Abstract
Background: Personal trainers (PTs) frequently encounter musculoskeletal (MSK) complaints. Effective management depends on accurate scope knowledge, risk perception, and clear referral pathways into regulated healthcare such as chiropractic.
Aim: To describe PTs’ knowledge and perceptions of chiropractic in Gauteng, South Africa, and explore how these relate to collaboration and referral behaviour.
Methodology: Cross-sectional online survey of PTs (n = 119). demographics/qualifications; knowledge (20 Likert items; reverse-scored where specified); perceptions (10 Likert items); collaboration/referral (including clinical vignettes). Descriptives, internal consistency (Cronbach’s α), and exploratory Spearman correlations were computed.
Results: A total of 119 personal trainers participated; most were aged 25–40 years and had qualified since 2016. Overall knowledge of chiropractic scope was strong, with appropriate recognition of core musculoskeletal roles and rejection of non-musculoskeletal roles, although perceived risk of spinal manipulation was often inaccurate. The mean composite knowledge score was 80.9% correct, and perceptions of chiropractic were broadly favourable (mean 4.0/5). Collaboration and referral were reported most frequently with biokineticists and physiotherapists, with comparatively lower collaboration and referral to chiropractors. Knowledge showed a modest positive association with perceptions but only weak relationships with reported referral behaviour. Vignette responses generally aligned with recommended referral pathways.
Conclusion:
PTs show good knowledge and positive perceptions of chiropractic, yet referrals follow established non-chiropractic pathways likely reflecting training exposure and local systems. Pathway clarification and structured interprofessional onboarding may help align attitudes and behaviour.