Perception towards physiotherapy among

the general population in Gujrat, Pakistan

Item Type Article

Authors Akram, K.; Mohammadnezhad, Masoud; Gulzar, K.; Raza, A.;

Islam, F.

Citation Akram K, Mohammadnezhad M, Gulzar K et al (2023) Perception

towards physiotherapy among the general population in Gujrat,
Pakistan. Global Journal of Health Science. 15(5): 34-40.

Rights © 2023 The Authors. Reproduced in accordance with the

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licenses/by/4.0/).

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 Global Journal of Health Science; Vol. 15, No. 5; 2023
ISSN 1916-9736 E-ISSN 1916-9744
Published by Canadian Center of Science and Education

Perception towards Physiotherapy among the General Population in

Gujrat, Pakistan
Kunza Akram1, Masoud Mohammadnezhad2, Khushboo Gulzar1, Asim Raza1 & Farooq Islam1
1
University institute of physiotherapy, University of Lahore, Gujrat Campus, Pakistan
2
School of Nursing and Healthcare Leadership, University of Bradford, Bradford, West Yorkshire, United
Kingdom
Correspondence: Masoud Mohammadnezhad, Associate Professor of Public Health, School of Nursing and
Healthcare Leadership, University of Bradford, Bradford, West Yorkshire, United Kingdom. Tel: +44-793-533-
3005.

Received: April 6, 2023 Accepted: May 16, 2023 Online Published: May 25, 2023
doi:10.5539/gjhs.v15n5p34 URL: https://doi.org/10.5539/gjhs.v15n5p34

Abstract
Introduction: Physiotherapy is a dynamic profession that employs various therapeutic strategies to help people
regain movement and function in their bodies. Physiotherapists provide comprehensive care for patients with
different medical and surgical conditions. This study aimed to assess the perceptions regarding physiotherapy
among the general population of Gujrat, Pakistan.
Methodology: This descriptive cross-sectional survey was carried out among the general population of Gujrat
from March to June 2021. Non-probability sampling technique was used to select the 126 participants >20 years
of age. A self-structured Likert scale questionnaire was developed to collect data. The responses were analyzed
through Statistical Packages for Social Sciences (SPSS). P-value less than 0.05 was considered as level of
significance.
Results: Majority of participants (75.4%) were from the age group 20–29 years and 90(71.4%) of the participants
had either undergraduate or postgraduation education. Out of 126 participants, 103(81.75%) participants were
highly aware and had adequate awareness regarding physiotherapy, whereas 20(50.9%) participants showed
moderate awareness and 3(2.4%) of participants showed a deficient level of awareness. No association was seen
between awareness and variables including age, gender, socioeconomic status, and education.
Conclusion: General population of Gujrat were highly aware of physiotherapy. Education plays an impactful role
in better understanding of physiotherapy, so further steps should be taken to increase positive perception in
different socioeconomic statuses, including advertisements, social media campaigns and seminars.
Keywords: Perception, Physiotherapy, Awareness, General population, Pakistan
1. Introduction
Physiotherapy is a type of treatment used to help people more than musculoskeletal sports injuries. Even though
this is the most popular notion of the occupation (Dissanayaka & Banneheka, 2014), it is a broad approach that
employs various techniques (Mishra & Vidhyadhari, 2019). The significance of physical therapy in raising and
elevating health standards is crucial (Ali et al., 2023). A major increase in the incidence of chronic illnesses is
occurring in tandem with the ageing of our people. As a result, the demand for physical therapists and physical
therapy services has surged across the board Igwesi-Chidobe (2012). Physiotherapists are trained to help people
develop, maintain, and recover their maximal mobility and functional capacity throughout their lives.
Physiotherapy needs professional leadership to direct the adjustments required for the profession’s long-term
growth and development (McGowan, 2017). Physiotherapists who want high-quality therapy for adult or child
clients must combine diverse information and viewpoints in their practice, despite the biomedical prominence
during physical activity (Bjorbaekmo, Stendal Robinson, & Engebretsen, 2018). Any domain with a significant
social impact must have a distinct identity with the public, who should have an elevated level of understanding of
the profession (Olawale & Adjabeng, 2014).
Previous studies showed few people are aware of physiotherapy’s vital role in the healthcare system. Even in
nations with a high Human Development Index (HDI), previous studies identified a low awareness towards the
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role of physiotherapists among various populations which reveals an urgent demand for population training (Paul
& Mullerpatan, 2015). Measures shall be taken immediately to raise awareness of the field and its specialties. A
comprehensive education program should be implemented to change how the public and the medical community
view and understand physiotherapy (Dissanayaka & Banneheka, 2014). To effectively care for patients in various
circumstances, doctors must be knowledgeable about physiotherapy treatments (Senarath et al., 2019). Therefore,
there is an obvious need to enhance perception and expertise in physiotherapy (Webster et al., 2008).
Physiotherapy services are now accessible in a wide range of contexts, including health institutions, private
practices, schools, sports, and workplaces, with the interaction between physical therapists, patients, other health
professionals, families, caregivers, and communities (Bargaje et al., 2017). A successful physiotherapy
intervention and appropriate patient care are built on a foundation of proper education (Acharya et al., 2015).
Though there has been increased public awareness of the physiotherapy profession in recent years, there is still a
long way to go (Harikrishnan & Kamalambal, 2017).
Physical therapy, widely accepted worldwide as a remedy, is not justified in general awareness in Pakistan, which
has a population of over 185 million. Only 13.5% of our population is aware of the profession (Shafqat et al.,
2012). According to the findings, there is a requirement for physical therapy education between medical students
and professionals (Mishra & Vidhyadhari, 2019). Slowly and systematically promoting the importance of
physiotherapy and collaborating with other organizations will hopefully make a difference (Acharya et al., 2015).
Several studies have been conducted to ascertain the general public’s perception of physiotherapy. However, the
results obtained from these studies may not reflect the situation of every country because of differences in
healthcare systems (Olawale & Adjabeng, 2014). The decision-making regarding physiotherapy treatment should
be left to the physiotherapist’s responsibility considering their professional competency (Pattanshetty & Metgud,
2019). In Pakistan, which is still developing, most medical specialties are still in the development stage including
physical therapy (Babur, Siddique, & Awan, 2014). Limited literature was available regarding the prevalence of
physiotherapy in the general population of Pakistan, and no literature in Gujrat, Pakistan. Studies have been
conducted to ascertain the general public’s perception of physiotherapy in different countries, but the results
obtained from these studies may not reflect the situation of every country because of differences in healthcare
systems. Therefore, the current study aimed to assess the level of perception about physiotherapy among the
general population in Gujrat, Pakistan. It may include publicizing the benefits of the physiotherapy profession,
boosting the number of employment opportunities for bachelor’s and master-trained physiotherapists in
governmental departments, giving conferences to other medical practitioners about the significance of
physiotherapy, and growing social interactions and networking in the physiotherapy profession.
2. Methodology
2.1 Study Design and Setting
A descriptive cross-sectional study was carried out to determine the perception of physiotherapy among the general
population of Gujrat, Pakistan from March to June 2021. Gujrat is a remote Pakistan region where people from
different ethicists, religions, and backgrounds live there. People allocated in towns and villages nearby Gujrat
approach Gujrat because it is a district of Punjab Pakistan.
2.2 Study Sample
This study was conducted among all the males and females who self-identified as Pakistani with different specialist
skills and from different educational and socioeconomic statuses. They should understand the survey
questionnaire’s contents and age 18 and over. Those who were unwilling to participate in the research and the
people working in the physiotherapy department were not included in this study.
Non-probability convenient sampling was used to collect the sample for this study. The sample size for this study
was 126 participants, which was calculated by using this formula Sample size formula: n = (Z1-α/2)2P (1-P) /d2
with 95% confidence level, the absolute precision required to calculate the sample size was 0.05 with 0.9 % of the
anticipated population proportion (Harikrishnan & Kamalambal, 2017).
2.3 Data Collection Tool
The data were collected using a self-made Likert scale questionnaire which consisted of two sections. Section A;
included participants’ demographic information such as age, gender, socioeconomic status, and education level,
whereas Section 2; contained 15 closed-ended questions to check participants’ perception regarding physiotherapy
and the scale was in English language. The scale had five categories strongly disagreed, disagree, neutral, agree
and strongly agree ranged from 0 to 5, respectively. The total score was 75 from which 1–25 reflected a low level

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of perception whereas 26–50 showed neutral which means have a moderate level and 51–75 depicts that
participants in these categories have an adequate level of awareness.
The questionnaire was checked by the experts for face and content validity. Thirty participants were a part of the
pilot study to check the reliability of the questionnaire. The Cronbach’s Alpha reliability coefficient for the
questionnaire is 0.714, assessed from the data collected from the general population.
2.4 Data Management and Analysis
The raw data was entered in the excel file for cleaning and coding. The data were then transferred to the Statistical
Package for Social Sciences (SPSS) version 25 for further analysis. Descriptive analysis was used to present
frequencies and percentages of data. The chi-square test was used to compare the mean of categorical variables
including the level of awareness. P-value ≤0.05 was considered as level of significance.
2.5 Ethical Consideration
All the participants were informed about the aim and procedure of the study and were asked to sign a written
consent form. Ethical approval was sought from the ethical committee of the university of Lahore before collecting
data.
3. Results
3.1 Demographic Characteristics of Respondents
The study consisted of 126 participants who mostly were female (60.32%).
The majority of participants (75.4%) were from the age group 20–29 years, while only 1 (0.8%) was from the age
group above 70 years of age. The results also show that 52.4% of participants’ income was 50000–100000 rupees
per month and 28 (22.2%) had <20000 rupees per month. In terms of education, 90 (71.4%) of the participants had
either undergraduate or postgraduation education, while 6 (4.8%) participants were illiterate (Table 1).

Table 1. General characteristics of study participants (n = 126)

Variables Frequency (%)
Male 50 (39.7)
Gender
Female 76 (60.3)
20-29 95 (75.4)
30-39 16 (12.7)
40-49 9 (7.1)
Age
50-59 2 (1.6)
60-69 3 (2.4)
>70 1 (0.8)
<20000 28 (22.2)
Income (Rs) per month 50000-100000 66 (52.4)
>100000 32 (25.4)
<Primary 6 (4.8)
Primary-elementary 15 (11.9)
Education level
Secondary School Certificate-Higher 15 (11.9)
Undergrade-Post Grade 90 (71.4)

Table 2 illustrates that from this study, 103 (81.7%) participants had high level of perception about physiotherapy
while 15.9% and 2.4% of the participants showed medium and low levels of perception towards physiotherapy,
respectively.

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Table 2. Level of perception towards physiotherapy

Variables Categories Frequency (%)
1-25 (low level) 2 (2.4%)
Awareness score 26-50 (medium level) 20 (15.9%)
51-75 (high level) 103 (81.7%)

Table 3 reveals that there is no statistical significance between independent variables and the level of perception
towards physiotherapy.

Table 3. Association of different variables with the perception towards physiotherapy

Association Chi-Square test Spearman correlation p-value
Gender 5.758 -0.108 0.227
Age Group (Years) 4.967 0.049 0.586
Socioeconomic Status 9.904 0.095 0.288
Education 3.743 0.055 0.543

4. Discussion
The study’s objective was to check the perception of physiotherapy in the general population of Gujrat, Pakistan.
There were 126 participants in the current study, of whom 81.75% demonstrated a high level of perception, 15.87%
demonstrated a moderate comprehension of the profession, and 2.38% demonstrated a lack of knowledge of the
Gujrat population.
A study conducted among 198 medical students to identify their perception towards physiotherapy showed that
only 37.4% of them were aware of the role of physiotherapy. The study came to the conclusion that medical and
health sciences undergraduates are not familiar with or knowledgeable about physiotherapy. The right steps must
be taken to increase their understanding of physiotherapy. The emphasis on inter-professional education during
their undergraduate program of study can help with this (Ebenezer et al., 2019).
In another study among 320 males and 456 females in Sri Lanka, the awareness of physiotherapy among high
school students was only 30.5%. The students who took part in the study presented a low level of awareness
regarding physiotherapy, and the study suggested increased participation by a physiotherapist to enlighten the
public (Dissanayaka & Banneheka, 2014). A previous study, including 308 eligible participants, was conducted in
2020 by He, Danmei to evaluate how the public views physiotherapy. Only 13.6% of participants had sufficient
expertise, demonstrating that knowledge of physiotherapy increased with education. As a result, the study
concluded that the Chinese population lacked knowledge of physiotherapy (He, 2020).
Another study on the perception of physiotherapy among the general population of an African market in Ghana,
which included 500 participants consisting of 209 (41.8%) men and 291 (58.2%) women of age 20 years and above,
showed 68.6% of participants aware of physiotherapy emphasized on there was still a need to educate the general
population of Ghana about physiotherapy (Olawale & Adjabeng, 2014). Though the present study comprises 126
participants, 76 (60.32%) were female. In contrast, 50 (30.68%) were male, and an adequate overall level of
awareness (81.75%) was seen; the age group 20 or more than 20 was the inclusion criteria for participants. The
results show that the population of Gujrat is more mindful of physiotherapy than the general population of Ghana.
If talking specifically about the Pakistan study, which took place in KPK Pakistan based on the evaluation of
physicians and surgeons ‘perceptions regarding physiotherapy in 2020, included a total sample size of 108
physicians and surgeons. The total sample included 34 (32%) females and 74 (68%) males. The result showed that
37% of physicians and surgeons had no idea of the actuality and presence of the physiotherapy profession, though
they were highly qualified (Keramat et al., 2020). An additional study took place in Hyderabad, Pakistan, to
evaluate the awareness of physiotherapy among general practitioners. The cross-sectional study included 100
practitioners, 67 males and 33 females. The age group of practitioners was above 25 or more whereas 77 out of
100 were between 25 and 35 years old. The results concluded that 96% of practitioners were positive regarding
the physiotherapist’s role related to musculoskeletal conditions. In contrast to other conditions, 70% GPs did not

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have enough information on any part of physiotherapy treating other medical conditions. So, the study suggested
taking steps to promote understanding of physiotherapy (Feroz et al., 2016).
Although the current study had 60.32% females and 30.68% males from a total sample size of 126 participants
with different educational backgrounds, participants from a higher level of education, not even all from the medical
experience only (2.38%) had a low level of awareness regarding physiotherapy. In contrast, the other two studies
had more males than females. Although the current study had 60.32% females and 30.68% males from a total
sample size of 126 participants with different educational backgrounds, participants from a higher level of
education, not even all from the medical experience only (2.38%), had a low level of awareness regarding
physiotherapy. In contrast, the other two studies had more males than females. Though above mentioned both
studies took place in Pakistan but in different provinces. The current study took place in Gujrat city, part of Punjab,
Pakistan and shows an extremely elevated level of perception regarding physiotherapy in the Gujrat area compared
to KPK and Hyderabad Sindh. Another study took place in Peshawar to assess the understanding of physiotherapy
in electronic media persons. Numerous TV network electronic media personnel were included in this study, with
a total sample of 114 people. Shockingly 44.7% thought that massage therapy is physiotherapy, and just 20.2%
knew that a physiotherapist performs physiotherapy. The study advises explaining and advancing the concept of
physiotherapy (Darain, S. Ali, & B. Ali, 2019).
In Lahore, a study on intermediate students took place to check their perception of physiotherapy as a career. In
Lahore, a survey of intermediate students took place to check their perception of physiotherapy as a career. The
study comprised 500 students who contained both science and non-science groups. There was low insight about
physiotherapy as a profession in students pursuing their intermediate, and 48% of students had an idea about
physiotherapy from social media, so social media was highlighted as an influential foundation for their information
about physiotherapy (Nadeem et al., 2021).
Research by Anila Paul et al in 2015 on Review of physiotherapy awareness around the globe depending on
inclusion criteria, nine studies were chosen for review, of which six were from countries with very high human
development index (HDI) scores, two from those with medium HDI scores, and one from low HDI countries.
Three studies involved students, one involved patience, and five research involved the general population
suggesting that the general people had limited awareness, there is a misperception about the profession that mostly
deals with massage and fitness. Even in countries with relatively high human development index (HDI). Hence, It
is necessary to raise awareness of the physiotherapy profession to improve functional outcomes (Acharya et al.,
2015). Similarly, the current study performed in Gujrat Pakistan lies in low HDI and showed misconceptions about
the profession of physiotherapy.
The study revealed no significant association between the independent variables and the participants’ perception
towards physiotherapy. This could be due to influence contextual and perceptual factors that affected all the
participants similarly. It also can happen when the general population doesn’t value or is not aware on the role of
physiotherapy due to lack of training. It highlights the role of community-based training that can be provided by
the policy makers.
4.1 Limitations
Due to covid, it was a little tough to approach the patients, and the sample size is small, so the perception of the
general population should be checked with large sample sizes in different cities.
5. Conclusion
The study concludes most of the general population of Gujrat had an adequate understanding of physiotherapy.
Education was an important attribute linked with the level of understanding. No association was witnessed between
the variables and the perception of the profession. However, there is still a need to take specific steps to promote
physiotherapy to make people fully aware of physiotherapy. It is recommended that we publicize the various
aspects of the physiotherapy profession, growing social interactions with other medical practitioners about the
significance of physiotherapy and networking in the physiotherapy profession. Social media campaigns and free
workshops to increase the knowledge of people regarding the domain.
Competing Interests Statement
The authors declare that there are no competing or potential conflicts of interest.
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