Musculoskeletal imaging authority, levels of training, attitude, competence, and utilisation among clinical physiotherapists in Nigeria: a cross-sectional survey

Ogochukwu Kelechi Onyeso, Joseph O Umunnah, Joseph C Eze, Ayodele Teslim Onigbinde, Canice Chukwudi Anyachukwu, Charles Ikechukwu Ezema, Ifeoma Uchenna Onwuakagba, Ukachukwu Okoroafor Abaraogu, Agba Peter Awhen, Ernest Emezie Anikwe, Odunayo Theresa Akinola, Michael Ebe Kalu

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Background: Direct-access physiotherapy practice has led to a global review of the use of differential-diagnostic modalities such as musculoskeletal imaging (MI) in physiotherapy. Objective: To explore the MI authority, levels of training, attitude, utilisation, and competence among clinical physiotherapists in Nigeria. Methods: This national cross-sectional study analysed a voluntary response sample of 400 Nigerian physiotherapists that completed the online version of the Physiotherapist’s Musculoskeletal Imaging Profiling Questionnaire (PMIPQ), using descriptive statistics, Spearman’s correlation, Mann-Whitney U, Kruskal-Wallis, and Friedman’s ANOVA tests. Results: Of the 400 participants, 93.2% believed that physiotherapists should use MI in clinical practice. However, only 79.8% reported having MI authority in their practice settings. The participants’ median (interquartile range) levels of training =10 (24) and competence =16 (24) were moderate. Nonetheless, levels of training (χ2 [15] = 1285.899, p = 0.001), and competence (χ2 [15] = 1310.769, p < 0.001) differed across MI procedures. The level of training and competence in x-ray referral and utilisation was significantly higher than magnetic resonance imaging, computed tomography scan, ultrasonography, scintigraphy, and dual-energy x-ray absorptiometry, in that order (p < 0.05). There was a significant positive correlation between the levels of training and competence (rho =0.61, p < 0.001). The participants had a positive attitude =32 (32) and occasionally used MI in clinical practice =21 (28). Conclusion: Majority of the respondents believed they had MI authority although there was no explicit affirmation of MI authority in the Nigerian Physiotherapy Practice Act. Participants had a positive attitude towards MI. However, levels of MI training, competence, and utilisation were moderate. Our findings have legislative and curriculum implications.

Original languageEnglish
Article number701
Number of pages11
JournalBMC Medical Education
Publication statusPublished - 4 Oct 2022


  • attitude of Health Personnel
  • clinical competence
  • cross-sectional studies
  • humans
  • Nigeria
  • physical therapists/education
  • physical therapy modalities
  • radionuclide imaging
  • surveys and questionnaires
  • diagnostic imaging
  • physical therapists
  • referral
  • curriculum

ASJC Scopus subject areas

  • Education


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