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Major Project Prashant
Major Project Prashant
Introduction
Chronic nonspecific neck pain (CNNP) is a common problem that is more and more common
in young people. It is associated with limited cervical mobility, impaired function, neck
muscles, myofascial pain syndrome and stress at work.
The above factors are strongly related and have a negative impact on health related quality of
life. Risk factors for non-specific neck pain initiation and maintenance are personal and
work-related psychosocial factors.
This is very common and not a concern in general. For example, being exposed to cold drafts
or sleeping in awkward positions or working long hours at a computer can cause tension in
muscles. But in majority of cases there is no obvious reason. If symptoms persist for more
than three months, it is considered chronic neck pain.
Stress is often a factor if the pain becomes chronic. Some people with neck pain avoid
physical activity for fear of injuring themselves. But there is no reason to worry as long as
there are no warning signs for more serious problems. It is always good to be active and
move forward despite the pain. Exercises that target the neck can help prevent neck pain.
Neck pain is very common. It is estimated that 1 in 3 people are affected once a year –
women are affected more than men. The risk of neck pain problems usually increases with
age. This problem often lasts longer and is more severe in people who are mentally distressed
by the accident or are more concerned about the consequences.
Structure of neck is made up of vertebrae which originates from the skull and
reaches till the upper tarsal. Cervical bones are made up of a structure such that it can
easily absorbs the shock between the bones. Our head is supported by the bones,
ligaments, and the muscles of the neck and they allow for the motion of the head. Any sort of
abnormalities, inflammation or injury in the neck may lead to neck pain or stiffness.
There are some people experience neck pain or stiffness occasionally but in most cases,
it is mainly due to poor posture or may be due to overuse of the joint. Many a times,
neck pain is not a very serious condition to be worried about and which can be
relieved within few days by following a proper neck exercise or by performing neck
stretching. But in rare cases, neck pain can be a serious condition due to any injury
or illness which require proper doctors care.
Neck pain is very common musculoskeletal injury which is seen in the general population,
especially seen in the office workers. Poorly designed office workstation or poor ergonomics
have also been a major reason for neck pain. Over and prolonged use of computer/ laptops/
mobile phone and tablets leads to various kinds of health injury including upper extremity
pain.
Laptop are used very commonly than the desktop now a days, especially among graduate or
school students and IT professionals. Using laptop may have severe physiological effects on
its user which can be following such as strain in the eye, poor or bad posture, pain in upper
back or any other upper extremities, and overuse injuries. Thus, it is very important to
educate these graduation students about the best or very feasible ergonomic position to use
laptops.
It has been suggested by the scientists that the screen work that is being done on desktop,
laptop, notebook or tablet computers may lead to neck pain and upper extremity symptoms in
office workers.
For example, awkward or poor body postures and repetitive body movements while screen
work have been suggested as a major risk factors for musculoskeletal symptoms, as they may
lead to increased tension in the muscles of the forearm and neck/shoulder region.
Workplace-based ergonomics are very important to reduce the stress of neck pain.
During these times as we all are working from home due to lockdown. While
working from home we should maintain a proper posture while working and if
possible use
Ergonomically designed workplace at home. At home we practice awkward postures
while doing any work. Sometimes we do not use proper chair and desk and instead
do our work with neck tilted or rotated which results in neck pain or neck stiffness.
Neck disorders are the main reason for pain and activity limitations amongst the workers.
Most of the neck pain are result of complex relationships between the individual and poorly
applied workplace ergonomics.
The ergonomics design of the workstation is applied in every office environment and
wherever you find yourself working either you are working from home or may be from any
other place. How we set up the working space has a huge impact on reducing the use of
awkward or poor postures and also reduce the risk of injury over the body.
Neck pain symptoms can include general aches in the neck and pain that can be due to fatigue
in the neck, shoulders, arms, or discomfort in soft tissues structure surrounding the neck and
shoulders. Therefore, preventive measures like ergonomic advice, postural advice and
demonstration of neck exercises are to be integrated in places (colleges, schools or
workstations) of prolonged use of computers.
Neck pain nowadays is a common problem affecting a vast number of people due to
extensive use of computer or laptop at work or home, which causes increased pressure on
musculoskeletal system of neck and upper back.
Longer duration of working hour in front of the computer or laptop leads to alteration in the
posture like rounded shoulder and forward head posture, this faulty posture cause’s loss of
normal lordotic curvature of the upper cervical spine which in turn increases muscle tension
and shortening and eventually lead to neck pain. Along with the faulty postures there are
other associated factors which aggravate the problems in desktop or laptop users like duration
of working hours on desktop, interval or breaks taken during working, setting of desktop,
laptop, keyboard and mouse.
There has also been several research done to compare the effects of biofeedback with
conventional physiotherapy approaches. Physiotherapy treatment including modalities like
hot pack, transcutaneous electrical nerve stimulation and exercises has shown to improve
pain, but it is yet not clear that whether these approaches will help to correct habitual muscle
tension during work thus improving pain and posture.
Yoga is one of the six orthodox philosophical schools of Hinduism. There are many types of
yoga schools, practices and goals in Hinduism, Buddhism and Jainism. In the Western world,
the term "yoga" often refers to ascetic yoga as a practice and modern yoga as mostly asanas
or asanas.
Yoga is considered to be an ancient Vedic Indian tradition; probably in the Indus Valley
Civilization in 3000 BC. Yoga is mentioned in the Vedas, and also in the Upanishads,
although it developed into a systematic study of the Sanyasi and Ramayana movements in
ancient India in the 5th and 6th centuries BC. Happened. Note the chronology of the early
texts describing yoga practices is unclear, attributed differently to the Upanishads. Patanjali's
Yoga Sutras gained prominence in the West from the second century BC and after being first
introduced by Swami Vivekananda in the 20th century. Hatha yoga texts originated in Tantra
and Tantra between the 9th and 11th centuries.
After the conquest of Swami Vivekananda in the late 19th century and the beginning of the
20th century Indian yoga teachers introduced yoga to the West by following the yoga
tradition except asanas. Outside India, it has evolved into a posture-based physical fitness,
stress reliever and relaxation technology. Yoga in Indian traditions rather than physical
exercise; It has a meditative and spiritual origin. Yoga Darshan, one of the six major
orthodox philosophies or schools of Indian philosophy, has its own epistemological approach
that deals with the oncology and metaphysics of adjacent statistical philosophy.
Benefits:
Helps treat neck sprains, reduces stiffness in neck, shoulders and knees, tightens in ankles
and tones arm and leg ligaments
Stretches the spine.
Give strength to thighs, calves and buttocks.
Stimulates the nerves of the spine.
It improves the flexibility of the spine, the proper alignment of the shoulders
It relieves back pain, gastritis, indigestion, acidity, flatulence
It stimulates the nervous system and reduces nervous depression, strengthens the pelvic area
and tones the reproductive organs.
Marzariasana, commonly known as Cat Pose and Cat Stretch Pose in English, is a back
stretching pose. The Sanskrit name Marjarasan is formed from the two words Marjari and
Asan, where Marjari means cat and Asan means asana. During the practice of this asana, the
body is drawn like a cat and hence its name.
Benefits:
Practicing this asana regularly improves body posture and strengthens muscles and joints.
Increases the flexibility of the spine, shoulders and neck.
Improves blood flow in the body, hence better circulation.
Practicing this asana is beneficial for women as it tones the female reproductive system and
eliminates cramps.
Раrivrttа Sukhаsаnа оr the eаsy seаted twist роse is bаsed оn the eаsy seаting роsture
саlled Sukhаsаnа. In Sаnskrit, Раrivrttа meаns twisted аnd Sukhа meаns eаsy,
соmfоrtаble оr jоyful аnd Аsаnа meаns а yоgiс роse. It is аn eаsy роsture thаt саn
be рerfоrmed by аll рrасtitiоners.
Benefits:
It inсreаses the flexibility оf the bасk musсles аnd the sрine.
It makes the neсk musсles flexible. Hоwever, there is а wоrd оf саutiоn fоr thоse
suffering frоm sроndylitis оr severe neсk раin. They shоuld nоt twist the neсk
beyоnd the роint where it stаrts tо раin. By рrасtiсing this роse, оne will eventuаlly
be аble tо turn the neсk mоre withоut раin. Аlsо, the рrосess оf twisting shоuld be
dоne аs slоwly аs роssible.
It stretсhes the uррer сhest аnd shоulders аnd саn relieve shоulder раin.
It energizes the nervоus system аnd releаses stress аnd аnxiety.
Seаted Eаgle Роse оr the seаted Gаrudаsаnа орens uр the jоints in the аrms аnd
shоulders. In Sаnskrit, Gаrudа is the nаme оf the eаgle whiсh is the vehiсle оf Lоrd
Vishnu.
Benefits:
Seаted Eаgle Роse stretсhes the jоints оf the wrists, elbоws аnd shоulders.
Imрrоves the роsture оf the uррer trunk.
Remоves stress frоm the shоulders аnd the lоwer neсk regiоn.
It орens uр the shоulders аnd сhest.
It can imрrоve the sense оf bаlаnсe.
Need of this study: There is lack of literature to study the effectiveness of yoga on non-
specific neck pain in IT Professionals during work from home.
OBJECTIVE:
This study aims to quantitatively summarize the efficiency of yoga for treating nonspecific
neck pain in IT professionals working from home. This analysis will be based on an original
study that will be conducted to investigate the physical effects of a 4-week yoga course on
non-specific neck pain and will be compared with physical effects of home exercise protocol
(hot pack + upper trapezius stretching+ chin tucks + isometric exercises).This secondary
analysis uses statistical method to investigate the individual trajectories of pain intensity in
participants before, and after the yoga and home exercise protocol (hot pack + upper
trapezius stretching + chin tucks + isometric exercises) course.
RESEARCH HYPOTHESIS
1. Rajib Chandra Sarkar, et al has performed a study on the topic upper extremity
musculoskeletal pain among young adult computer users with the aim of this study
was to determine the prevalence and factors associated with upper extremity
musculoskeletal pain among young adult computer users. The conclusion of the study
showed that the upper extremity musculoskeletal pain is now a growing concern for
all professions even students due to long time use of computer. Factors related for the
development of these symptoms and also agronomical factors should be modified.
3. Cecily smith stated that the effects of an ergonomic workstation intervention and
exercise on office workers with neck pain. The aim of this study was to evaluate the
short-term efficacy of individual computer workstation ergonomic adjustments, with
the addition of a computer-based neck exercise programme. The conclusion of the
study was that the individual ergonomic workstation adjustments are able to
significantly reduce the neck pain disability index score of office workers
complaining of Grade I/II neck pain. The addition of a computer based neck exercise
programme is able to add significant improvements to this population group.
4. Maryam Shabbir, et al has performed a study on Frequency of neck and shoulder pain
and use of adjustable computer workstation among bankers, the main objective of this
study was to find the frequency of neck and shoulder pain and use of adjustable
computer workstation among bankers of Islamabad/Rawalpindi/Multan. The main
conclusion of this study was that neck and shoulder pain are common occurrences
among bankers. Most of the components of workstations of bankers were adjustable
but some of them still need attention. As adjustability does not necessarily indicate a
reduction in musculoskeletal pain, therefore there is a need for further in-depth
ergonomic analysis and introduction of ergonomically approved workstations to the
bankers in order to minimize the occurrence of neck and shoulder pain and improving
their productivity at work.
5. Emily R. Howell stated on the association between neck pain, the Neck Disability
Index and cervical ranges of motion. The main objective was to review the literature
to determine how the NDI is associated with neck pain and cervical range of motion
outcomes. This review outlines the strength of the NDI as a self-reported neck
disability questionnaire, but also demonstrates a need for further research to explore
the association between the NDI, neck pain and cervical ranges of motion.
7. Pieter Coenen, et al performed a study on Associations of screen work with neck and
upper extremity symptoms with the aim is to systematically review the association of
exposure to screen work with neck and upper extremity symptoms from prospective
studies. Studies were synthesized regarding extracted data and risk of bias, and meta-
analysis were conducted. They have found an increased risk of musculoskeletal
symptoms with screen work. However, the evidence is heterogeneous, and it is
striking that it lacks information from contemporary screen work using laptop,
notebook or tablet computers.
8. Bart N Green stated on the neck pain associated with computer use: public health
implication. Prolonged use of computers during daily work activities and recreation is
often cited as a cause of neck pain. This review of the literature identifies public
health aspects of neck pain as associated with computer use. While some retrospective
studies support the hypothesis that frequent computer operation is associated with
neck pain, few prospective studies reveal causal relationships. is a common problem
for office computer workers, especially since an upward trend for computers use can
be seen each year. Today, a large number of people use computers for work and
recreation, taking up a great deal of their time each day. Primary prevention strategies
have largely been confined to addressing
9. Environmental exposure to ergonomic risk factors, since to date, no clear cause for
this work-related neck pain has been acknowledged.
10. Andrew Shashi Reggie, et al has performed a study on the topic prevalence of neck
pain among desktop and laptop computer users in university staff and students with
the main objective of this study is to find out the prevalence of neck pain among
desktop and laptop computer users in both university staff and students. A cross
sectional study was performed in Manipal university campus, India by distributing
questionnaires to 328 computer users aged between 19 and 50 years. 110 of them are
desktop users and the remaining 218 are laptop users. The results show that
prevalence of neck pain is high in laptop users compared to desktop users. The
prevalence of neck pain is more in laptop users at the very young age, the reasons
being use of awkward positions or postures.
11. J H Andersen, et al did a detailed study on Computer mouse use predicts acute pain
but not prolonged or chronic pain in the neck and shoulder. This study assessed the
risk of neck and shoulder pain associated with objectively recorded professional
computer use. Objectively measured mouse and keyboard activities were positively
associated with acute neck and shoulder pain but were not associated with prolonged
or chronic neck and shoulder pain. The result showed that the risk for acute neck pain
and shoulder pain increased linearly by 4% and 10%, respectively. Mouse and
keyboard usage time did not predict the onset of prolonged or chronic pain in the neck
or shoulder. Women had higher risks for neck and shoulder pain. A few psychosocial
factors predicted the risk of prolonged pain. Most computer workers have no or minor
neck and shoulder pain complaints, few experience prolonged pain, and even fewer,
chronic neck and shoulder pain.
SELECTION CRITERIA
The subjects were included in the study considering the following criteria:
Inclusion criteria:
Exclusion Criteria:
INSTRUMENTS REQUIRED:-
1. Survey form
2. Neck Disability Index
3. Numerical Pain Rating Scale
PROCEDURE:-
Randomly patients were divided into 2 groups one group was asked to follow Home
Exercise protocol and the other group was asked to follow Yoga asana.
The selected indiviauls based on the inclusion were connected by a video call and all
necessary instructions were given to them which they need to follow and also we
provide them either with certain home exercises of neck or yoga asanas.
We adviced the subjects to follow all the instructions given for 30 days and we also
adviced them to stop practicing all other measures which they were performing
before.
Some ergonical principles and guidelines were prescribed to IT workers which they
need to follow :-
o Creating work space :- Identify the space in your home with a desk or table
that can be used for computers or laptops; avoid working while sitting on a
bed or sofa for long durations of time. Use a different monitor, keyboard and
mouse; if you are using a laptop place it on some stand or you can also use
some books. Use a chair which will support the lower back and aslo use seated
cushion; if using a kitchen or dining chair insert a seat cushion and also put a
soft towel or blanket by rolling it up and then place in your lower back area.
o Use apmle or sufficient natural lighting :- Create the work area with as
much as natural lighting (sun) as possible. Don’t create your working area in a
dark corner, but instead of this use good lighting (like in your office space) to
improve your performance. Use study lamps where needed. The monitor
screen should be the brightest thing in the entire working space.
o Drink plenty of water and take regular intervals throughout your
day :- Drinking water continously throughout the day is very important. Take
movement or breaks every half an hour while working and change postures
when starting to feel fatigue or any tiredness. Try finding ways to stand in
between and do alternate job or doing some other work for short period of
time.
o Work in a neutral posture :- Maintaing a proper posture throughot the day
and especially during work is neccesary. Working too long with a “C” curve in
back can cause strain. Keeping the proper alignment of neck, hand and wrist is
also very important.
o Reduce excessive motion :- Repetitive motion during work needs to be
avoided. Repetitive motion can cause disorder and numbness in the long run.
o Move, exercise and stretch :- Move and perform stretching exercise
whenever possible.It is better to take intervals between the work and perform
stretching and also move your body.
o Provide clearance :- Place where you are working in your home should have
proper and adequate height such that head should not be bend or tilted due to
insufficient height when kept upright while sitting or standing.
* Patient was asked to perform all these 4 asana continuously and then repeat this cycle 2
times and perform it twice a day.
* Patient was asked to follow the above entioned protocol and repeat it twice a day.
Precautions advised to the patient:
CHAPTER 4
Observation of various variables BEFORE advising treatment protocol.
Name Age: Gender Number of What you use, during NPRS NDI
working your working hour score
hours?
Mansi 21 Female 8 Chair 4 16%
Shreya gupta 26 Female 8 Bed 3 22%
Harshwardha 26 Male 8 Bed 3 12%
n Yadav
Akhil 29 Male 9 Couch 3 16%
Nikhil 25 Male 9 Chair 2 8%
Sharma
Garry sandhu 26 Male 7 Chair 4 18%
Karan aujla 24 Male 9 Couch 2 8%
Ranveer 28 Male 7 Couch 3 14%
Arora
Himani 27 Female 9 Bed 2 24%
malhotra
sumit Jaiswal 29 Male 6 Couch 3 10%
Alfaaz 32 Male 9 Couch 3 16%
rehman
Pankaj 25 Male 7 Bed 2 16%
sharma
Ankur singh 26 Male 6 Chair 3 14%
Kapil dhingra 28 Male 7 Couch 3 38%
chandan 28 Male 8 Couch 2 20%
maurya
Arijit gupta 29 Male 8 Couch 3 14%
Nitin jangia 23 Male 7 Bed 4 30%
Ritwik 25 Male 7 Chair 2 12%
phukan
Pravesh arora 28 Male 9 Couch 3 24%
Shraddha 26 Female 9 Couch 2 22%
sharma
MEAN 26.55 7.85 2.8 18%
STANDARD 2.459 1.039 0.695 0.074
DEVIATION
DATA ANALYSIS
Data was compiled and exported to Microsoft excel for analysis. The data collected was
arranged for comparison of pre and post results of treatment protocol on neck pain and 4
weeks which was analysed using descriptive statistics. Descriptive statistics was checked
using mean and SD. The results were analysed pre and post technique by using paired and
unpaired t test. The p=<0.05 was taken as the level of significance for checking the
significant differences in means. Data analysis was done by Microsoft Excel.
A total of 40 subjects were taken. Analysis is done on the basis of data collected after 4
weeks of performing the prescribed treatment protocol.
RESULTS:
Table 4 shows all the values before we advised them the treatment protocol (pre sample).
TOTAL
TOTAL
After analysing their pain and all other essential details we sent the treatment protocol to the
sample and advised them to follow the exact same protocol for 4 weeks. We advised them the
treatment protocol via video calls. After 4 weeks we again sent them the different
questionnaire and we asked them to fill it and when we got the details, we started analysing it
and then calculated the mean and standard deviation.
The result which we found has been concluded in Table 5 below.
Table 5 shows all the values after we advised them the treatment protocol.
TOTAL
TOTAL
Table 6 Showing difference in mean and standard deviation between before and after giving
the treatment protocol.
GENDER
25%
75%
MALE FEMALE
COUCH
28%
Fig. 2 shows Ratio of working platform if they work on couch, chair or bed.
6
543%
4
355%
3 280%
0.93 1.05
1 0.695 0.657
30% 18% 16%
0.122 0.074
0
NPR NDI NPR NDI NPR NDI
MEAN STDEV
Fig 3. clearly shows the difference between the mean and standard deviation of pain in
neck and qualityof life before and after the treatment protocol. It also compares the mean
and standard deviation between yoga asanas and physiotherapy protocol.
UNPAIRED T TEST: