OBJECTIVE: To evaluate whether a web-based exercise programming system improves adherence to a home exercise program for people with musculoskeletal conditions. DESIGN: Eligible patients with a musculoskeletal condition presenting to a physical therapist in private practice were randomised to: (1) control (home exercise prescribed by therapist's usual methods), or (2) intervention (home exercise prescribed using a web-based exercise programming system). The primary outcome was self-rated exercise adherence measured at week 3 via 11-point numeric rating scales (NRS). Secondary outcomes were satisfaction with exercise delivery and confidence in ability to undertake prescribed exercise. Process measures were also included. RESULTS: We enrolled 305 participants, with loss-to-follow-up of 14.5% (22/152) and 13.7% (21/153) in intervention and control groups, respectively. Compared with controls, the intervention group reported higher exercise adherence (mean difference NRS units (95% confidence intervals): adherence overall -1.0 (-1.6 to -0.3) and regarding number of exercises in session -0.7 (-1.3 to -0.1), number of repetitions -0.8 (-1.4 to -0.2) and number of sessions -1.0 (-1.6 to -0.3)). The intervention group showed greater confidence to exercise than control, with no difference in satisfaction. CONCLUSIONS: A web-based exercise programming system improved home exercise adherence and confidence in ability to undertake exercise, although the clinical relevance of the results needs to be established.

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