Research Reort On Musculoskeletal Problems

Musculoskeletal Problems and the use of heavy weight
bags among school children of Karachi
Submitted To: Sir Ghazanfar Inam
Submitted By
Ayesha (SP17-MBAG-0005)
Fahad Shafique (SP17-MBAG-0041)
Muhammad Ali Sheikh (SP17-MBAG-0079)
Muhammad Musab Ahmed (SP17-MBAG-0045)
5/19/2018
Musculoskeletal Problems and the use of heavy weight bags among
school children of Karachi
ACKNOWLEDGEMENT
At the submission of our term report, we thank The Almighty for enabling us to complete this
report. The unwavering support of our family, teachers and faculty, friends and colleagues has
been priceless. We would like to take this opportunity to acknowledge everyone who has been
a continuous source of support and encouragement to us.
First and foremost, we would like to thank our teacher Mr. Ghazanfar Inam for providing us
with this invaluable learning experience and opportunity. Your constant knowledge, guidance
and encouragement have been instrumental in achieving our goals.
We would not have been able to complete this project without the sheer support and
encouragement from our families, friends and colleagues. We thank you.
Lastly, we thank the Muhammad Ali Jinnah University for such an opportunity that will be vital
in our professional grooming.
MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 1

LETTER OF TRANSMITTAL
Date: 22nd May, 2018
Dear Readers:
Here is the report on “Association between Musculoskeletal problems and the use of heavy
weight bags among school children of Karachi” which is the requirement for the completion of
our course “Quantitative Research Methods” in our MBA Grad Program.
We are thankful to you, for providing us with the guidance and support which has added to our
knowledge and understanding of the topic. We hope that the research findings of this study
would be useful and would pave the way to further research in the similar area.
Thanks & Regards,

ABSTRACT
Today school bag carried by school children as daily load becomes severe health issue. The purpose of
the study was to determine the incidence of musculoskeletal problems due to heavy weight bags among
the school children of Karachi. We conducted a cross-sectional analytical study involving school children
from public and private sector in different area of Karachi. The study setting was play grounds, summer
camps and tuition centers .The survey area was mixed in terms of socio-demographics and also in terms
of urban and rural population. Data were collected between April-May 18. Investigator administered a
self-completion questioner to the children and to make anthropometric measurements. The study was
conducted on the sample size of 100 school children. Electronic body scale was used to electronically
measure the weight and height of the participants. All students were asked to determine the pain
intensity on VAS or faces pain scale for young children. Questionnaire then assessed for completeness
before data entry.School bag weight percentage was evaluated for the intensity of the pain. Results of
our study showed that highest intensity of pain is associated with the bag weight percentage more than
15%-20% of the bodyweight. There were no any marginal differences between the perceptions about
school bag’s weight found. Student carried the weight of their school bag which was higher than 15%-
20% of their body weight. The most common type of school bag used by the students is two strap school
bag which they carried on their both shoulders. No difference found between girls and boys for the type
of school bag. When asked for the incidence of musculoskeletal pain majority of students agreed for the
pain in shoulder, back, and neck areas of the body. Association between the incidence of
musculoskeletal problems and the use of heavy bags found. The school bag weight, its percentage to
body weight and also the way of carrying school bag is found to be the risk factor for the incidence of
musculoskeletal problems. The weight of school bag has negative correlation with the incidence of
musculoskeletal problems. There is association between the school bags and the way of carrying school
bags.
Key Words: Lower back pain, musculoskeletal diseases

INTRODUCTION
Heavy schoolbag weight is associated negative effect on the posture of children and can induce pain
(Skaggs, Early, & D’Ambra P, 2006, p.358-363).Studies have shown that weight of school bags is
associated with the incidence of neck, shoulders and back pain. (Puckree T, Silal SP, & Lin J, 2004, p.54-
59) However, previous researches mainly focused on adolescents, while less information about the back
pain problem exists with regard to youth especially School going children. (Mackenzie WG, Sampath JS,
& Kruse RW, 2003, p.78-84) Similarly gender differences related with the use of bag has not been
thoroughly investigated.
It is well known that lower back pain with no clinical evidence is common in children’s of school going
age .Although such complaints rising regarding lower back pain and heavily loaded school bags but no
etiology is clear yet. All over the world parents, teachers and health professional are complaining about
the school bags load and associated lower back pain. Now, it is becoming a threat that school bags
which are heavily loaded are becoming a cause of various pain associated conditions in school going
kids. The school going children are in the developing age it is known that heavy loaded bags may cause
cessation of developing their spine and heavily effecting their musculoskeletal development.
Development of musculoskeletal system passes through various phases with the growth of child.
Specifically skeletal stature body weight(BW),and height show a constant increase starting from the age
of 05 years continuously until the age of 10-11 years .Growth rate shows peak between the age of 11
and 15 years. (Malina RM, Bouchard JP, Malina RM, & Bouchard JP, 1991), (Tanner J, 1962). However,
there are changes in BW during children development that is not quite proportional to the height of the
body. BW increases at slower rate at the age of 9-10 and the increase in weight shows a rapid
acceleration by contrast, the rate of height gain when enters in puberty. (Malina RM, Bouchard JP,
Malina RM, & Bouchard JP, 1991) Conversely, the rate of increase in height remains low up to the
adolescents spurt. That is followed later by a rapid acceleration (Tanner J, 1962).
The children’s back pain is an controversial issue within literature as some studies show association
while others does not show any association between heavily loaded bags and back pain. Much of the
international research of health related issues suggested that children’s should carry the bag 10%-15%
of their body weight. (Leboeuf-Yde C, Kyvik KO, &Bruun NH, 1998, p. 2207- 2213)Some studies showed
that prevalence of such pain is more in girls than boys. Type of school bags and the way of carrying the

bag may vary depending on student’s preference and its context. Students often choose bag and select
the way to carry it depending upon the fashion criteria. Fashion trends vary country to country and also
age specific. (Whittfield JK, Legg SJ, &Hedderley DI, 2001, p.819-824), (Negrini S, &Carabalona R, 2002,
p.187-195)
In country like Pakistan there has not been much research on the incidence of lower back pain and
associated heavily loaded school bags, therefore we found scope of doing this study in our context. This
study is designed to investigate the association between musculoskeletal problems and heavily loaded
school bags.
OPERATIONAL DEFINITIONS
Musculoskeletal diseases:
Musculoskeletal diseases are musculoskeletal injuries and disorders affecting body movements or
locomotor (Matt Middlesworth, 2014)
Lower back pain:

Low back pain is neither a disease nor a diagnostic object of any kind. The word mentions to pain of
variable duration in an area of the anatomy distressed so often that it is has become a paradigm of
responses to external and internal stimuli ⎯for example, “Oh, my aching back” is a manifestation used to
mean that a person is troubled. (George E. & Ehrlich, 2003, p. 09)
RATIONALE OF THE STUDY

There is a limited amount of research work conducted in Pakistan to find out the hazardous effects of
heavy school backpacks and its association with the development of musculoskeletal disorders.
SIGNIFICANCE OF THE STUDY

By conducting this study we aim to create awareness among Parents, Teachers and Health professionals
regarding musculoskeletal problems that are severe matter suffered by school going children bearing
heavy weight bags. Repeated carrying and lifting backpacks might alter the children's normal posture in
a wide spectrum starting with simple muscles strain of their necks, shoulders and backs, extended to the
other extreme of posture deviations.

OBJECTIVE
Primary Objective:
To determine the incidence of musculoskeletal problems due to heavy weight bags among the school
children in Karachi.
Secondary Objective:
To find out the effects of the musculoskeletal problems among school children and their studies and
their playing activities due to heavy weight bags.
Research question:
Is there any association between incidence of musculoskeletal problems and heavy weight bags among
school going children?
HYPOTHESIS
1. Null Hypothesis (H0)
There is no association between incidence of musculoskeletal problems and heavyweight bags among
2. Alternate Hypothesis (HA)
There is an association between incidence of musculoskeletal problems and heavy weight bags among
There is no difference between male and female student for the incidence of musculoskeletal problems.
There is a difference between male and female student for the incidence of musculoskeletal problems.

There is no impact of heavy weight bags on the incidence of musculoskeletal problems among school
children of Karachi
There is an impact of heavy weight bags on the incidence of musculoskeletal problems among school
children of Karachi
There is no correlation between incidence of lower back pain and the use of heavy weight bags among
school children of Karachi.
There is correlation between incidence of lower back pain and the use of heavy weight bags among
school children of Karachi.
LITERATURE REVIEW
According to experts, school bags should not be weightier than 10% of a child’s weight to evade causing
health problems at a crucial stage in the body’s growth. But the average schoolbag in secondary school
weighs 26% and in primary school weighs 15 percent of a children body weight. (David Bême, 2013)
One of the studies by Alkabbaz et alwho used EMG to analyze trunk-lower extremity muscle activities
and trunk postural changes during carrying backpacks. Results showed that 20% BW of the backpack
weight causes the most significant muscular and postural changes so it should be avoided. (Al-Khabbaz ,
YS.Shimada, & T.Hasegawa, 2008, p. 297-302)
The weight of the backpack, duration and frequency of the carriage and the way in which the weight is
borne all the requirements on the musculoskeletal system and may affect the prevalence of
musculoskeletal pain or discomfort. Currently, school-age children reporting lower back, shoulders and
neck. (Lockhart RA1, Jacobs K, & Orsmond G., 2004, p. 155-168) It has been seen that the most common
MSD in school going children are back pain, shoulder pain, and arm /wrist pain. Such a heavy load on
back may also cause a problem in the developing spine. (Ibrahim, 2012, p.1526-1534)

Weight of the backpack is one of many contributing factors related to musculoskeletal symptoms among
school-aged students. In addition to the weight of the backpack, duration and frequency of the carriage
and the way in which the weight is borne all the requirements on the musculoskeletal system and may
affect the prevalence of musculoskeletal pain or discomfort. Currently, school-age children reporting
lower back, shoulders and neck (Lockhart RA1, Jacobs K, & Orsmond G., 2004, p. 155-168)
Grimmer and Williamshad investigated the backpack use and the occurrence of low back pain in 1269
students of south Australia .They stated that the students carrying heavy back pack have complains of
low back pain (Grimmer & Williams, 2000, p. 343-360)
Another study by Pasceoet al. suggest that the carriage of school bag weighing more than 17 % of the
body weight or using one strap may lead to variety of musculoskeletal problems such as muscle
soreness and back pain(Pascoe,DD.,D.E.Pascoe,YT.Wang,D.M.Shim and C.K. Kim,1977)
There is particular concern for the junior students in schools, as the spine is at a critical stage of
development in children at the age 0f 7-14 (Dockrell, Kane, & O’Keeffe, n.d.)
A general guideline of 10% body weight, initially proposed by Voll and Klimt in 1977[, continues to be
the designed guideline when carrying a backpack style schoolbag. (Voll H & Klimt F, 1977, p. 369-378)
Dianat et al done a cross-sectional, descriptive-analytical study among a sample of 307 elementary

school children in Tabriz, Iran(Dianat I, Javadivala, Z, &Allahverdipour, H, 2011, p.369-378)
Shamsoddini et al evaluate that the backpack's weight carried by secondary school children in Tehran
appeared to be strongly related to the shoulder, neck, back and extremities complaints. (Shamsoddini,
A.R., M.T.Hollisaz, &R.Hafezi, 2010, p. 120-128)
MATERIALS AND METHODS

Design and Setting:
Cross-sectional analytical study, play grounds, summer camps and tuition centers
Duration of study:
Duration of the study is estimated to be 01 Month.

Sample population:
School children of public and private sector, Children between the ages of 4 years to 16 years were
selected from primary and secondary classes.
Sample size:
The sample size was calculated using Raosoft software for proportion. The sample size found to be
384.But it was a pilot study conducted on sample size of 100 students due to limitation of time duration.
Inclusion criteria:
 Children willing to participate

 Children studying in 3rd to 4th grade
 Healthy children without any acute or chronic disease.
 The BMI should be <95 % to prevent misinterpretation of body balance results from overweight
[WWW.DRPAUL.COM/LIBRARY/BMIFORAGE.HTML]
 No recent fractures of upper or lower extremities.
Exclusion criteria:
 Children who are not carrying their school bags by their own e.g. parents ,servants and any other
person carrying their bags are excluded from the non-exposed group
 Any cause of balance disturbance as vertigo, inner ear infection and blurred vision.
 Students suffering from any musculoskeletal disorder
 Students with BMI equal to or more than 95%.
 Any cause leading to inability of the student to stand upright on both feet.
Sampling technique:
Snowball technique
Data collection tool:
Questionnaire

Study variables:
 Weight of the school bag.

 Weight & height of the school children.
 The musculoskeletal pain or discomfort in different body areas.
Scale:
Visual analogue scale used to identify the pain associated with the use of heavy school bags.
Procedure:
We conducted a cross-sectional analytical study involving school children from public and private sector
in different area of Karachi. The survey area is mixed in terms of socio-demographics and also in terms
of urban and rural population. Data were collected between June-20014-july2014.Investigator
administered a self-completion questioner to the children and to make anthropometric measurements.
The questionnaire had been assessed in pilot study was found to both reliable and comprehensible. A
consent form that includes a simple description of the study and its significance was distributed upon
school students to obtain parent approval .The study was conducted on the sample size of 384 school
children. Electronic body scale was used to electronically measure the weight and height of the
participants. All students were asked to determine the pain intensity on VAS or faces pain scale for
young children. Questionnaire then assessed for completeness before data entry.
Data analysis procedure:
Statistical analysis of the data was performed with SPSS software version20.0. And Microsoft Excel
(2010) program to draw the figures. The percent of the backpack to the BW was calculated using the
equation; Backpack weight / BW X 100 =
To test the assumptions chi –square test, linear regression test, independent t-test and Pearson
correlation test were used to test the effect of school bag on different study variables which are defined
above. P-Values <0.05 were considered as significant for all analyses.

ETHICAL CONSIDERATIONS
 This study was approved by the Health Rehabilitation Sciences Department, Collage of Applied
Medical Sciences, King Saud University.
 Approval was obtained from the Directories of Ministry of Education for the procedure,
questionnaire, consent form and the information sheet
 The Ministry of Education given permission to the researcher to conduct this study in both public
and private schools of Karachi
 Inform consent from children /or their parents was taken by explaining purpose and objectives.
RESULTS
100 students completed the questionnaire.Table1 shows the profile of the study population as related
to the school bag weight. School bag weight percentage was evaluated for the intensity of the pain.
TABLE 1: PROFILE OF THE STUDY POPULATION AS RELATED TO SCHOOL BAG

WEIGHT
DESCRIPTION RANGES FREQUENCY MEAN STD. DEVIATION
4-6 years 27
7-9 years 23
Age
10-12 years 36 2.370000 1.031376
13-15years 14
49
Gender Male Female - -
51
1-2 27
Siblings 3-4 62
1.90
5-6 5 0.745
not at all 6
3-3.5" 13
3.6"-4 17
Height 4.1"-4.5" 16
3.71
4.6"-5 15 1.725
5.1"-5.5" 18
5.6"-6 21
10kg-15kg 14
16kg-20kg 21
Weight
21kg-25kg 36 2.88
1.140
26kg-30kg 21
31kg-35kg 8
Weight with carrying 12kg 2
school bag 18kg 9
19kg 9

20kg 5
23kg 2
24kg 8
25kg 6
27kg 6
28kg 11 - -
29kg 14
30kg 5
32kg 6
33kg 6
34kg 3
37kg 6
43kg 2
1kg-5kg
School bag weight 68
6kg-10kg 1.32
32 .469
10%-15% 16
School bag percentage 16%-20% 42
2.62
21%-25% 6 1.135
26%-30% 36
Figure 1: Siblings Figure 2: School Bag Percentage with Body Weight

Figure 2: Age Figure 3: Gender
Figure 4: Weight Figure 5: Height

Figure 1: Cross tab between school bag weight percentage and the intensity of pain
Results of our study showed that high intensity of pain is associated with the bag weight percentage
more than 15%-20%of the bodyweight as mentioned by figure 07.This sets evidence for the association
between school bag weight and intensity of pain.
Figure 2: Cross tabulations between way of carrying school bag and the perception of
school bag weight
Figure 8 shows that majority of students carried the school bag on both shoulders which is also revealed
by their perception of heavy weight of school bags. It means way of carrying school bags is also related
to the intensity of pain.
Figure 9: Cross tabulation between gender for the perception of school bags weight
school bag weight
We have also compared the perception of female and male students for the weight intensity of their
school bags. Result of our study shows no marginal differences between the perceptions of school bags.
Both male and female agree for the heavier weight of their school bags. As shown in Table 01 student
carries the weight of their school bag which is higher than their 15%-20% of their body weight. The most
common type of school bag used by the students is two strap school bag which they carried on their
both shoulders. No difference found between girls and boys for the type of school bag. When asked for
the incidence of musculoskeletal pain majority of students agreed for the pain in shoulder, back, and
neck areas of the body.

TABLE 2: CHI SQUARE RESULT FOR ASSOCIATION BETWEEN MUSCULOSKELETAL

PROBLEMS AND THE USE OF HEAVY SCHOOL BAGS
VALUE DF ASYMP. SIG. (2-SIDED)

Pearson Chi-Square 3 .065
7.326a
Likelihood Ratio 8.147 3 .043
Linear-by-Linear Association 3.588 1 .058
N of Valid Cases 100
Table 2 shows the result of chi –square test to find out the association between the incidence musculoskeletal
problems and the use of heavy bags among school children of Karachi. Its value is 7.326a and this value is less
than 50 which is good indicator for our sampling distribution. P-value is 0.065 which is greater than 0.05 so we
are fail to reject our null hypothesis. The result shows no association between the incidence of the
musculoskeletal problems and the use of heavy bags among school children of Karachi.
TABLE 3: IMPACT OF HEAVY WEIGHT SCHOOL BAGS ON THE INCIDENCE OF

MUSCULOSKELETAL PROBLEMS.
Table3 shows the results for the impact of heavy weight school bags on the incidence of musculoskeletal
problem. Linear regression testis applied here. It gives R value of .305a which is positive value so it indicates a
weak impact of heavy school bags on the incidence of musculoskeletal problem. The p-Value is also 0.002
that’s why we reject our null hypothesis. Heavy weight school bags have impact on the incidence of
musculoskeletal problems.

ADJUSTED STD. ERROR OF

MODEL R R SQUARE
R SQUARE THE ESTIMATE
1 0.3 .093 .084 .422
05
a
MODEL UNSTANDARDIZED STANDARDIZED T SIG.

COEFFICIENTS COEFFICIENTS
B STD. ERROR BETA
(Constant) 1.571 .107 14.735 .000
School bag percentage -.119 .037 -.305 -3.173 .002
Below Table04 shows the result of independent t-test to find out the difference in gender for the
incidence of musculoskeletal problems. We get the p-value of 0.089 which is greater than 0.05 so we are
fail to reject our null hypothesis. No difference found between male and female students for the
incidence of musculoskeletal problems. Both male and female students are equally affected by the
incidence of musculoskeletal problems due to the use of heavy weight school bags.

TABLE 4 GENDER DIFFERENCE FOR THE INCIDENCE OF MUSCULOSKELETAL

PROBLEMS
TABLE 5 CORRELATION BETWEEN THE INCIDENCE OF LOWER BACK PAIN AND THE
USE OF HEAVY SCHOOL BAGS
Table 5 shows the result for Person correlation test to find out correlation between incidences of lower
back pain and the use of heavy weight bags. Here we get person correlation-.305**values which show a
negative relationship between lower back pain and use of heavy school bags. P-value is .002 so we reject
our null hypothesis.

DISCUSSION
The study purpose was to determine the association between the incidence of musculoskeletal
problems and the use of heavy weight school bags. We hypothesized to find the association between
incidence of musculoskeletal problems and heavy weight bags among school children of Karachi. Our
results showed an association between the incidence of musculoskeletal problems and heavy weight
bags among school children of Karachi. The results showed in addition to lower back pain children also
experiencing pain in shoulders, neck, upper back and legs. This sets evidence for the association of these
pains with use of heavy loaded school bags. Another study conducted in Egypt also showed an
association between increase risks of back pain in Egyptian girls due to the use of heavy weight bags.
(Ibrahim, 2012, p.1526-1534).The results of present study are consistent with this study of Ibrahim etal.
We intended to find the difference between male and female student for the incidence of
musculoskeletal problems. The results were analyzed using independent t-test. Results of this study
revealed no differences in gender for the incidence of musculoskeletal problems. Results of this study
are inconsistent with another study conducted by Eleftherios Kellis etal.(Eleftherios Kellis & Maria
Emmanouilidou,, 2010, p. 17-25) which shows a significant different between gender for incidence of
musculoskeletal problems. The result of our study are inconsistent due to scanty sample size ,if the
sample size increased and study conducted on large sample size it will shows significant difference in
gender for the incidence of musculoskeletal problems.
We also intended to find out an impact of heavy weight bags on the incidence of musculoskeletal
problems among school children of Karachi. To test the hypothesis linear regression test was applied.
This gives R value of .305a which is positive value so it indicates a weak impact of heavy school bags on
the incidence of musculoskeletal problem. And p-Value is also 0.002 that’s why we are fail reject our null
hypothesis. The results are consistent with the study of Ibrahim etal. They found a strong impact of the
use of heavy bags on incidence of musculoskeletal problems same as our study.
We also assumed correlation between incidence of musculoskeletal problems and heavy weight bags
among school children. This assumption was analyzed using Person correlation test to find out
correlation. Results of the study give negative relationship between back pain and heavy school bags,
the intensity of pain is negatively associated the weight of school bag.

LIMITATIONS OF STUDY
 The sample size is small. The same study should be done on large sample.
 There is a big limitation in this study to get permission from the school administration to
conduct the research, esp. those schools whose students carry backpack daily.
 Follow up sample can be lost, or develop musculoskeletal problems through other mean
e.g. accidents, fall, fractures.
 This study is only limited to small proportion of public and private schools of Karachi; it
should be done on bigger demographic area of Pakistan.
 This is not a blinded study, in that students being asked questions about school bags and
musculoskeletal problems may suspect that the survey was geared toward finding a
relationship between school bags and musculoskeletal problems, and thus influence their
responses.
 Furthermore a limitation of this study was that the school bag weight was recorded only
during one day.
The readers should be aware of these limitations while interpreting the results.
CONCLUSION
The results showed a high weight (6kg-10kg) and high percentage (16%-20%) of school bags carried by
students of Karachi. The majority of students reported musculoskeletal problems especially in neck
shoulder and lower back. This problem of heavy school bags should be examined at both international
and national levels. Majority of students reported that their school bag is heavy. Association between
the incidence of musculoskeletal problems and the use of heavy bags found. The school bag weight, its
percentage to body weight and also the way of carrying school bag is found to be the risk factor for the
incidence of musculoskeletal problems. The weight of school bag has negative correlation with the
incidence of musculoskeletal problems.

RECOMMENDATIONS
From the results of our study we can suggest following recommendations.
1. Lower the percentage of school bags weight carried by school age children because at this age they
are passing through the rapid growth.
2. Introduce the e of light text books or introduce the use of CDs or even E-books or iPods.
3. Ensure some physical activity to strengthen the muscles of children.
4. Train children to keep their back healthy and ways to avoid various musculoskeletal problems.
5. There is need for further research to find out long term effects of carrying school bags.
6. There are additional factors that could also influence the effects of school bags use which have not
been taken into account. Like upper body strength and the level of physical activity. Others factors
are body height and bag length.
7. We recommend wide, padded shoulder strap for comfort and greater distribution of weight across
the shoulder of child depending upon socioeconomically because they are more costly.
8. We suggest the multiple compartments in bags for the distribution of load.
9. School children should also be taught about the all features and proper use of their school bags as
most of them has walking distance of more than 20-30 minutes.
10. School should provide students with locker for the storage of their school bags.
11. There is also need to introduce fully functional library where student can borrow text books instead
of carrying them regularly.

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17. Shamsoddini., A.R., M.T.Hollisaz., & R.Hafezi. (2010). Backpack weight and musculoskeletal
symptoms in secondary school student ,Tehran,Iran,. Iranian Journal Of Public Health, 39(4), 120-
125. Retrieved from http://www.slideshare.net/AlexanderDecker/low-back-pain-in-
schoolchildrenthe-role-of- school-bag-weight-and-carrying-way
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maturity/oclc/638322
19. Voll H., & Klimt F. (1977). Strain in children caused by schoolbags. Offentliche Gesundheitswesen, 39,
369-378. Retrieved from http://www.biomedsearch.com/article/Weight-varying-effects-carrying-

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20. Whittfield JK., Legg SJ., & Hedderley DI. (2001). The weight and use of schoolbags in New Zealand
secondary schools. Ergonomics, 44, 819–824. Retrieved from

http://www.tandfonline.com/doi/abs/10.1080/00140130117881

ANNEXURES: I
Disclaimer:
We are submitting this report on “Musculoskeletal problems and the use of heavy weight bags among
school children of Karachi” to satisfy the requirement of the MBA – Grad Program, course of
Quantitative Research Methods. This work is original and would not be presented in any other
institution. The data collected will be kept confidential and anonymity of respondents will be
maintained. No part of this report may be reproduced or transferred in any form or by any means,
graphic, electronic, or mechanical, including photocopying, recording, taping, or by any information
storage retrieval system, without the written permission of the Institute.
The accuracy and completeness of information provided herein are not guaranteed or warranted to
produce any particular results and the advice and strategies, contained herein may not be suitable for
every individual or community. The author, students, supervisors, institutions or any other
individuals/persons shall not be liable for any loss or damage incurred as a consequence of the use and
application, directly or indirectly, of any information presented in this work.

ANNEXURES: II
Informed Consent:
Dear Respondent,
We as students of MBA (Grad Program) at MAJU are conducting a survey on the subject of
“Musculoskeletal problems and the use of heavy weight bags among school children of Karachi”.
This survey is just for academic purpose and requires you to fill the following questionnaire which might
take 10-15 minutes of your time. The information which you provide will be appreciated and can
contribute to valuable information processing.
We assure you that your name will not be associated with your responses and your opinion will not be
revealed to anyone outside the project.
We thank you for your participation. If you would like to review the completed study, we can provide
you once it gets completed.
Regards,

ANNEXURES: III
Questionnaire:
Section I: completed by the researcher
1- Name (Optional):
2- Father’s name:
3- Siblings:
 01-02
 03-04
 04-06
 Not at all
4- Age:
 04 years - 06 years
5- Gender:
 Male
 Female
6- Height:
7- Weight:
8- Weight with carrying school bag:
9- School bag weight:
10- School bag %:

Section II: completed by the student
1. Which of this School bag is your bag?
o One Strap o Two Strap o Rolling Trolley
2- Which of this Way you carry your school bag?
o On One Shoulder o One Two Shoulder o Rolling Trolley by Hand
3- Since you started school, have you ever had any pain at these areas?
- Back YES NO
- Back & Shoulders YES NO
- Back and other areas YES NO

4- On the body diagram below, shade the area of pain you feel since you started school.
5- Since you started school, have you had any back or neck pain during carrying of School bag?
YES NO
6- Put a mark on the horizontal 10 cm line below, the line started from the left side with no pain
at all and ended with worst pain imaginable. Or check on the happy face- sad face scale which
started with happy face with no pain and ended with crying face with imaginable pain.
7- What is your feeling toward weight of your school bag?

o Light weight
o Normal weight
o Heavy weight

Research Reort On Musculoskeletal Problems

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Musculoskeletal Problems and the use of heavy weight

bags among school children of Karachi

Submitted To: Sir Ghazanfar Inam

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 1

Date: 22nd May, 2018

Thanks & Regards,

Fahad Shafique (SP17-MBAG-0041)

Muhammad Ali Sheikh (SP17-MBAG-0079)

Muhammad Musab Ahmed (SP17-MBAG-0045)

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 2

Key Words: Lower back pain, musculoskeletal diseases

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 3

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 4

Lower back pain:

RATIONALE OF THE STUDY

SIGNIFICANCE OF THE STUDY

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 5

2. Alternate Hypothesis (HA)

3. Null Hypothesis (H0)

4. Alternate Hypothesis (HA)

5. Null Hypothesis (H0)

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 6

6. Alternate Hypothesis (HA)

7. Null Hypothesis (H0)

8. Alternate Hypothesis (HA)

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 7

Dianat et al done a cross-sectional, descriptive-analytical study among a sample of 307 elementary

MATERIALS AND METHODS

Duration of the study is estimated to be 01 Month.

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 8

 Children willing to participate

Data collection tool:

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 9

 Weight of the school bag.

Data analysis procedure:

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 10

TABLE 1: PROFILE OF THE STUDY POPULATION AS RELATED TO SCHOOL BAG

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 11

Figure 1: Siblings Figure 2: School Bag Percentage with Body Weight

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 12

Figure 2: Age Figure 3: Gender

Figure 4: Weight Figure 5: Height

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 13

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 15

TABLE 2: CHI SQUARE RESULT FOR ASSOCIATION BETWEEN MUSCULOSKELETAL

VALUE DF ASYMP. SIG. (2-SIDED)

Likelihood Ratio 8.147 3 .043

Linear-by-Linear Association 3.588 1 .058

N of Valid Cases 100

TABLE 3: IMPACT OF HEAVY WEIGHT SCHOOL BAGS ON THE INCIDENCE OF

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 16

ADJUSTED STD. ERROR OF

1 0.3 .093 .084 .422

MODEL UNSTANDARDIZED STANDARDIZED T SIG.

B STD. ERROR BETA

(Constant) 1.571 .107 14.735 .000

School bag percentage -.119 .037 -.305 -3.173 .002

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 17

TABLE 4 GENDER DIFFERENCE FOR THE INCIDENCE OF MUSCULOSKELETAL

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 18

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 19

MUHAMMAD ALI JINNAH UNIVERSITY (MAJU) Page 20

From the results of our study we can suggest following recommendations.