DEPARTMENT OF PHYSIOTHERAPY

Background: While the biopsychosocial (BPS) model is the recommended framework for the management of Non-specific chronic low back pain (NSCLBP), there is a paucity of study on the knowledge, attitude and beliefs of BPS model among physiotherapists in Nigeria. Aim: This study investigated the knowledge, attitudes, and beliefs of physiotherapists in South- South Nigeria regarding BPS interventions for NSCLBP and to determine the influence of sociodemographic factors on these variables. Methods: A cross-sectional survey design was employed, involving 80 licensed physiotherapists (46 male, 34 female). Data were collected via an online questionnaire comprising a self- developed knowledge assessment tool on BPS and the validated Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT). Descriptive statistics were used to summarize the data, and Chi- square tests were used to analyze associations between variables at p < 0.05. Results: The findings revealed that all respondents (100%) agreed that psychological support, participation in return to work and social interaction are core components of BPS interventions. Respondents also demonstrated predominantly positive attitudes and beliefs aligned with the BPS model, acknowledging the influence of mental stress (85%) and coping with stress (91.3%). Gender was significantly associated with knowledge of patient self-management (p=0.030), educational level with beliefs about exercise for severe pain (p=0.016), and years of experience with knowledge of treatment standardization (p=0.033). Conclusion: Physiotherapists in South-South Nigeria show a strong theoretical understanding and positive orientation towards the BPS model for managing NSCLBP. However, the influence of demographic factors on specific aspects of their knowledge and beliefs suggests a need for targeted continuing education. These findings can inform curriculum development and professional training to enhance the practical application of holistic, evidence-based LBP care across the region. Keywords: Biopsychosocial Interventions, Non-Specific Chronic Low Back Pain, Knowledge, Attitudes and Beliefs.

Background/Aim: Motivational interviewing (MI) is increasingly recognised as a valuable communication approach in healthcare because it addresses key challenges such as patient engagement and sustained behaviour change. Although evidence supports MI as an effective strategy for promoting health behaviour change across conditions such as substance use and medication adherence, its implementation faces several barriers and facilitators that influence uptake and long-term success. This study therefore aimed to identify the barriers and facilitators to MI utilisation among healthcare providers.
Methods: To identify eligible studies, the following electronic databases were used for literature search: EMBASE, MEDLINE via OVID, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), SCOPUS, and Web of Science Core Collections. Furthermore, AJOL, ProQuest thesis and dissertation, Motivational Interviewing Network of Trainers (MINT) website and Google Scholar were also searched for grey literature. The reference lists of included studies were further screened for eligible studies. The inclusion criteria comprised of studies published in English Language, involving all healthcare (physicians, pharmacists, psychologists, nurses, physiotherapists and social workers), articles addressing the barriers and facilitators to the utilisation of MI and in context of healthcare settings. Screening and data extraction were conducted independently by two reviewers, with disagreements resolved with a consensus. Results were summarized using narrative synthesis following PRISMA-Scr framework.
Result: A total of 19 studies including 456 participants were included in this review. Majority of the participants were nurses as 11 out of the 19 studies included nurses as participants. Out of the included studies, 14 were qualitative studies, 1 randomised controlled trial (RCT), 1 mixed methods design, 1 quantitative design, 1 practice change project and 1 descriptive study. The narrative synthesis identified several barriers and facilitators to the use of motivational interviewing (MI). The most common barrier was the lack of time required to deliver MI effectively. Other identified barriers included insufficient provider training, high workload, patient-related challenges, and practitioner-related factors. Key facilitators reported were the availability of training, practice, support, and supervision, effective communication, readiness or tension for change, alignment of MI with existing practices (goodness of fit), and a supportive work environment.
Conclusion: This scoping review highlights key barriers and facilitators to healthcare providers’ use of MI. Barriers include time constraints, inadequate training, and heavy workloads, while facilitators include adequate training, organizational support, supervision, and positive work environments. Addressing these challenges can enhance MI’s effectiveness in improving patient outcomes.
Registration: The review protocol was developed, registered and made publicly available through the Open Science Framework database with the protocol registration link- https://osf.io/5pqh8
Keywords: Motivational interviewing, barriers, facilitators, healthcare providers, scoping review.

Background: Stroke continues to be one of the world's leading causes of long-term disability and a major factor in the exclusion of working-age adults from the workforce. Although there is little data from Southern Nigeria, returning to work (RTW) following a stroke is a key sign of effective rehabilitation and reintegration.

Aim: This study aimed to determine the socio-demographic, clinical, and psychosocial determinants of return to work among stroke survivors in Benin City, Edo State, Nigeria.

Methods: 67 stroke survivors who were 18 years of age or older and undergoing physical therapy at the University of Benin Teaching Hospital and Edo Specialist Hospital participated in a cross-sectional study. The Mini-Mental State Examination (MMSE) for cognitive function, the National Institutes of Health Stroke Scale (NIHSS) for stroke severity, the Modified Rankin Scale (mRS) for disability, the Functional Independence Measure (FIM) for functional ability, the Rosenberg Self-Esteem Scale (RSES), the Social Support Questionnaire (SSQ), and the General Self-Efficacy Scale (GSE) were among the standardised tools used. Descriptive statistics were used to summarise the data, and Chi-square tests were employed for inferential statistics to ascertain the relationship between RTW and variables with p < 0.05.

Results: The majority of participants 50 (75%) returned to work following stroke. Significant associations were observed between RTW and age (χ² = 9.216, p = 0.027), cognitive function (χ² = 8.544, p = 0.014), disability level (χ² = 12.463, p = 0.002), self-efficacy (χ² = 10.138, p = 0.019), and social support (χ² = 9.804, p = 0.012). While gender, marital status, stroke type, stroke laterality, stroke severity, and self-esteem were not significantly related. Younger survivors with better cognitive and functional abilities and higher self-efficacy and social support were more likely to return to work.

Conclusion: Functional independence, cognitive capacity, and psychosocial factors such as self- efficacy and social support are critical to post-stroke work reintegration. Rehabilitation programs should integrate vocational training, psychological empowerment, and family support to improve RTW outcomes.

Background: In Nigeria, stroke is a major cause of death and disability, and recovery are greatly impacted by health-seeking behaviour (HSB). According to the biopsychosocial (BPS) model, these behaviours are shaped by a combination of biological, psychological, and social factors; however, little is known about how these factors interact among stroke survivors in Edo State, Nigeria. Purpose: This study aimed to use a mixed-methods design to examine the Biopsychosocial determinants of Health Seeking Behaviour among stroke survivors in Edo State. Methods: For the quantitative arm, a convergent parallel mixed-methods approach was used to recruit 55 stroke survivors through multistage sampling. Structured questionnaires (NIHSS, MAS, Berg Balance Scale, HADS, MSPSS) were used to evaluate Biopsychosocial factors and Health Seeking Behaviour. From this group, ten individuals were specifically chosen to participate in in- depth qualitative interviews. While qualitative data was subjected to thematic analysis, quantitative data was subjected to descriptive and inferential statistics (chi-square tests) using SPSS version 27.0. Results: No statistically significant correlations (p > 0.05) were found between Health Seeking Behaviour and any of the Biopsychosocial variables (such as social support, anxiety, comorbidities, and stroke severity). However, a qualitative analysis revealed five major themes that impact HSB: coping strategies, emotional reactions, family, community, and spiritual influences, clinical features and perceived cause, and health-system barriers. Notably, family support, financial limitations, and cultural beliefs played a significant role in the pathways and decisions surrounding care-seeking. Conclusion: Although there was no statistically significant correlation between HSB and standard BPS measures in this sample, qualitative findings highlight the significant impact of systemic, social, and cultural factors. The results emphasize the need for stroke rehabilitation services in Edo State that are accessible, family-inclusive, and culturally sensitive.

Background: Residency training is a supervised postgraduate medical program in Nigeria designed to prepare doctors for specialization. Resident doctors play a critical role in patient management and interdisciplinary collaboration, including aiding referral to rehabilitation services such as physiotherapy. However, evidence suggests that the utilization of physiotherapy services largely depends on physicians’ awareness and perception of its role. Therefore, this study aimed to assess the knowledge and perception of physiotherapy among resident doctors in the University of Benin Teaching Hospital (UBTH), Benin City, Edo State. Methods: A cross-sectional descriptive survey was conducted among 169 resident doctors in UBTH, selected using convenience sampling. Data were collected using a structured questionnaire adapted from validated instruments. The questionnaire assessed sociodemographic characteristics, knowledge of physiotherapy, perception of the profession, and factors influencing both. Data were analysed using the Statistical Package for Social Sciences (SPSS v26). Descriptive statistics including frequencies and percentages were used to summarize responses. Results: Of the 169 participants, 62.1% were male and 49.1% were aged 31–45 years. Most respondents (89.9%) identified a degree as the qualification required to practice physiotherapy, and 59.8% reported five years of training. However, 74.0% believed that a doctor’s referral was mandatory before patients could access physiotherapy. While 96.4% recognized physiotherapy as essential in rehabilitation and 60.9% considered it first-line management for musculoskeletal disorders, only 41.4% had personally consulted physiotherapists. Overall, 62.1% demonstrated satisfactory perception of physiotherapy, while 32.0% exhibited good perception. Key factors influencing knowledge and perception included clinical case outcomes (55.0%), interprofessional communication (55.0%), and research findings (46.2%).
Conclusion: Resident doctors in UBTH demonstrated good knowledge and largely positive perception of physiotherapy, although misconceptions about physiotherapy autonomy and limited awareness of practice settings persist. Strengthening undergraduate exposure, interprofessional education, and clinical collaboration may improve referral practices and enhance integration of physiotherapy in patient care.

Academic-related musculoskeletal disorders (ARMSDs) are increasingly common among university students due to prolonged sitting, poor posture, and
extended study hours. This study investigated the prevalence and determinants of ARMSDs among undergraduates, with a focus on ergonomic behavior, academic workload, and demographic characteristics. A descriptive cross- sectional research design was adopted, and data were collected through a structured questionnaire administered to undergraduates. Descriptive statistics were used to summarize the prevalence and patterns of ARMSDs, while Chi- square tests and Binary Logistic Regression were employed to identify significant associations and predictors of ARMSDs. Results: Findings revealed a high prevalence of musculoskeletal symptoms, especially in the neck, lower back, and shoulders. The Chi-square analysis showed that academic workload and academic level were significantly associated with ARMSDs (p < 0.001), while gender and ergonomic behavior were not statistically significant (p > 0.05). The Binary Logistic Regression model further identified academic level as the only significant predictor of ARMSDs (B = 0.006, p = 0.001, Exp(B) = 1.006), The model explained approximately 6.9% of the variance in ARMSDs (Nagelkerke R² = 0.069). Conclusion: The study concludes that academic workload and progression are major contributors to the development of ARMSDs among undergraduates. These findings underscore the cumulative effects of academic stress, prolonged study duration, and suboptimal posture on students’ musculoskeletal health. iii
Keywords: Academic-related musculoskeletal disorders, undergraduates, ergonomic behavior, academic workload, Chi-square analysis.

Background/Purpose of Study: High-heeled shoes are widely used among females for aesthetic, social, and cultural reasons. However, empirical studies examining the effects of high- heeled shoes on biomechanical alterations and energy expenditure of different body somatotypes are scarce. Aim: The study investigated the effect of 3-inch high-heeled shoe on selected biomechanical parameters (lumbar flexibility (LF), quadriceps angle (QA), limb length discrepancy (LLD), quadriceps muscle length (QL) and gastrocnemius muscle length (GL) and aerobic capacity (total lap covered (TLC), oxygen saturation rate (SPO2), systolic blood pressure (SBP) and diastolic blood pressure (DBP), pulse rate (PR)) in female undergraduate's body somatotypes (ectomorph, mesomorph and endomorph) in the University of Benin. Method: A single-blind randomized controlled trial of 75 female undergraduates recruited through consecutive sampling and blocked randomized into ectomorph, mesomorph, and endomorph using Sheldon’s body types classification questionnaire. Participants biomechanical parameters (LF, QA, LLD, QL and GL) were measured using standardized procedures. Aerobic capacity of TLC was assessed using the 6-minute walk test, while SBP, DBP, SPO2 and PR were measured using Omron digital blood pressure. All measurements of biomechanical parameters and aerobic capacity of participants were taken under two footwear conditions: normal heel and 3-inch high-heeled shoes. Descriptive statistics of mean, standard deviation, frequency and percentages were used to summarise data. Inferential statistics of Wilcoxon’s test, paired t-test, Kruskal Wallis, Mann Whitney-U, ANOVA were used to analyse data at p<0.05. Results: Biomechanical parameters (LF, QA, LLD, QL and GL) and aerobic capacity of TLC were significantly (p<0.001) reduced following the application of 3-inch heel shoe in the three body types, whereas aerobic capacity of SBP, PR, and SPO2 were significantly (p<0.001) increased. Only DBP of mesomorph was significantly (p<0.001) increased. Conclusion: This study indicates that 3-inch high-heeled shoe has significant effects on biomechanical parameters and aerobic capacity of female undergraduate’s body somatotype.

Background: Spinal pain is a prevalent musculoskeletal disorder globally and a major cause of disability among young adults, including university students. Factors such as sedentary lifestyle, prolonged sitting, poor posture and physical inactivity have been implicated. This study investigated the relationship between physical activity levels and spinal pain among students of
the school of Basic Medical Sciences, University of Benin.

Methods: A cross-sectional descriptive study was conducted among 356 undergraduate students of the School of Basic Medical Sciences, University of Benin. Participants were selected using a stratified random sampling technique. Data on sociodemographic characteristics, anthropometric indices, physical
activity levels and spinal pain prevalence were collected using standadized questionnaires. Statistical analyses included descriptive statistics, Chi-square test, independent t-test, one-way ANOVA and Pearson correlation with significance set at p<0.05.

Results: The mean age of the respondents was 21.49 ± 2.22 years. Most participants (74.4%) engaged in physical activity, and the majority had moderate (45.5%) or high (37.9%) activity levels. The 12-month prevalence of lower back pain was 50.5%, neck pain 34.8% and upper back pain 27.5%. There was no significant association between physical activity level and the prevalence of spinal pain (p<0.05). However, gender showed a significant association with lower back pain (p<0.001).

Conclusion: Spinal pain, especially low back pain, is common among students of the School of Basic Medical Sciences, University of Benin, irrespective of physical activity level. Preventive interventions focusing on posture, ergonomics and spinal health education are recommended.

Background: Knee injuries are among the most prevalent musculoskeletal problems affecting student- athletes, often resulting in pain, impaired performance, and limited participation. Despite the growing engagement of university students in organized sports, limited research has addressed the prevalence and contributing factors of knee injuries within Nigerian university settings. Aim: This study aimed to determine the prevalence, types, risk factors, and socio-demographic correlates of knee-related injuries among student-athletes at the University of Benin. Methods: A descriptive cross-sectional research design was employed. A total of 207 student-athletes from various faculties of the University of Benin participated in the study. Data were collected using a structured, self-administered questionnaire assessing socio-demographic characteristics, types of knee injuries, associated risk factors, and management strategies. Descriptive statistics summarized the data, while inferential analysis using Chi-square tests assessed associations between variables at a 0.05 significance level. Results: Findings revealed a high prevalence of knee injuries, with 185 respondents (89.4%) reporting a history of knee injury. The most common types were fractures (45.4%), ligament tears (24.9%), and meniscus injuries (15.7%). Injuries were mostly sports-related (29.7%) or caused by sudden movement (25.9%), and the left knee was the most frequently affected (36.8%). More than half of the injured athletes (51.9%) sought treatment—mainly through medication and physiotherapy—while 39.5% reported persistent pain during activity. iv Statistical analysis showed no significant relationship between intrinsic risk factors (flexibility, previous lower limb injury, and muscle imbalance) or extrinsic risk factors (training intensity, surface type, warm-up routine, and use of protective gear) and knee injury occurrence (p > 0.05). However, sport type was significantly associated with knee injury prevalence (χ² = 17.12, p = 0.029), with football and volleyball athletes being more affected. Age, gender, body mass index (BMI), and level of study were not significantly related to knee injury prevalence. Conclusion: Knee injuries are highly prevalent among student-athletes at the University of Benin, primarily associated with the type of sport rather than intrinsic, extrinsic, or demographic variables. There is a critical need for improved injury prevention programs, enhanced warm- up and training protocols, better facility maintenance, and accessible physiotherapy services to reduce the burden and recurrence of knee injuries in university sports settings

Background: Work-related stress is a major occupational health challenge in healthcare settings, particularly among healthcare professionals who are interns transitioning from academic training to clinical practice. Moreover, prolonged exposure to stress can negatively affect job performance, mental well-being, and quality of patient care. This study investigated the prevalence, sources, consequences of work-related stress among interns of the University of Benin Teaching hospital (UBTH) Benin City, Nigeria. Methods: A cross-sectional survey was conducted among 188 interns selected through stratified random sampling from seven clinical departments in UBTH. Data were collected using Demographic and Work profile Questionnaire and the Perceived Stress Scale (PSS— 10) tools. Descriptive statistics summarized prevalence and stressors, while inferential statistics examined relationships between stress and demographic variables using SPSS version 27.0 Results: The results of the study indicated that most respondents (81.9%) experienced moderate stress, 6.9% high stress, and 11.2% Low stress. Major stressors included excessive workload, poor communication with Supervisors, and Lack of appreciation. Stress negatively affected concentration (40.4%), quality of patient care (40.4%), and motivation (36.7%). Physical and psychological symptoms reported included fatigue, headaches, sleep disturbances, anxiety, and depressive feelings. No significant association was found between stress Levels and age, gender, department, duration of internship, number of patients attended daily, or weekly working hours (p > 0.05). Conclusion: Work-related stress is highly prevalent among interns at UBTH and impacts their performance and well-being. Institutional interventions, including stress management programs, supportive supervision, and moderated workload, core recommended to improve intern welfare and patient safety