Low Back and Neck Pain in Nursing Students at The University of The West Indies

NCT ID: NCT07167888

Last Updated: 2025-09-11

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 400 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-10-04
• Study Completion Date: 2026-10-03

Brief Summary

The purpose of this study is to identify the prevalence of neck and low back pain in nursing students enrolled at the University of the West Indies, Mona; to assess their knowledge, attitude and practice of good spine health and to determine the outcome of a standardised spine exercise program on nursing students experiencing neck and low back pain, using a prospective randomised control design.

Detailed Description

Neck and low back pain are among the most common musculoskeletal problems affecting individuals worldwide. Although they are often self-limiting, these conditions may become disabling, significantly impairing productivity, social life, and activities of daily living. Research suggests that approximately 37% of back pain is associated with occupational factors. Prolonged sitting and awkward postures considerably increase the risk of back pain, while neck pain is strongly associated with slouching and repeated or prolonged neck movements. Nursing students, are particularly vulnerable to musculoskeletal pain, and evidence shows that this risk begins as early as their training years. During the preclinical phase of nursing education, students typically spend long hours sitting in lectures, studying, and completing assignments, often with sustained use of computers or tablets. As they progress into their clinical years, nursing students are exposed to a physically demanding environment that involves prolonged standing on ward rounds, assisting during clinical procedures, and performing manual patient handling tasks such as lifting and turning. These activities, when combined with poor ergonomic practices and inadequate core stability, may contribute to the development of neck and low back pain. Alshagga et al. conducted a cross-sectional study in a private Malaysian medical college and reported a higher prevalence of musculoskeletal pain among clinical students, with factors such as increased computer use, elevated BMI, prior trauma, and family history of musculoskeletal disorders playing significant roles. While such studies exist internationally, to the researcher's knowledge, no published study has yet investigated the prevalence of neck and low back pain specifically among nursing students in Jamaica or the wider Caribbean. Exercise therapy is widely recognised as an effective intervention for musculoskeletal pain. Chou and Huffman (2007), in their study on non-pharmacologic therapies for acute and chronic low back pain, demonstrated significant improvements in both pain reduction and function with exercise compared to other noninvasive interventions. Exercise not only strengthens muscles and improves flexibility but also enhances spinal stability and facilitates nutrient transfer to soft tissues, ligaments, and intervertebral discs, thereby promoting spinal health and reducing the risk of injury. The University of the West Indies (UWI), Mona, currently has approximately 400 nursing students enrolled across its four years of training, averaging 130 students per cohort. This study will focus on nursing students enrolled at the UWI Mona to: 1. determine the prevalence of neck and low back pain, 2. assess their knowledge, attitude, and practice toward spine health, and 3. evaluate the effect of a standardised spine exercise program on pain and functional outcomes. Nursing students reporting neck or low back pain will be prospectively randomised into two groups: a control group (Group A) with no intervention, and an intervention group (Group B) that will follow an eight-week standardised spine exercise program. Nursing students will also be assessed to provide a comparative perspective between preclinical and clinical stages of training. Outcome measures will include the Numeric Rating Scale (NRS), the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), and structured questionnaires designed to evaluate knowledge, attitude, practice, and functional status. To the researcher's knowledge, this will be the first randomised controlled study examining neck and low back pain among nursing students in Jamaica, with the dual aim of establishing prevalence and evaluating the effectiveness of exercise-based intervention strategies in this population. The identity of all participants will be protected and will only be identified by an assigned study number. Basic demographic information, presenting complaints and outcome information will be obtained for the purposes of the study. All data will be managed securely using REDCap, a password-protected, web-based platform compliant with national data protection standards. Data exported for analysis will be handled using SPSS software, ensuring confidentiality is maintained throughout. All records will be securely destroyed three years after study completion.

Conditions

Back Pain; Low Back Pain; Musculoskeletal Pain; Neck Pain; Spine Health; Musculoskeletal Pain Disorder; Lower Back Pain; Nursing Students; Preclinical Education

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: PREVENTION
• Blinding Strategy: NONE

Study Groups

Clinical Control (Group A)

All participants will complete the Cornell Musculoskeletal Discomfort Questionnaires (CMDQ) to assess the frequency, discomfort and interference with work due to musculoskeletal pain; the Numeric Rating Scale (NRS) to assess for perceived pain; as well as Questionnaire A to assess their knowledge, attitude and practice towards musculoskeletal problems of neck or low back pain. Participants who are found to have neck or low back pain will be randomised into two (2) groups: a clinical control group (Group A) and an intervention group (Group B). Group A will not be given any exercise programs over an eight (8) week period after which time, participants will be reassessed using the CMDQ and NRS, as well as a Questionnaire B to evaluate for changes in their knowledge, attitude and practice towards musculoskeletal problems of the neck and low back pain, without having received any intervention.

Group Type: EXPERIMENTAL

Clinical Control Group (Group A)

Intervention Type: BEHAVIORAL

The participants who reported the presence of neck or low back pain and were assigned to the clinical control group (Group A) after randomisation will not receive the intervention of an exercise program. The interventional group (Group B) will be asked to keep the standardised exercise program confidential and not share with the control group (Group A). After eight (8) weeks, Group A participants will receive: the Cornell Musculoskeletal Discomfort Questionnaires (CMDQ) to assess for changes in the frequency, discomfort and interference with work due to musculoskeletal pain; a Questionnaire B, to ascertain any changes in their pain level using the Numeric Rating Scale (NRS); as well as their knowledge, attitude and practice towards musculoskeletal problems of the neck and low back pain, without having received any intervention.

Spine Exercise Program (Group B)

All participants will complete the Cornell Musculoskeletal Discomfort Questionnaires (CMDQ) to assess the frequency, discomfort and interference with work due to musculoskeletal pain; the Numeric Rating Scale (NRS) to assess for perceived pain; as well as Questionnaire A to assess their knowledge, attitude and practice towards musculoskeletal problems of neck or low back pain. Participants who are found to have neck or low back pain will be randomised into two (2) groups: a clinical control group (Group A) and an intervention group (Group B). Group B will be given a standardised spine exercise program over an eight (8) week period, after which time they will be reassessed using the CMDQ and NRS, as well as Questionnaire B to evaluate for changes in their knowledge, attitude and practice towards musculoskeletal problems of the neck and low back pain, having received the intervention.

Group Type: EXPERIMENTAL

Spine Exercise Program (Group B)

Intervention Type: BEHAVIORAL

The standardised spine exercise program will be provided in a handout and given only to the intervention group (Group B), and will include simple basic neck or low back exercises to be done three (3) times per week, as well as brief stretching exercises, to be done during periods of sitting for greater than sixty (60) minutes. The selected participants will be asked to comply with instructions on the handout. Participants who experience worsening of their symptoms, or who develop new symptoms will be assessed as having an adverse outcome and will be withdrawn from the study.

Interventions

Clinical Control Group (Group A)

The participants who reported the presence of neck or low back pain and were assigned to the clinical control group (Group A) after randomisation will not receive the intervention of an exercise program. The interventional group (Group B) will be asked to keep the standardised exercise program confidential and not share with the control group (Group A). After eight (8) weeks, Group A participants will receive: the Cornell Musculoskeletal Discomfort Questionnaires (CMDQ) to assess for changes in the frequency, discomfort and interference with work due to musculoskeletal pain; a Questionnaire B, to ascertain any changes in their pain level using the Numeric Rating Scale (NRS); as well as their knowledge, attitude and practice towards musculoskeletal problems of the neck and low back pain, without having received any intervention.

Intervention Type: BEHAVIORAL

Spine Exercise Program (Group B)

The standardised spine exercise program will be provided in a handout and given only to the intervention group (Group B), and will include simple basic neck or low back exercises to be done three (3) times per week, as well as brief stretching exercises, to be done during periods of sitting for greater than sixty (60) minutes. The selected participants will be asked to comply with instructions on the handout. Participants who experience worsening of their symptoms, or who develop new symptoms will be assessed as having an adverse outcome and will be withdrawn from the study.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

1. All students enrolled in the student nursing program at the University of the West Indies, Mona Campus, Jamaica during the period October 4, 2025 to October 3, 2026.

2. Individuals who express a willingness to consent to the study.

3. Individuals who express a willingness to adhere to the standardised exercise program for the stipulated period.

Exclusion Criteria

1. Individuals with a history of having spine surgery.

2. Individuals who were previously diagnosed with spine pathology and currently receiving rehabilitation therapy.

3. Individuals who express an unwillingness to participate in the study.

• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

The University of The West Indies, Mona

UNKNOWN

Sponsor Role: collaborator

The University of The West Indies

OTHER

Sponsor Role: lead

Responsible Party

Paula Dawson, MBBS

Head, Physical Medicine and Rehabilitation. Principal Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Paula U.A Dawson, MBBS, Diplomate ABPMR

Role: PRINCIPAL_INVESTIGATOR

Division of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica.

Locations

Faculty of Medical Sciences Teaching and Research Complex, University of The West Indies-Mona Campus

Kingston, , Jamaica

Countries

Jamaica

Central Contacts

Paula U. A. Dawson, MBBS, Diplomate ABPMR

Role: CONTACT

paula.dawson@uwimona.edu.jm

1-876-927-1297 ext. Ext. 8049

Shantelle B Peddlar, MBBS

Role: CONTACT

pmrphysiatryclinic@gmail.com

1-876-927-1297 ext. 8050

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Other Identifiers

CREC-MN.0192,2024/2025

Identifier Type: -

Identifier Source: org_study_id