PREVALENCE OF MUSCULOSKELETAL DISORDERS AND AWARENESS OF PHYSIOTHERAPY MANAGEMENT FOR THE ABOVE AMONG PRIMARY SCHOOL TEACHERSHTML Full Text
PREVALENCE OF MUSCULOSKELETAL DISORDERS AND AWARENESS OF PHYSIOTHERAPY MANAGEMENT FOR THE ABOVE AMONG PRIMARY SCHOOL TEACHERS
P. Ponmathi *, M. Keeerthiga and V. P. R. Sivakumar
SRM College of Physiotherapy, SRM University, Kattankulathur, Kancheepuram - 603203, Chennai, Tamil Nadu, India.
ABSTRACT: Background: According to World Health Organization the global prevalence of musculoskeletal disorder ranges from 14% to as high as 42%.Teachers are generally prone to neck, shoulder and low back pain . The work tasks of school teachers often involve significant use of a head down posture, such as frequent reading and marking of assignments. According to World Health Organization working with a heavily bent, extended or twisted trunk can result in an overload of spinal structures and increased activity of the entire muscles. Objective: To find out the prevalence of musculoskeletal disorders and awareness of physiotherapy management among the primary school teachers. Study Design: Non-experimental. Subjects: 340 samples. Permission from the Institutional head along with the concerned teachers was taken initially to conduct the study. Prior information about the study was given. The purpose of the study was explained to all the subjects to take part in the study. The subjects were selected based on the inclusion and exclusion criteria. Then the “Extended Nordic musculoskeletal questionnaire’’ and the “Physiotherapy Awareness questionnaire” was distributed to them and made sure that the questionnaire is fully completed Outcome Measures: Extended Nordic musculoskeletal questionnaire, physiotherapy awareness questionnaire. Results: The prevalence of Musculoskeletal discomfort were Neck (30.6%), Shoulder (30.3%) and knees(30.3%), lower back(28.8%) Upper back (25.0%). Ankle (21.5%), then Elbow(18.5%) Hip (16.8%). wrists/Hand(15.9%).The true answer rates for the questions on Physiotherapy awareness were 40%, 48% and 63% respectively Conclusion: There is a prevalence of musculoskeletal discomfort among primary school teachers, only slightly less half (48%) of 340 teachers were believed to have had some knowledge of physiotherapy.
Primary school teachers, Physiotherapy awareness, Nordic, Musculoskeletal
INTRODUCTION: The term “Musculoskeletal disorders” include a wide range of inflammatory and degenerative conditions affecting the muscles, tendons, ligaments, joints, peripheral nerves and supporting blood vessels.
These include clinical syndromes such as tendon inflammations and related conditions (tenosynovitis, epicondylitis, bursitis), nerve compression disorders (carpal tunnel syndrome, sciatica) and standardized conditions such as myalgia, low back pain, neck pain 1. Musculoskeletal disorders (MSDs) are put into different categories according to pain location. One category is upper limb disorders which include any injury or disorder located from fingers to shoulder or the neck. Another category of musculoskeletal pain disorder is lower limb disorders which include injury and disorders from hips to toes 2.
Most musculoskeletal disorders develop over time and are caused either by the work itself or by the working environment. Health problems range from discomfort, minor aches, and pains to more serious medical conditions requiring time off work and even medical treatment 3.
Many international studies among school teachers have reported high prevalence of musculoskeletal pain disorders. 4-10 School teachers relative to other occupational groups, report a high prevalence of musculoskeletal disorders 11.
Among different populations studied, the teachers are found to be at higher risk of developing musculoskeletal pain although prevalence among them was not uniform and ranged between 23.7% and 95.1%. 7, 11-16. Musculoskeletal pain is the main cause of absenteeism and early retirement among school teachers 17. Musculoskeletal pain also leads to stress which will affect school teaching performance 18. The prevalence of musculoskeletal pain disorder is positively associated with female gender 4, 12, 19.
The work tasks of school teachers often involve significant use of a head down posture, such as frequent reading and marking of assignments 19, 20. According to World Health Organization working with a heavily bent, extended or twisted trunk can result in an overload of spinal structures and increased activity of the entire muscles. Due to continuous bending and twisting of the trunk the risk of spinal injury is considerably increased in teachers 1.
The work of teachers does not only involve teaching students but also preparing lessons, assessing students' work, and participating in different school committees. These may cause teachers to suffer adverse mental and physical health issues due to the variety of job functions 4. Long time sitting in a fixed posture is accompanied by long lasting musculoskeletal problems 2.
Abnormal muscular activity may lead to an overload within muscular structures. So such working positions should be avoided or the time of working in such positions should be kept to a minimum 1. A profession is a rewarded occupation, especially one that involves appropriate qualification and training to improve quality of an individual‟s life. Physical therapy, as a health care profession was formally recognized in the second decade of the 20th century after the World War I (1914-1918). It gained its importance due to the breakout of poliomyelitis after World War II.
World Confederation for Physical Therapy(WCPT) defines Physical Therapy as "A profession which is concerned with identifying and maximizing quality of life and movement potential within the Spheres of promotion, prevention, intervention, habilitation and Rehabilitation. This encompasses social, psychological, physical and emotional wellbeing."
A study conducted by Pratiand Liu in October 2006 showed that the students have a positive attitude towards physical therapy. Awareness of physiotherapy among teachers have less data analyzed, the teachers who are prone for musculoskeletal disorders should be aware of physiotherapy and treatment used in it for getting proper treatment and also it is important in encouraging the students to plan their future with physiotherapy.
There are very few studies that have documented the prevalence of musculoskeletal disorders and awareness of the physiotherapy management among primary school teachers. Thus the aim of this study is to find the prevalence of musculoskeletal disorders and awareness of Physiotherapy management among the primary school teachers
MATERIALS AND METHODS: Permission from the Institutional head along with the concerned teachers was taken initially to conduct the study. Prior information about the study was given. The purpose of the study was explained to all the subjects to take part in the study. Full time Primary school teachers with five years of experience, both male and female, age between 30-45 years and those who are willing to participate in the study were selected. Teachers with pregnancy, deformity (Spinal Deformities, Limb Length Discrepancy, Poliomyelitis, Rheumatoid arthritis), teachers who does daily exercise and yoga, any neurological complaints, metabolic disorders are excluded from the study. Then the “Extended Nordic musculoskeletal questionnaire ’’ and the “Physiotherapy Awareness questionnaire” was distributed to them and made sure that the questionnaire is fully completed. Any doubt regarding the questions was cleared at the same time. The answered questions were collected at the end of the session from each teacher. About 340 teachers from private schools in Chennai participated in this study.
TABLE 1: THE PREVALENCE OF PAIN IN NECK, SHOULDER, UPPER BACK, ELBOW, WRISTS/HANDS, LOW BACK, HIP/THIGHS, KNEE, AND ANKLE REGIONS AMONG THE PRIMARY SCHOOL TEACHERS
This table infers the prevalence of pain in neck, shoulder, upper back, elbow, wrists/hands, low back, hip/thighs, knee, and ankle regions among the primary school teachers.
GRAPH 1: THE PREVALENCE OF PAIN IN NECK, SHOULDER, UPPER BACK, ELBOW, WRISTS/ HANDS, LOW BACK, HIP/THIGHS, KNEE, AND ANKLE REGIONS AMONG THE PRIMARY SCHOOL TEACHERS
This Graph infers the prevalence of pain in neck, shoulder, upper back, elbow, wrists/hands, low back, hip/thighs, knee, and ankle regions among the primary school teachers.
TABLE 2: AWARENESS OF PHYSIOTHERAPY MANAGEMENT AMONG PRIMARY SCHOOL TEACHERS
|Topic question||Sub question||Right answer||Wrong answer||Don’t know|
|1.Physiotherapy is,||A. Practised by physiotherapist||297||87.4||3||0.9||40||11.8|
|B. A branch of acupuncture||60||17.6||148||43.5||132||38.8|
|C. Practised by massage therapist||149||43.8||80||23.5||111||32.6|
|D. An indigenous treatment method||38||11.2||143||42.1||159||46.8|
|2.Physiotherapy unit includes||A. A gymnasium with exercising machines, gym balls and other equipment||206||60.6||57||16.8||77||22.6|
|B. Electrical modalities||185||54.4||56||16.5||99||29.1|
|C. A section for manual treatments using bandages, tapes and splints.||165||48.5||73||21.5||102||30.0|
|D. A therapeutic pool||98||28.8||38||11.2||204||60.0|
|3. Places where the physiotherapy services can get||A. Private clinics||281||82.6||26||7.6||33||9.7|
|B. Government hospitals||210||61.8||37||10.9||93||27.4|
|C. Private hospitals||260||76.5||33||9.7||47||13.8|
|4. Physiotherapy treatments include||A. Exercise therapy||295||86.8||10||2.9||35||10.3|
|B. Ice or heat therapy||133||39.1||83||24.4||124||36.6|
|5. Do you know when to meet a physiotherapist?||A. When you have an injury||90||26.5||206||60.6||44||12.9|
|B. When there is pain arising in any body part with or without a known cause.||184||54.1||121||35.6||35||10.3|
|C. When you feel pain or discomfort in any sporting technique||169||49.7||124||36.5||47||13.8|
|D. When you have fever or flu.||12||3.5||289||85.0||39||11.5|
This table infers the number of teachers and the percentage of awareness and unawareness of physiotherapy among the primary school teachers.
DISCUSSION: This study is done on the prevalence of musculoskeletal disorders and physiotherapy awareness among primary school teachers.
Focusing on school teacher’s occupational health is important, but little recent research is available. Thus, the musculoskeletal discomforts confronted by school teachers in most countries are relatively unknown. In the present study, it was aimed at investigating the prevalence of musculoskeletal disorders among the teachers with a questionnaire survey.
Sunisa and Pornnapa pointed out that among workers including teacher’s prolonged posture, static works and repetition are the cause of repetitive strain injuries (RSIs), which is one type of musculoskeletal discomforts that directly affect the area of upper limb, neck, shoulder and low back.
Work activities that involve heavy lifting, awkward postures, bending, twisting or stooping, prolonged sitting or standing and repetitive motions may contribute to the development of musculoskeletal disorders. Activities of sustained sitting of frequent reading, marking of assignment and in front of computer, standing up teaching in class, repetitively overhead writing on board are also unsafe act and favourable to the development of Low back pain and upper limb pain which are found high in teachers 21.
Studies have also confirmed that sitting for more than 3 hours daily could be a risk factor for Low back pain. But Lis and col-leagues, in their systematic review, found that sitting it-self does not increase the risk of low back pain, but sitting for more than half a workday, combined with whole-body vibration and/or awkward postures, does increase the likelihood of having low back pain, and it is the combination of those risk factors that leads to the greatest increase in Low back pain.
The results of this study confirms that musculoskeletal problems are prevalent in primary school teachers, of its Neck (30.6%), Shoulder (30.3%) and knees (30.3%), Then comes the discomforts in lower back(28.8%) followed by Upper back (25.0%). The next joint affected was Ankle (21.5%), then Elbow(18.5%) followed by Hip (16.8%).The least affected joint according to this study was wrists/Hand(15.9%).
This goes in hand with Thomas T.W. Chiu. Peggo K.W. Lam (2010) concluded that neck and upper limb pain were highly prevalent in school teachers in Hong Kong. Gender, age, head down posture and some psychosocial factors were found to be significant risk factors.
This goes in hand with Nilufer Cetisli Korkmaz, Uur cavlak, Emine Aslan Telci (2011) concluded that pain in neck, upper back and shoulder region were common in female teachers and the pain severity increases with the overhead activities. Gender, age, emotional status and improper posture are significant risk factors in terms of developing musculoskeletal disorders.
In general, the awareness about physiotherapists, structure of a physiotherapy unit and the availability of physiotherapy services was unsatisfactory (Questions 1, 2 and 3). The true answer rates for these questions were 40%, 48% and 63% respectively (Table 1).
Interestingly, 86% of teachers are aware that exercise therapy are available at physiotherapy units. In average, nearing a half of the study population (54%) was aware of treatment methods used in physiotherapy (Question 4), and only 34% did know when to meet a physiotherapist (Question 5).
The overall awareness about physiotherapy as indicated by true answers to the questions was approximately 48%. In general, nearing half (52%) of primary school teachers were unaware of physiotherapy profession and its applications in patient management. This finding suggest that the Primary school teachers in India are less aware about the field of physiotherapy.
Many primary school teachers thought that physiotherapy is practiced by masseurs (44%). Also, 48% of teachers do not have an idea if physiotherapy is an indigenous method of treatment (Table 1)
Pain management is a most important aspect that should be available in primary care settings. Previously most physiotherapy services are confined to large hospitals, often in private sector and located in urban areas and also now provision in rural or government hospitals appears to be inadequate. The lack of awareness on physiotherapy is alarming. Only slightly less Half (48%) of 340 teachers were believed to have had some knowledge of physiotherapy and also this study emphasizes that there was a high prevalence of musculoskeletal disorders especially neck and shoulder among primary school teachers.
Future studies with interventions for the musculoskeletal discomforts can be done, high school teachers, college lectures can be included. Physical activity questionnaire can be included. Difference in discomforts between male and female teachers can be documented, difference in discomforts between primary school teachers and secondary school teachers can be done in further studies, difference in years of experience can be planned for further studies, difference between urban school teachers and rural school teachers can be taken in to account for further research.
CONCLUSION: This study aims to study on the prevalence of musculoskeletal disorders and physiotherapy awareness among primary school teachers. The results of this study confirms that musculoskeletal problems are prevalent in Primary school teachers, of it the commonest musculoskeletal discomforts are Neck(30.6%), Shoulder (30.3%) and knees(30.3%).
Regarding the Physiotherapy awareness only slightly less Half (48%) of 340 teachers were believed to have had some knowledge of physiotherapy which shows more than half of the population of teachers are not aware of the physiotherapy profession in detail which was quite alarming and that may indirectly hinder the development of this profession, so awareness programmes on physiotherapy should be made to reach the public and school sector for the better growth of the Profession.
- World Health Organization. Preventing Musculoskeletal Disorders in the Workplace. 2003. (Protecting Workers' Health Series no. 5).
- Health and Safety Executive. Musculoskeletal Disorders 2011-2012.
- European Agency for Safety and Health at work. Work-related musculoskeletal disorders in the EUfacts and figures. European Risk Observatory Report. 2010.
- Chong EYL, Chan AHS. Subjective health complaints of teachers from primary and secondary schools in Hong Kong. International Journal of Occupational Safety and Ergonomics. 2010; 16(1):23–39.
- Reynolds DL, Chambers LW, Badley EM, et al. Physical disability among Canadians reporting musculoskeletal disorders .Journal of rheumatogy 1992;19(7):1020-1030
- Jiménez-Sánchez S, Jiménez-García R, Hernández-Barrera V, Villanueva-Martínez M, Ríos-Luna A, Fernández-de-las-Peñas C. Has the prevalence of invalidating musculoskeletal pain changed over the last 15 years (1993–2006)? A spanish population-based survey. Journal of Pain. 2010; 11(7):612–620.
- Chopra A, Saluja M, Patil J, Tandale HS. Pain and disability, perceptions and beliefs of a rural Indian population: a WHO-ILAR COPCORD study. Journal of Rheumatology.2002; 29(3):614–621.
- Manahan L, Caragay R, Muirden KD, Allander E, Valkenburg HA, Wigley RD. Rheumatic pain in a Philippine village. A WHO-ILAR COPCORD study. Rheumatology International. 1985; 5(4):149–153.
- Darmawan J, Valkenburg HA, Muirden KD, Wigley RD. Epidemiology of rheumatic disease in rural and urban populations in Indonesia: a World Health Organisation International League against Rheumatism COPCORD study, stage I, phase 2. Annals of the Rheumatic Diseases.1992; 51(4):525–528. Cardoso JP, de Queiroz Batista Ribeiro I, de Araújo TM, Carvalho FM, dos Reis EJFB. Prevalence of musculoskeletal pain among teachers.2009; 12(4):1–10.
- Korkmaz NC, Cavlak U, Telci EA. Musculoskeletal pain, associated risk factors and coping strategies in school teachers. Scientific Research and Essays. 2011; 6(3):649–657.
- Samad NIA, Abdullah H, Moin S, Tamrin SBM, Hashim Z. Prevalence of low back pain and its risk factors among school teachers. American Journal of Applied Sciences.2010; 7(5):634–639.
- Atlas AP, Bondoc RG, Garrovillas RA, Lo RD, Recinto J, Yu KJ. Prevalence of low back pain among public high school teachers in the City of Manila. Philippine Journal of Allied Health Sciences. 2007;2(1):34–40.
- Jin K, Sorock GS, Courtney TK. Prevalence of low back pain in three occupational groups in Shanghai, People’s Republic of China. Journal of Safety Research. 2004; 35(1):23–28.
- Kovess-Masféty V, Sevilla-Dedieu C, Rios-Seidel C, Nerrière E, Chee CC. Do teachers have more health problems? Results from a French cross-sectional survey.BMC Public Health. 2006;6(article 101)
- Porto LA, Reis IC, Andrade JM, Nascimento CR, Carvalho FM. Doençasocupacionaisem professoresaten didospelo Centro de Estudos da Saúde do Trabalhador (CESAT) Revista Baiana de Saúde Pública. 2004; 28(1):33–49.
- Punnett L, Wegman DH. Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. J Electromyogr Kinesiol 2004; 14: 13–23.
- Chiu TTW, Lam PKW. The prevalence of and risk factors for neck pain and upper limb pain among secondary school teachers in Hong Kong. Journal of Occupational Rehabilitation. 2007; 17(1):19–32.
- Horng YS, Hsieh SF, Wu HC, Feng CT, Lin MC. Work-related musculoskeletal disorders of the workers in a Child Care Institution. Taiwan Journal of Physical Medicine and Rehabilitation. 2008; 36(1):15–21.
- Bernard BP. Musculoskeletal disorders and workplace factors: a critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper-extremity, and low back. Cincinnati (OH): US Health and Human Services; 1997.
- Sluiter JK, Rest KM, Frings-Dresen MH. Criteria document for evaluation of the work-relatedness of upper extremity musculoskeletal disorders. Scand J Work Environ Health 2001; 27 Suppl 1: 1–102.
- Malchaire J, Cock N, Vergracht S. Review of the factors associated with musculoskeletal problems in epidemiological studies.2001; 74: 79–90.
How to cite this article:
Ponmathi P, Keeerthiga M and Sivakumar VPR: Prevalence of musculoskeletal disorders and awareness of physiotherapy management for the above among primary school teachers. Int J Pharm Sci Res 2017; 8(6): 2648-53. doi: 10.13040/IJPSR.0975-8232.8(6).2648-53.
All © 2013 are reserved by International Journal of Pharmaceutical Sciences and Research. This Journal licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
P. Ponmathi *, M. Keeerthiga and V. P. R. Sivakumar
SRM College of Physiotherapy, SRM University, Kattankulathur, Kancheepuram, Chennai, Tamil Nadu, India.
06 December, 2016
09 May, 2017
16 May, 2017
01 June, 2017