categorizing
exercises.
Recommended codes defined in this
document and SNOMED CT to represent
category are provided in Annex B.
Type of exercise
The recommended codes defined in this
document.
Each organization may utilize its pre-
INNER_THIGH_
2 Type 1.1 Code
ferred coding system for categorizing
STRET
exercises.
Recommended codes defined in this doc-
ument to represent type are provided in
Annex B.
Ses-
It indicates a specific exercise and how it
[1]
3 Session 1.* sion(Com- Session
is performed.
plex)
Number of Total number of sessions included in the
4 0.1 Integer 2
Session recommendation.
Enumera-
5 Equipment 0.1 Types of equipment used for the exercise Exercise_band
tion
5.4.2 Object Session within the object Exercise Program
The Exercise Program object should contain one or more Session objects to indicate a specific exercise and
how it should be performed. The Session object includes the BodyPart data element to represent which part
of the body should be exercised, the Repetition data element to represent how many times exercise should
be performed, and the Narrative data element which can be prescribed with free text.
The BodyPart and Repetition data elements are required in this object. One or more objects can be contained
in the Session object. The Narrative data element is optional.
The BodyPart data element should be expressed in the Enumeration data type; the Repetition data element
should be represented in Integer data type; and the Narrative data element should be expressed in the String
data type.
The data elements which make up the Session object are shown in Figure 4, and the data types and
description of characteristics for each data element are shown in Table 3.
Figure 4 — Data elements of the object Session

Table 3 — Data fields of the object Session
Data
No. Cardinality Datatype Description Example
element
Indicates the site on the subject’s
body where the s
...