Physical Activity Versus Exercise: Patient Perspectives on Word Choice in Clinic-Based Physical Activity Screening...

Physical activity (PA) is an important component of health, yet PA screening is not broadly adopted in clinical practice. Screening tools present trade-offs between efficiency and comprehensiveness, and patient understanding and interpretation of terms like "physical activity" and "exercise" may influence reporting. We aimed to describe how patients interpret and report these terms in primary care.

We conducted a survey-based study with English- and Spanish-speaking participants. Four open-ended questions asked participants to define "exercise" and "physical activity" and describe their own PA and exercise in the past week. Thirteen close-ended questions asked participants to classify activities. Responses were analyzed qualitatively and descriptively.

Of 142 participants, most defined PA broadly as movement, while exercise was described as intentional movement with a purpose. When describing PA, Spanish speakers less often included housework and yardwork and more often considered job-related activity as exercise. Many classified occupational and household activities as PA but not exercise. About one quarter viewed transportation-related activities as exercise only. Recreational activities were frequently classified as both, though many participants considered structured moderate- and high-intensity activities as exercise only.

Patients view PA and exercise as overlapping but distinct constructs, highlighting the importance of terminology in PA screening.