The aetiology of upper quadrant musculoskeletal pain in high school learners using desktop computers : a prospective study
Date
2008-03
Authors
Prins, Yolandi
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
The Western Cape Education Department initiated a project that aims to provide all the
learners from the province with computer access and to promote computer use in
schools. Prolonged sitting in front of computers and psychosocial factors have been
associated with musculoskeletal symptoms internationally. However, the impact of
computer use on musculoskeletal pain among South African high school learners is yet
to be determined.
Objective
The objective of the study was to determine whether sitting postural alignment and
psychosocial factors contribute to the development of upper quadrant musculoskeletal
pain in grade ten high school learners working on desktop computers.
Study design
An observational analytical study was performed on a sample of 104 asymptomatic high
school learners.
Methodology
Six high schools in the Western Cape metropole were randomly selected 322 grade ten
learners who are using desktop computers, were screened for upper quadrant
musculoskeletal pain. Measurements at baseline were taken of the 104 asymptomatic
learners, 49 girls and 55 boys. The sitting postural alignment was measured by using
the Portable Posture Analysis Method (PPAM), which measured head tilt; cervical angle; shoulder pro- and retraction angle and thoracic angle in the sagittal plane.
Depression and anxiety were described by using the Beck Depression Inventory (BDI)
and the Multidimensional Anxiety Scale for Children (MASC) respectively. The exposure
to computer use was described in terms of duration and frequency of daily and weekly
computer use. At three and six months post baseline, the onset and area of upper
quadrant musculoskeletal pain was determined by using the Computer Usage
Questionnaire.
Results
After six months, 27 of the 104 learners developed upper quadrant musculoskeletal pain
due to seated or computer-related activities. There was no difference in computer
exposure between the learners who developed upper quadrant musculoskeletal pain
symptoms and the learners who remained asymptomatic. An extreme cervical angle
(<34.75° or >43.95°; OR 2.6; 95% CI: 1.0-6.7) and a combination of extreme cervical
and thoracic angle (<63.1° or >71.1°; OR 2.19; 95% CI: 1.0-5.6) were significant
postural risk factors for the development of upper quadrant musculoskeletal pain. There
was a tendency for boys to be at a greater risk for upper quadrant musculoskeletal pain
than the girls (OR 1.94; 95% CI: 0.9-4.9). Weight greater than 54.15kg and a depression
score greater than 11 was found to be significantly associated with a poor posture (OR
3.1; 95% CI: 1.0-9.7; OR 1.02; 95% CI: 1.0-1.1).
Discussion and conclusion
The study concluded that poor posture, relating to extreme cervical and thoracic angles,
is a risk factor for the development of upper quadrant musculoskeletal pain in high school learners working on desktop computers. South African boys were at a greater
risk of developing upper quadrant musculoskeletal pain than the girls. However the
study found no causal relationship between depression, anxiety and upper quadrant
musculoskeletal pain among South African high school learners and computer usage.
Description
Thesis (MScPhysio (Physiotherapy))--Stellenbosch University, 2008.
Keywords
Musculoskeletal pain, Sitting posture, Psychosocial factors, High School learners, Dissertations -- Physiotherapy, Theses -- Physiotherapy