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

Not Applicable

Not yet recruiting

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

• Registration Number: NCT07167888
• Lead Sponsor: The University of The West Indies

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.

Study Timeline

• Status Verified: 2025-09
• Study First Submitted: 2025-09-03
• Study First Submitted QC: 2025-09-03
• Last Update Submitted: 2025-09-03
• Study First Posted: 2025-09-11
• Last Update Posted: 2025-09-11
• Study Start: 2025-10-04
• Primary Completion: 2026-10-03
• Study Completion: 2026-10-03

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 400

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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Change from Baseline in the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ)	From enrollment to the end of treatment at eight (8) weeks	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.

Secondary Outcome Measures

Name	Time	Method
Knowledge, Attitude and Practice towards Musculoskeletal Problems of Neck and Low back Pain (Questionnaire A)	Done at the time of enrollment (Baseline)	Questionnaire A is a self-administered general questionnaire used to evaluate knowledge, attitude and practice towards musculoskeletal problems of neck and low back pain.
Change from Baseline in Knowledge, Attitude and Practice Towards Musculoskeletal Problems of Neck and Low Back Pain (Questionnaire B)	From Enrollment to the end of treatment at 8 weeks	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.
Change from Baseline in the Numeric Rating Scale (NRS)	From Enrollment to the end of treatment at 8 weeks	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.

Trial Locations

Locations (1)

Faculty of Medical Sciences Teaching and Research Complex, University of The West Indies-Mona Campus; 🇯🇲 Kingston, Jamaica