The aetiology of upper quadrant musculoskeletal pain in high school learners using desktop computers : a prospective study

[摘要] The Western Cape Education Department initiated a project that aims to provide all thelearners from the province with computer access and to promote computer use inschools. Prolonged sitting in front of computers and psychosocial factors have beenassociated with musculoskeletal symptoms internationally. However, the impact ofcomputer use on musculoskeletal pain among South African high school learners is yetto be determined.ObjectiveThe objective of the study was to determine whether sitting postural alignment andpsychosocial factors contribute to the development of upper quadrant musculoskeletalpain in grade ten high school learners working on desktop computers.Study designAn observational analytical study was performed on a sample of 104 asymptomatic highschool learners.MethodologySix high schools in the Western Cape metropole were randomly selected 322 grade tenlearners who are using desktop computers, were screened for upper quadrantmusculoskeletal pain. Measurements at baseline were taken of the 104 asymptomaticlearners, 49 girls and 55 boys. The sitting postural alignment was measured by usingthe 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 exposureto computer use was described in terms of duration and frequency of daily and weeklycomputer use. At three and six months post baseline, the onset and area of upperquadrant musculoskeletal pain was determined by using the Computer UsageQuestionnaire.ResultsAfter six months, 27 of the 104 learners developed upper quadrant musculoskeletal paindue to seated or computer-related activities. There was no difference in computerexposure between the learners who developed upper quadrant musculoskeletal painsymptoms 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 cervicaland thoracic angle (<63.1° or >71.1°; OR 2.19; 95% CI: 1.0-5.6) were significantpostural risk factors for the development of upper quadrant musculoskeletal pain. Therewas a tendency for boys to be at a greater risk for upper quadrant musculoskeletal painthan the girls (OR 1.94; 95% CI: 0.9-4.9). Weight greater than 54.15kg and a depressionscore greater than 11 was found to be significantly associated with a poor posture (OR3.1; 95% CI: 1.0-9.7; OR 1.02; 95% CI: 1.0-1.1).Discussion and conclusionThe 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 greaterrisk of developing upper quadrant musculoskeletal pain than the girls. However thestudy found no causal relationship between depression, anxiety and upper quadrantmusculoskeletal pain among South African high school learners and computer usage.

[发布机构] Stellenbosch University