An interventional study of Clinical Control Group (Group A) and Spine Exercise Program (Group B) in Back Pain, Low Back Pain and Musculoskeletal Pain, sponsored by The University of The West Indies. Not yet recruiting at 1 site in Jamaica. Per ClinicalTrials.gov, last updated 2026-02-24.
Sponsored by The University of The West Indies · Not applicable, Interventional, and Prevention
The purpose of this study is to determine the prevalence of neck and low back pain among physical therapy students enrolled at The University of the West Indies, Mona. It also aims to assess students' knowledge, attitudes, and practices regarding spine health and to evaluate the effectiveness of an eight-week standardised spine-specific exercise programme in reducing musculoskeletal pain and improving functional status among those reporting symptoms. The study will be conducted in two phases, beginning with a descriptive cross-sectional assessment of prevalence, followed by a prospective randomised controlled trial in which students experiencing neck and/or low back pain will be allocated to either a spine-specific exercise intervention group or a non-spine-specific exercise control group for comparative analysis of outcomes.
Neck and low back pain are among the most common musculoskeletal conditions worldwide, affecting individuals across a wide range of professions. Although often self-limiting, these conditions may become recurrent or chronic, leading to functional limitations, reduced productivity, and diminished quality of life. Occupational and training-related factors such as prolonged sitting, sustained computer use, awkward postures, repetitive spinal movements, and poor ergonomics are well-recognised contributors to spinal pain. It is estimated that approximately 37% of low back pain is occupation-related, with neck pain strongly associated with forward head posture, sustained flexion, and repetitive movements.
Physical therapy (PT) students represent a unique population at increased risk for musculoskeletal pain, with vulnerability beginning during their training years. The physical and academic demands of physiotherapy education expose students to multiple risk factors in both preclinical and clinical phases of training. During the preclinical phase, students spend prolonged hours attending lectures, studying, and completing assignments, frequently involving sustained sitting and extensive use of electronic devices. During clinical training, students are exposed to physically demanding tasks including prolonged standing, manual therapy techniques, therapeutic exercise demonstration, patient transfers, and assisted mobility activities. These repetitive and load-bearing activities may place significant stress on the cervical and lumbar spine.
International literature demonstrates a high prevalence of neck and low back pain among physical therapy students. Systematic reviews report low back pain prevalence rates ranging from 60-80% during training. Comparative studies suggest that physical therapy students may experience higher rates of low back pain than medical students, likely due to the physically demanding nature of manual therapy training and patient handling. Neck pain is also highly prevalent, with studies reporting rates between approximately 50-70%, often attributed to prolonged studying, suboptimal posture, electronic device use, and psychosocial stress. Identified risk factors are multifactorial and include poor ergonomics, repetitive manual techniques, prolonged standing, sedentary behaviours during study periods, elevated academic stress, and variable personal exercise habits.
Despite this growing body of international evidence, there is currently no published research examining the prevalence of neck and low back pain among physical therapy students in Jamaica or the wider Caribbean. At The University of the West Indies (UWI), Mona, approximately 120 physical therapy students are enrolled across three years of training, with an estimated 40 students per cohort. Understanding the burden of musculoskeletal pain within this population is essential, particularly given their future professional role in musculoskeletal rehabilitation and injury prevention.
Exercise therapy is widely recognised as one of the most effective non-pharmacological interventions for both acute and chronic spinal pain. Evidence supports structured exercise programmes in improving muscular strength, flexibility, endurance, spinal stability, and functional outcomes, while reducing pain intensity. Targeted spine-specific and core-strengthening exercises enhance neuromuscular control and promote optimal spinal alignment, thereby reducing mechanical strain and risk of recurrent injury.
This study aims to determine the prevalence of neck and low back pain among physical therapy students at The University of the West Indies, Mona, and to assess their knowledge, attitudes, and practices regarding spine health. It also seeks to evaluate the effectiveness of an eight-week standardised spine-specific exercise programme in reducing pain and improving functional status among students reporting musculoskeletal discomfort.
The study will be conducted in two phases using descriptive and experimental frameworks. In the first (descriptive) phase, a cross-sectional design will be used to assess the prevalence of neck and low back pain among all enrolled PT students. Participants will complete questionnaires assessing musculoskeletal discomfort, as well as knowledge, attitudes, and practices related to spine health.
In the second (experimental) phase, students who report neck and/or low back pain will be prospectively randomised into either an intervention group or a control group. The intervention group will participate in an eight-week standardised spine-specific exercise programme, while the control group will receive a non-spine-specific exercise programme administered in parallel to minimise placebo effects. Outcome measures will include the Numeric Rating Scale (NRS), the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), and structured questionnaires assessing functional status and spine-health knowledge, attitudes, and practices. Participant confidentiality will be strictly maintained. Each participant will be assigned a unique study identification number, and only demographic, occupational, clinical, and outcome data relevant to the study will be recorded. All data will be securely managed using REDCap, a password-protected web-based platform compliant with national data protection standards. Statistical analysis will be conducted using IBM Statistical Package for the Social Sciences (SPSS), and all study records will be securely stored and destroyed three years after study completion.
2,922 studies on the registry are indexed under Low Back Pain; 580 are open to participants now.
This study's planned enrollment of 120 is above the median of 60 across 2,364 interventional studies indexed under Low Back Pain.
Browse Low Back Pain studies →The University of The West Indies is the lead sponsor of 64 studies on the registry; 15 are open to participants now.
Compared within Low Back Pain, this study's primary condition as ClinicalTrials.gg classifies it; the registry's first condition term is Back Pain. The counts are of registry records indexed under each term, refreshed daily. How we classify →
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Exclusion Criteria:
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-spine specific 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.
Behavioral: Clinical Control Group (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 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.
Behavioral: Spine Exercise Program (Group B)
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-spine specific 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.
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.
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
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 participants' knowledge, attitudes, and practices regarding musculoskeletal problems of the neck and low back. Knowledge is scored on a scale of 0-5, with 0-1 indicating poor or inadequate knowledge, 2-3 indicating moderate knowledge, and 4-5 indicating good or adequate knowledge. Attitude is scored 0-4, with 0-1 representing poor attitude, 2-3 moderate attitude, and 4 good attitude. Practice is scored 0-56, based on 12 questions, with 0-12 indicating poor or inadequate practices, 13-24 below average or fair, 25-32 average or moderate, 33-43 above average or good, and 44-56 excellent practices. Higher scores indicate better knowledge, more positive attitudes, and healthier practices related to neck and low back musculoskeletal problems. The questionnaire is administered at baseline (time of enrolment), and each domain will be analysed separately.
Time frame: Done at the time of enrollment (Baseline)
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 participants' knowledge, attitudes, and practices regarding musculoskeletal problems of the neck and low back. Knowledge is scored on a scale of 0-5, with 0-1 indicating poor or inadequate knowledge, 2-3 indicating moderate knowledge, and 4-5 indicating good or adequate knowledge. Attitude is scored 0-4, with 0-1 representing poor attitude, 2-3 moderate attitude, and 4 good attitude. Practice is scored 0-56, based on 12 questions, with 0-12 indicating poor or inadequate practices, 13-24 below average or fair, 25-32 average or moderate, 33-43 above average or good, and 44-56 excellent practices. Higher scores indicate better knowledge, more positive attitudes, and healthier practices related to neck and low back musculoskeletal problems. The questionnaire is administered at the end of treatment at 8 weeks, and each domain will be analysed separately.
Time frame: From Enrollment to the end of treatment at 8 weeks
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
Plan to share: Undecided
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The University of The West Indies