Neck and Low Back Pain in Physical Therapy Students at The University of the West Indies, Mona, Jamaica

NCT ID: NCT07177001

Last Updated: 2025-09-16

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 120 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-11-01
• Study Completion Date: 2026-10-31

Brief Summary

The purpose of this study is to identify the prevalence of neck and low back pain in physical therapy 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 physical therapy students experiencing neck and low back pain, using a prospective randomised control design.

Detailed Description

Neck and low back pain are common musculoskeletal problems that affect most persons at some point in their lives, cutting across various professions. These conditions may be self-limiting, but in many cases, they become disabling and significantly impact productivity, social life, and activities of daily living. It is estimated that approximately 37% of back pain is associated with occupational factors. Prolonged sitting and awkward postures considerably increase the risk of low back pain, while neck pain is closely linked to slouching and repeated or prolonged neck movements. Health care professionals, including physical therapists, are one such group highly susceptible to musculoskeletal pain, and this vulnerability begins as early as their training years. Physical therapy training involves both preclinical and clinical phases that expose students to unique risk factors. During the preclinical period of training, physiotherapy students spend long hours sitting during lectures, studying, and completing assignments, often with sustained use of computers or electronic devices. In the clinical periods, students are immersed in a physically demanding training environment involving prolonged standing, manual patient handling and therapeutic exercises. A systematic review by Smith et al. found that low back pain was reported by 60-80% of physical therapy students during their education. Similarly, Johnson et al. revealed that 66.8% of physical therapy students experienced low back pain, with a significant proportion reporting limitations in daily activity. Comparative studies suggest that physical therapy students are at even higher risk of low back pain than medical students, with prevalence rates of 77.9% versus 54.3%, respectively. This difference is attributed to the physical nature of physical therapy training, which requires manual therapy techniques, patient transfers, and prolonged standing during clinical practice. Neck pain is also highly prevalent among physical therapy students. Brown et al. reported a 69% prevalence of neck pain among physical therapy undergraduate students, most of whom attributed symptoms to prolonged studying, poor posture, and excessive electronic device use. Regional studies in Saudi Arabia and Pakistan further reported neck pain prevalence rates of 48.8% and 51.8%, respectively, with postural strain, poor ergonomics, and psychosocial stress identified as major contributors. Risk factors for neck and low back pain pain among physical therapy students are therefore multifactorial, including poor ergonomics while studying or performing manual techniques, the physical demands of training such as lifting patients and prolonged standing, sedentary behaviours during study periods, and psychosocial stress arising from academic pressure. Although physical therapy students are trained in exercise science, their personal levels of physical activity may vary, which may further influence susceptibility to musculoskeletal pain. Exercise therapy is one of the most effective non-pharmacological interventions for musculoskeletal pain. Chou and Huffman (2007), in their review of non-pharmacologic therapies for acute and chronic low back pain, demonstrated significant improvements in both pain reduction and function with exercise compared to other interventions. Exercise enhances spinal strength, flexibility, and stability, while promoting nutrient transfer to discs, ligaments, and soft tissues, thereby reducing the likelihood of injury. Low back and core-strengthening exercises, in particular, are widely regarded as an optimal approach to restoring spinal balance and alleviating pain.

At the University of the West Indies (UWI), Mona, there are currently 120 physical therapy students enrolled across three years, with approximately 40 students per cohort. This study seeks to determine the prevalence of neck and low back pain in physical therapy students, to assess their knowledge, attitude, and practice regarding spine health, and to evaluate the outcome of a standardised spine-specific exercise program on reducing pain and improving functional status. Students reporting pain will be prospectively randomised into control and intervention arms, with the latter receiving the standardised spine-specific exercise program over an eight (8) weeks period. Outcome measures will include the Numeric Rating Scale (NRS), the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), and structured questionnaires to assess function, knowledge, attitude, and practice. To the best of the researcher's knowledge, this will be the first randomised controlled study conducted in the Caribbean investigating the prevalence of neck and low back pain among physical therapy students, while simultaneously assessing the effectiveness of a targeted exercise based intervention.

Conditions

Back Pain; Low Back Pain; Musculoskeletal Pain; Spine Health; Physical Therapy; Physiotherapist Students; Physiotherapy; Rehabilitation; Neck Pain

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 be given a non-specific spine exercise program 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.

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 receive a non-specific spine exercise program provided in a handout. The interventional group (Group B) will be asked to keep the standardised spine-specific 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.

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-specific exercise program over an eight (8) week period, after which time they will be 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-specific exercise program will be provided in a handout and given only to the intervention group (Group B), and will include specific spine 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 and referred for evaluation and treatment if necessary.

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 receive a non-specific spine exercise program provided in a handout. The interventional group (Group B) will be asked to keep the standardised spine-specific 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.

Intervention Type: BEHAVIORAL

Spine Exercise Program (Group B)

The standardised spine-specific exercise program will be provided in a handout and given only to the intervention group (Group B), and will include specific spine 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 and referred for evaluation and treatment if necessary.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

1. All students enrolled in the Physical Therapy program at the University of the West Indies, Mona Campus, Jamaica during the period November 1, 2025 to October 31, 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 UA 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

Facility Contacts

Paula U.A Dawson, MBBS, Diplomate ABPMR

Role: primary

paula.dawson@uwimona.edu.jm

876-631-4000 or 876-927-1297 ext. 8049

Shantelle B Peddlar, MBBS

Role: backup

pmrphysiatryclinic@gmail.com

1-876-927-1297 ext. 8050

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Other Identifiers

CREC-MN.0228,2024/2025

Identifier Type: -

Identifier Source: org_study_id