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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.
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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.
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400 participants in 2 patient groups
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Paula U. A. Dawson, MBBS, Diplomate ABPMR; Shantelle B Peddlar, MBBS
Data sourced from clinicaltrials.gov
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