Non-specific musculoskeletal pain in schoolchildren: Relationship with ergonomic factors of child educational environments

Introduction
Non-specific musculoskeletal pain is one type of concealed disability with negative influences on academic and other activities of school children. Ergonomics is widely gaining attention in school health promotion. Mismatched ergonomics contribute to physical pain. Baseline information is essential to contemplate feasible solutions to mitigate negative influences.

 Aims:
To describe the prevalence of non-specific musculoskeletal pain and the relationship of recurrent musculoskeletal pain with selected ergonomic factors of educational environments in school-going early adolescents.

 Methods:
An Adolescent Musculoskeletal Pain Assessment Tool (AMPAT) was developed and validated. A descriptive cross-sectional study was conducted with a sample of 1607 schoolchildren of 11–13 years selected using stratified multistage cluster sampling in a district of Sri-Lanka. Data collected with an interviewer-guided self-administered questionnaire. Selected anthropometric and ergonomic measurements related to schoolbag and seating were taken. A comparative study was conducted to ascertain the relationship of ergonomic factors with recurrent musculoskeletal pain.

 Results:

AMPAT showed high validity and reliability (Cronbach’s alpha=0.773). Prevalence of musculoskeletal pain was 71.2%. Prevalence for acute, one-time and recurrent pain categories were 19%, 16.2% and 35.9% respectively. Knees (28.8%), lower back (24.4%) and shoulders (23.2%) were common sites of pain. Pain warranted informing in 82%, necessitated medication in 63% and >50% perceived academic performance and school attendance affected.

Schoolbag carrying distance (Z =-2.015 p=0.044) and mismatched seat depth (OR=1.59 95%CI: 1.07-2.36) showed a high risk of recurrent musculoskeletal pain. Carrying backpack over both shoulders (OR=0.06 95%CI:0.03-0.12), use of waist belt (OR=0.57 95%CI:0.34 -0.98) and regular use of backrest (OR=0.55 95%CI: 0.37-0.81) lowered the risk. Schoolbag/body weight, angle looking at or distance to blackboard and other ergonomic factors of seating showed no association.

 Conclusions and recommendations:
Non-specific musculoskeletal pain negatively affects schoolchildren. Several ergonomic factors are associated with recurrent pain. Ergonomic awareness and promotion of proper ergonomic behaviour are recommended.