Exercise as medicine has emerged as an independent discipline in clinical research. Over the last decades, numerous randomised controlled trials (RCTs) have documented the beneficial effects of exercise on various patient-related, disease-related and health-related outcomes in clinical populations.1 Nevertheless, the evaluation of harms in clinical exercise research remains unsatisfactory (table 1).2 3 For instance, nearly half of all exercise trials do not report harms, and there is evidence of selective non-reporting of harms.2 4 5 Furthermore, emerging evidence indicates that exercise might increase the risk of serious adverse events in certain populations.2 We contend that this is concerning; as for any clinical intervention, the benefits of exercise should be carefully balanced against accurate risk estimates of harms to appropriately inform evidence-based clinical use. With this call to action, we aim to improve the evaluation of harms in clinical exercise research.

Suboptimal practices of harms collection, analysis and interpretation as well as their consequences2 3 5

The Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network reporting guidelines have been instrumental in improving research reporting. However, we assert that the exercise-specific reporting guidelines do not adequately encompass several critical aspects relevant to clinical exercise prescription.6 For example, in the Consensus on Exercise Reporting Template,6 the reporting of harms focuses solely on adverse …