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The purpose of this study is to determine the prevalence of neck and low back pain among full-time staff at the Faculty of Medical Sciences Teaching and Research Complex (FMSTRC), The University of the West Indies, Mona. It also seeks to assess staff members' knowledge, attitudes, and practices regarding spine health and to evaluate the effectiveness of an eight-week standardised spine-specific exercise programme in reducing musculoskeletal discomfort among those experiencing neck and low back pain. The study will be conducted in two phases using a descriptive cross-sectional design followed by a prospective randomised controlled trial, in which participants reporting 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. Although often self-limiting, these conditions can become disabling and negatively affect productivity, occupational performance, social participation, and activities of daily living. Occupational factors such as prolonged sitting, sustained computer use, forward head posture, repetitive movements, awkward positioning, prolonged standing, and manual handling tasks are well-recognised contributors to spinal pain.
Workers within the Faculty of Medical Sciences Teaching and Research Complex (FMSTRC) at The University of the West Indies, Mona represent a diverse occupational group that includes academic staff, administrative personnel, clinical instructors, laboratory staff, and ancillary workers. Academic and administrative staff frequently engage in prolonged desk-based work, extended computer use, and sustained sitting during lectures, research, and documentation. Clinical and laboratory personnel are exposed to prolonged standing, ward rounds, procedure assistance, and repetitive task performance. Ancillary staff may perform physically demanding duties such as lifting, cleaning, equipment handling, and working in sustained or awkward postures. These occupational exposures, compounded by suboptimal ergonomic practices and reduced core stability, may increase the risk of developing neck and low back pain.
International literature demonstrates a high prevalence of musculoskeletal pain among university employees and healthcare-related occupational groups. Identified risk factors include prolonged sedentary behaviour, repetitive strain, elevated body mass index, smoking, prior musculoskeletal injury, psychosocial stressors, and family history of spinal disorders. Despite this growing body of evidence, there is currently no published study examining the prevalence of neck and low back pain among university staff in Jamaica or the wider Caribbean, particularly within a multidisciplinary academic and clinical complex such as the FMSTRC.
Exercise therapy is widely recognised as an effective non-pharmacological intervention for both acute and chronic spinal pain. Evidence shows that structured exercise programmes improve muscular strength, flexibility, endurance, and spinal stability while reducing pain intensity and functional limitations. Exercise also promotes improved posture, enhances neuromuscular control, and supports overall spinal health, thereby reducing the risk of recurrent injury.
This study aims to determine the prevalence of neck and low back pain among full-time staff at the Faculty of Medical Sciences Teaching and Research Complex (FMSTRC), The University of the West Indies, Mona, and to compare the effectiveness of a standardised spine-specific exercise programme versus a non-spine-specific exercise programme in reducing pain and improving knowledge, attitudes, and practices related to spinal health.
The study will be conducted in two phases and guided by both descriptive and experimental frameworks. In the first phase (descriptive phase), a cross-sectional design will be used to assess the prevalence of neck and low back pain among full-time FMSTRC workers across all occupational categories. Participants will complete questionnaires assessing the presence of musculoskeletal discomfort in the neck and low back, as well as their knowledge, attitudes, and practices regarding spine health.
In the second phase (experimental phase), staff members who report neck and/or low back pain will be randomised into either an intervention group or a control group. The intervention group will participate in an eight-week standardised spine-specific exercise programme. The control group will receive a non-spine-specific exercise programme administered in parallel during the study period to minimise placebo effects. Pre- and post-intervention data will be collected using the Numeric Rating Scale (NRS), the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), and structured questionnaires (Questionnaires A and B) to assess changes in pain intensity, 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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Clinical Control (Group A) | Experimental | 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. |
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| Spine Exercise Program (Group B) | Experimental | 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. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Clinical Control Group (Group A) | 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-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. |
| Measure | Description | Time Frame |
|---|---|---|
| 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. | From enrollment to the end of treatment at eight (8) weeks |
| Measure | Description | Time Frame |
|---|---|---|
| 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. |
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Inclusion Criteria
Exclusion Criteria
Cisgender men and cisgender women
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Paula U. A. Dawson, MBBS, Diplomate ABPMR | Contact | 1-876-927-1297 | Ext. 8049 | paula.dawson@uwimona.edu.jm |
| Shantelle B Peddlar, MBBS | Contact | 1-876-927-1297 | Ext. 8050 | pmrphysiatryclinic@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Paula U. A. Dawson, MBBS, Diplomate ABPMR | Division of Physical Medicine and Rehabilitation, Faculty of Medical Sciences, The University of the West Indies, Mona, Jamaica. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Medical Sciences Teaching and Research Complex, University of The West Indies-Mona Campus | Kingston | Jamaica |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 17909209 | Background | Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK; Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 Oct 2;147(7):478-91. doi: 10.7326/0003-4819-147-7-200710020-00006. | |
| 28939263 |
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| Spine Exercise Program (Group B) | 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 spine-specific 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. |
|
| 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. | 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. | From Enrollment to the end of treatment at 8 weeks |
| Background |
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| ID | Term |
|---|---|
| D019547 | Neck Pain |
| D001416 | Back Pain |
| D059352 | Musculoskeletal Pain |
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
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