Perception of Exercise Among Musculoskeletal Population

Based on research on health outcomes, the perception of patients who are suffering frommusculoskeletal conditions vary on many defined factors based on their experience and fears withphysiotherapists and exercise. According to Ferguson et al. (2019), on their survey and research onthe effectiveness of individual REVIVE randomized controlled trial (RCT) on patients, includingqualitative methods which are in line with patient’s needs is crucial as it gives them a sense ofautonomy and it acts as a motivator to their recovery program. On a survey done to 30 patientsallocated an exercise group, 21 who completed did provide detailed insight on their experience after acritical illness. It was noted that patients always do have a strong sense of the importance of exerciseprograms to their recovery and the key identifiers of such factors include; supervision, tailoring ofexercises to personal needs and the mention of exercise manuals all favoring positive attitudestowards quick recovery. However, some few challenges noted whatsoever in such programs bypatients include; poor mental health, existing limitations and lack of motivation which developnegative attitudes and perceptions which might alter the effectiveness of physiotherapy. What wassurprising is how patients were unsure of what should be the best way to maximize outcomes and howtheir health was affected. In this view, research has been conducted further to understand how futurephysiotherapy involvements would be to incorporate full recovery maintaining maximumengagements by the participants and positivity.

An observation made by Slade et al. (2014) on patient’s beliefs and perception on exercise is that ifparticipants are engaged, exercise is moderately effective and improved. It is noted that theidentification of such elements which enhance engagements could enable clinicians introduce andprescribe the best methods for appropriate interventions. In their case study, some emerging issuesbrought fourth were; perceptions and classification of exercise, the role and impact of healthprofessionals, exercise and activity enablers or facilitators as well as exercise and activity barriers. Aclear distinction was however drawn between general activity, fitness exercises and medical exercisesand it was concluded that participant experience in physiotherapy culture was to be considered in thedesign of exercise programs to allow unconditional involvement by the patients. It is asserted thatpatients recovering from musculoskeletal conditions might feel comfortable if part of their exerciseprograms are designed to match their abilities and more so their experiences. It is therefore clear that some routines in physiotherapy are not seen as effective by patients since such interventions do onvarious occasions interfere with the everyday life of patients and it may project some difficultiestrying to catch up or cope with such changes or pressure to conform to such methods to recovery. Thishas been a major reason as to why musculoskeletal patients recovering and who are endorsed into thisprograms end up deciding to quit and to discontinue the whole process. It is therefore clear to identifythat the mixed reactions and perceptions towards exercise vary from patient to patient and it is relativeto the methods and routines defined by physiotherapists or clinicians towards a quick recovery.

From the above inclusion, it’s evident that most people will always prefer to play a part in exerciseor training activities which are solely designed with specific considerations towards their fitnesslevels, exercise and experience as well as current circumstances (Slade et al. 2014). The failuretherefore of not considering such factors would arise to a negative perception towards the whole ideaof exercise and it would affect the general view and acceptance of exercise as not being effective inrecovery rather than the vice versa. This would mean that some accepted complimentary alternativemethods including exercise might be rejected due to negative perceptions.

Louie et al. (2021) on their article on patients and therapists experience and perception onexoskeleton-based physiotherapy in rehabilitating sub-acute stroke comment that patients with stroke,were seen to be more optimistic than therapists towards the experience and benefits brought fourth. Intheir conclusion, it was cited that patients develop positivity towards exoskeleton based physiotherapyfor such identified powered robotic exoskeletons provide a relatively higher duration and a repeatedwalking routine practice especially for non-ambulatory patients. For them, physiotherapy highlyfavors them and it’s attributed with a greater opportunity and benefits. However the positivity towardsrobotic physiotherapy also requires considering learning challenges associated with patientcharacteristics and the barriers brought fourth by the use of exoskeleton based training.

In this view of negative perceptions on physiotherapy, Baceviciene et al. (2019), in their researcharticle about self-perception of physical activity and fitness concluded that this might somehow berelated to lower psychosomatic health and unhealthy lifestyles. Therefore, emotional stress and otherpsychological problems do have a role to play in the course of how patients might change attitudestowards exercise posing a challenge where patients feel they are being overburdened with physical4fitness despite them being positive that they should get well. It is worth noting that physical activitiesare noted to play a key role in not only physical health but also mental health especially to adolescentsand this has been identified to increase with age. Some predisposing factors to such negativeperceptions are sedentary lifestyles, use of alcohol and smoking and necessarily not exercising. Thisbehaviors during rehabilitation through physiotherapy become a hindrance to positiveacknowledgement of the role of exercise in the wellbeing of such persons upon being diagnosedtherefore, it’s likely such patients will feel uncomfortable as their preference is different. The role ofpsychological input in this case would suffice as restructuring the perceived barriers may work tofacilitate patients adopting exercise.

Louie et al. (2021) in their conclusion on efficacy of an exoskeleton based physical therapyprogram found that it does not necessarily result to greater improvements to the lower limbs inwalking independence as compared to standard care therefore, the trigger to such perceptions isintrinsic based on the specific beliefs of individual patients. Kozlowski et al. (2015) on their researchon rehabilitating spinal cord injury (SCI) did quantify the time and effort required by patients to learnto use exoskeletal devices and they did conclude that people recovering from different severities ofinjury including those with motor complete C7 tetraplegia and motor incomplete C4 tetraplegia canlearn to walk with very little or no assistance.

Based on the detailed research, more positive experiences which were found to be in thedescription of patients was towards serving their point of view of wellbeing and this favored theirattitudes towards the therapies prescribed to them. The identification of patient recommendations andother considerations in the integration of physiotherapy and daily routines in such identified methodsplayed a key role in developing positive attitudes. It is therefore common to find patients developingpositivity if they feel autonomous in their wellbeing other than being pressured by physiotherapists.The identification of routines and consistency in active follow up of this methods and which favorpatients are a likelihood to achieving positivity to exercise only when a patient feels in control of theirown health. This assumption can be based on the positive perception of a number of musculoskeletalpatients towards exoskeletal therapy and negativity towards standard therapy supervised byphysiotherapists.

In conclusion therefore and based on research conducted and data collected by clinicians andphysiotherapists, there are varied perceptions of exercise which exists among populations living withmusculoskeletal conditions. This perceptions have been defined as both positive and negative andthey differ among individual patients. An occurrence of negativity would be as a result of patientsperceiving that such exercises prescribed to them do not suit their preference and or physical fitness.This arises due to them not being involved in designing such routines. Those feeling negative anduncomfortable or unconvinced end up discontinuing as compared to those who develop positivity dueto their involvement in designing such routines and they seemingly find meaning and feel comfortablehaving a sense of positivity towards recovery through exercise. It is therefore important to considerinstilling a sense of physical fitness to adolescents as it has been noted that its essence increases asage increase and if it’s not, negative perceptions will arise among the ageing population who are ingreater numbers being affected more by musculoskeletal issues which need physiotherapy andexercise to recover.


Baceviciene, M., Jankauskiene, R. & Emeljanovas, A. (2019). Self-perception of physical activity and
fitness is related to lower psychosomatic health symptoms in adolescents with unhealthy lifestyles.

Ferguson K, Bradley J.M, McAuley D.F, Blackwood B, O’Neill B. (2019). Patient’s perception of an
exercise program delivered following discharge from hospital after critical illness.(The Revive
Trial). Journal of intensive care medicine, 34 (11-12), 978-984.

Kozlowski, A. J., Bryce, T N., & Dijkers, M. P. (2015). Time and effort required by persons with
spinal cord injury to learn to use a powered exoskeleton for assisted walking. Topics in spinal cord
injury rehabilitation, 21(2), 110-121.

Louie, D, R., Mortenson, W.B., Durocher, M. Schneeberg, A., Teasell, R., Yao, J & Eng, J. J.(2021).
Efficacy of exoskeleton-based physical therapy program for non-ambulatory patients during
subacute stroke rehabilitation: A randomized controlled trial. Journal of NeuroEngineering and

Slade, S. C., Patel, S., Underwood, M. & Keating, J. L.(2014). What are patient beliefs and
perceptions about exercise for nonspecific chronic low back pain? A systematic review of
qualitative studies. The clinical journal of pain, 30(11),995-1005.