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.
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.
Individuals who express a willingness to consent to the study.
Individuals who express a willingness to adhere to the standardised exercise program for the stipulated period.
Individuals with a history of having spine surgery.
Individuals who were previously diagnosed with spine pathology and currently receiving rehabilitation therapy.
Individuals who express an unwillingness to participate in the study.
Parallel
Clinical Control Group (Group A)
BehavioralThe 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.
Spine Exercise Program (Group B)
BehavioralThe 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.
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.
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.
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.
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