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People living with ataxia recounted uniquely situated and contextualized understandings of exercise and physiotherapy that may differ significantly from the meaning of these terms to physiotherapists. Special attention should be given to patients' perspectives in order to provide services that are meaningful and valued by people living with ataxia. Implications for Rehabilitation Physiotherapists should consider exploring the meaning of exercise and physiotherapy with individual patients to inform appropriate exercise prescription and advice. Poorly managed and inexpertly prescribed home exercise programs risk inadvertently disregarding the possible positive psychosocial effects of exercise participation and may prevent long-term engagement. To sustain long-term engagement prescribed exercises should be enjoyable, meaningful, satisfying and appropriately challenging. Physiotherapists should consider providing sustained, collaborative and flexible services.

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IntroductionSince 2003, widening participation in higher education has been a strategic objective of Higher Education Funding Council for England [1] supported by the Office For Fair Access [2].This agenda has particular relevance for professions such as physiotherapy, where lack of diversity has raised concerns resulting in some to call for the profession to more appropriately reflect the general population [3]. Indeed, some physiotherapists have suggested that the lack of diversity within the workforce is a barrier to both clinical practice and service provision [4].Physiotherapy has traditionally been a white, female profession [5,6] but this demographic is changing with the national profile of all students studying physiotherapy in the 2009/10 cohort reported as 30% male and 50% mature entrants [6,7]. 12% were from minority ethnic backgrounds [7], a leap from under 5% in 2005 [8].Increasing diversity of the profession is welcomed, but these changes do require Higher Education Institutions (HEI) to be vigilant towards ensuring the progression and success of students from all demographic profiles [9]. Whilst some reports question if increasing diversity may present specific challenges to HEIs due to the potential for different learning needs within these groups [9], there remains limited literature and a lack of clarity as to the 2 specific challenges this may present within physiotherapy. Examples of previous research includes the suggestion that mature students in general are effective learners, more motivated and achieve more academically than younger students [3]. Conversely, there is also limited data within physiotherapy suggesting achievement of a better final degree classification by standard entry students [10].Research considering the performance of physiotherapy students based on gender, presents a decline in performance of mature male physiotherapy students when measured for aspiration, satisfaction and identity as a learner as part of a series of questionnaire studies across all three years of physiotherapy training [11]. A later study by Hammond [6] focussed on clinical placement performance alongside related academic requirements (such as reflection portfolio's) both indicated better attainment by female students (female grades 3% higher, p=0.001). There was also a significant increase in the number of male students failing clinical placements in comparison to their female counterparts (13% male vs. 2% female).At present, there is no literature considering physiotherapy students in the UK and the potential relationship between ethnicity and performance. American literature suggests the potential of covert bias in the evaluation of physical therapy student's clinical performance based on ethnicity; with those from minority ethnic groups marked lower [12]. Although there are some significant limitations with this study, corroboration for these findings is in part provided in a later study by Clouten et al [13], who report that a small but significant number of physical therapy clinical instructors...