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RecruitingNCT03707288Updated Sep 10, 2025

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

An interventional study of Clinical Control Group (Group A) and Spine Exercise Program (Group B) in Back Pain, Low Back Pain and Neck Pain, sponsored by The University of The West Indies. Recruiting at 2 sites in Jamaica. Per ClinicalTrials.gov, last updated 2025-09-10.

Sponsored by The University of The West Indies · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
1,000
Allocation
Randomized
Sex
All
01

Study summary

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

Read the detailed description

There is a surfeit of literature on musculoskeletal pain especially that of neck and low back pain, which are commonly associated with lifestyle practices including varied occupations that affect individuals of all ages.

Medical students in the clinical years of training are more likely to be involved in prolonged and strenuous activities such as standing during ward rounds, bending forward to examine patients and occasionally engaging in manual handling of patients. During the early phase of preclinical training, medical students primarily sit for extended periods in lectures, use computers or tablets, or study in the library while completing assignments. These practices may all contribute to the increased risk of developing neck and low back pain among other musculoskeletal problems, especially in instances where the strength and stability of the spine is not maintained and safe spine precautions are not taken.

To the researcher's knowledge, there is no published study in Jamaica, or in the wider Caribbean, which looks at the prevalence of musculoskeletal pain -- specifically neck and low back pain in medical students. This study aims to determine the prevalence of neck and low back pain in medical students at the University of the West Indies (UWI), Mona, as well as to assess their knowledge, attitude and practice toward good spine health in preventing neck and low back pain.

Using a prospective randomised control study model for students experiencing neck and low back pain, this study will evaluate the outcome of a standardised spine exercise program in participants over an eight (8) week period. These participants will be randomly assigned to the clinical control group (Group A), which will receive no intervention, or the intervention group (Group B), which will follow a standardised spine exercise program over the stipulated period. Data will be collected using Questionnaires A and B, the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), and the Numeric Rating Scale (NRS). The outcomes of both groups will then be compared to determine the program's effectiveness in reducing discomfort and promoting better knowledge, attitude and practice towards spine health among medical students.

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.

02

Conditions studied

  • Back Pain
  • Low Back Pain
  • Neck Pain
  • Neck Pain Musculoskeletal
  • Lower Back Pain
  • Spine Health
  • Musculoskeletal Pain
  • Musculoskeletal Pain Disorder

Keywords

  • lower back pain
  • low back pain
  • neck pain
  • neck and back pain
  • spine health
  • medical students
  • university students
  • musculoskeletal pain
03

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. All students enrolled in the medical program at the University of the West Indies, Mona Campus, Jamaica during the period October 1, 2018 to January 2, 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

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.
04

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
1,000 participants (estimated)

Study arms

  • Other
    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.

    Behavioral: Clinical Control Group (Group A)

  • Other
    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.

    Behavioral: Spine Exercise Program (Group B)

Interventions

  • BehavioralClinical 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.

  • BehavioralSpine 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.

05

What researchers measure

Primary outcomes

  1. Change from Baseline in the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ)

    The Cornell Musculoskeletal Discomfort Questionnaire measures the frequency, discomfort and interference with work due to musculoskeletal pain, as reported by participants. The individually reported frequency score is then multiplied by the discomfort score and by the interference score to determine overall severity of pain experienced. This tallied score is then classified by severity into: no discomfort (0), mild (1 to 4.5), moderate (5 to 14), severe (15 - 45) and very severe (45 or higher). All participants will complete this assessment upon enrollment, as well as after an eight (8) week period of treatment, to evaluate any changes in their reported scores.

    Time frame: From enrollment to the end of treatment at eight (8) weeks

Secondary outcomes

  1. Knowledge, Attitude and Practice towards Musculoskeletal Problems of Neck and Low back Pain (Questionnaire A)

    Questionnaire A is a self-administered general questionnaire used to evaluate knowledge, attitude and practice towards musculoskeletal problems of neck and low back pain.

    Time frame: Done at the time of enrollment (Baseline)

  2. Change from Baseline in Knowledge, Attitude and Practice Towards Musculoskeletal Problems of Neck and Low Back Pain (Questionnaire B)

    Questionnaire B is a self-administered general questionnaire used to evaluate changes in knowledge, attitude and practice towards musculoskeletal problems of neck and low back pain.

    Time frame: From Enrollment to the end of treatment at 8 weeks

  3. Change from Baseline in the Numeric Rating Scale (NRS)

    The Numeric Rating Scale is a reliable and valid, unidimensional 11-point scale used for patient self-reporting of perceived pain. Its scale uses integers which range from zero (0) to ten (10), where 0 represents no pain, and 10 represents the worst imaginable pain. This is then categorised into mild (1-3), moderate (4-6), and severe (7-10). All participants will complete this assessment upon enrollment, as well as after an eight (8) week period of treatment, to evaluate any changes in their perceived pain. This scale is from public domains and as such, permission for its use is not required.

    Time frame: From Enrollment to the end of treatment at 8 weeks

06

Study locations

1 of 2 sites recruiting
  • Faculty of Medical Sciences Teaching and Research Complex,The University of the West Indies, University Hospital of the West Indies
    Kingston, Kingston JMAAW15, Jamaica
    Not yet recruiting
  • Faculty of Medical Sciences Teaching and Research Complex, University of The West Indies-Mona Campus
    Kingston, Jamaica
    • Paula U.A Dawson, MBBS, Diplomate ABPMR · Contact · paula.dawson@uwimona.edu.jm · 876-631-4000 or 876-927-1297
    • Shantelle B Peddlar-Barclay, MBBS · Contact · pmrphysiatryclinic@gmail.com · 1-876-927-1297
    • Paula U.A Dawson, MBBS, Diplomate ABPMR · Principal investigator
    • Maxim U.S.I Christmas, MBBS, DM Ortho · Sub investigator
    Recruiting
07

References and documents

Publications

  • Ehrlich GE. Low back pain. Bull World Health Organ. 2003;81(9):671-6. Epub 2003 Nov 14. PubMed 14710509 ↗
  • Punnett L, Pruss-Utun A, Nelson DI, Fingerhut MA, Leigh J, Tak S, Phillips S. Estimating the global burden of low back pain attributable to combined occupational exposures. Am J Ind Med. 2005 Dec;48(6):459-69. doi: 10.1002/ajim.20232. PubMed 16299708 ↗
  • Lis AM, Black KM, Korn H, Nordin M. Association between sitting and occupational LBP. Eur Spine J. 2007 Feb;16(2):283-98. doi: 10.1007/s00586-006-0143-7. Epub 2006 May 31. PubMed 16736200 ↗
  • Smith DR, Wei N, Ishitake T, Wang RS. Musculoskeletal disorders among Chinese medical students. Kurume Med J. 2005;52(4):139-46. doi: 10.2739/kurumemedj.52.139. PubMed 16639985 ↗
  • Falavigna A, Teles AR, Mazzocchin T, de Braga GL, Kleber FD, Barreto F, Santin JT, Barazzetti D, Lazzaretti L, Steiner B, Beckenkamp NL. Increased prevalence of low back pain among physiotherapy students compared to medical students. Eur Spine J. 2011 Mar;20(3):500-5. doi: 10.1007/s00586-010-1646-9. Epub 2010 Dec 7. PubMed 21136121 ↗
  • Alshagga MA, Nimer AR, Yan LP, Ibrahim IA, Al-Ghamdi SS, Radman Al-Dubai SA. Prevalence and factors associated with neck, shoulder and low back pains among medical students in a Malaysian Medical College. BMC Res Notes. 2013 Jul 1;6:244. doi: 10.1186/1756-0500-6-244. PubMed 23815853 ↗
  • Smith DR, Leggat PA. Musculoskeletal disorders among rural Australian nursing students. Aust J Rural Health. 2004 Dec;12(6):241-5. doi: 10.1111/j.1440-1854.2004.00620.x. PubMed 15615575 ↗
  • Lorusso A, Vimercati L, L'abbate N. Musculoskeletal complaints among Italian X-ray technology students: a cross-sectional questionnaire survey. BMC Res Notes. 2010 Apr 24;3:114. doi: 10.1186/1756-0500-3-114. PubMed 20416101 ↗
  • Smith DR, Leggat PA, Walsh LJ. Workplace hazards among Australian dental students. Aust Dent J. 2009 Jun;54(2):186-8. doi: 10.1111/j.1834-7819.2009.01116_8.x. No abstract available. PubMed 19473172 ↗
  • Chou R, Huffman LH; American Pain Society; American College of Physicians. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007 Oct 2;147(7):492-504. doi: 10.7326/0003-4819-147-7-200710020-00007. PubMed 17909210 ↗
  • O'Sullivan PB, Phyty GD, Twomey LT, Allison GT. Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis. Spine (Phila Pa 1976). 1997 Dec 15;22(24):2959-67. doi: 10.1097/00007632-199712150-00020. PubMed 9431633 ↗
  • Mandel JH, Lohman W. Low back pain in nurses: the relative importance of medical history, work factors, exercise, and demographics. Res Nurs Health. 1987 Jun;10(3):165-70. doi: 10.1002/nur.4770100308. PubMed 2954190 ↗
  • Ariens GA, van Mechelen W, Bongers PM, Bouter LM, van der Wal G. Physical risk factors for neck pain. Scand J Work Environ Health. 2000 Feb;26(1):7-19. doi: 10.5271/sjweh.504. PubMed 10744172 ↗

Individual participant data

Plan to share: Undecided

08

Registry details

Key details

Study ID
NCT03707288
Lead sponsor
The University of The West Indies
Responsible party
Paula Dawson, MBBS (Head, Physical Medicine and Rehabilitation. Principal Investigator, The University of The West Indies) — Principal investigator
First posted
Oct 16, 2018
Start date
Oct 1, 2018
Primary completion
Jan 2, 2026 (estimated)
Completion
Dec 2, 2026 (estimated)
Last update
Sep 10, 2025

Study contacts

Paula U. A. Dawson, MBBS, Diplomate ABPMR
Contact
paula.dawson@uwimona.edu.jm
1-876-927-1297 ext. 8049
Shantelle B Peddlar, MBBS
Contact
pmrphysiatryclinic@gmail.com
1-876-927-1297 ext. 8050
Paula U. A. Dawson, MBBS, Diplomate ABPMR
principal investigator · Division of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica.

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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