INDEX

Introduction

Aims and Objectives

Method and Methodology

graphs

Discussion

Job description

Hazard Prevention and control

Pit falls and Improvement

Conclusion

Questionnaire

Master Chart

INTRODUCTION

A woman plays the central role in home making. She builds the entire

household but ends up neglecting her own health by not paying enough

attention to herself and her fitness.

In an Indian setup, the Indian housewife may suffer from a variety of

musculoskeletal problems but fail to take any substantial treatment for the

same.

Being brought up in such a community I would like to attribute these

problems to the work that these housewives have to do as physiotherapists

we are aware that if such problems are dealt with accurately then most of

them could be avoided.

Thus, my aim with this study is to find out incidence of musculoskeletal

problems in housewives mainly in Indian scenario.

AIMS AND OBJECTIVES

Aims:

To find out incidence of musculoskeletal problems in housewives.

Objectives:

To find out no. of housewives having musculoskeletal problems.

To find out commonly involved joints and structures.

To design possible solutions.

METHOD AND METHODOLOGY

Method

A questionnaire was prepared containing 20 questions (Closed Ended

Questions)

Methodology

A questionnaire was given to housewives at different places. The questions

were self explanatory, self informative consisting of closed ended questions.

Few questions however were open ended to allow subjects to express views

regarding their problems.

The nature and purpose of the study was explained to them, verbal consent

was taken and they were asked to fill up the questionnaire. After obtaining

the data, master chart was prepared and then analyzed to obtain results.

GRAPH 1

1. Distribution of Housewives having musculoskeletal problems

Musculoskeletal problem % of housewivesYes 68No 32

8%

92%

Physiotherapy treatmentNot having Physiotherapy treatment

Above graph shows 68% of housewives are suffering from musculoskeletal

problems & 32% not having musculoskeletal problems.

GRAPH 2

1. Incidence of individual site of affection

Site % of housewivesNeck 13Upper back 8Lower back 19Shoulder 8Elbow 5Wrist 3Finger 5Hip 0Knee 18Ankle 3Foot 5Heel 13

29%

36%

16%

19%

YogaBrisk WalkingPranayamGym

Above graph shows 19% of housewives have pain at the low back, 18%

have pain at the knee & 13% have heel and neck pain.

GRAPH3

1. Age wise affected subjects

Age % of housewives20-30 2031-40 4541-50 35

29%

36%

16%

19%

YogaBrisk WalkingPranayam

As the above graph shows 45% of housewives are in the age group of 31-

40yrs, 35% are in the age group of 41-50yrs and 20% are from 20-30.

GRAPH 4

1. Distribution of housewives having Domestic help

Domestic help % of housewivesYes 77No 23

8%

92%

Physiotherapy treatmentNot having Physiotherapy treatment

Above graph shows 77% housewives having domestic help and 23% do not

having domestic help.

GRAPH 5

1. Type of work the housewives have to do

Type of work % of housewivesSweeping 12Mopping 7Washing 13Cooking 18Wringing 8Drying 12Ironing 11Market shopping 19

29%

36%

16%

19%

YogaBrisk WalkingPranayamGym

As the above graphs shows 19% of housewives do market shopping, 18% do

cooking, 13% do washing, 12% do sweeping & drying, 11% do ironing, 8%

do wringing and 7% do mopping type of work.

GRAPH 6

1. Nature of Pain

Nature % of housewives

Dull aching 68

Tingling Numbness 0

Sharp Shooting 28

Throbbing 4

29%

36%

16%

19%

YogaBrisk WalkingPranayamGym

As the above graph shows 68% of housewives have dull aching type of pain,

28% have sharp shooting & 4% have throbbing type of pain.

GRAPH 7

1. Relieving factors

Reliving factors % of housewives

Rest 41

Massage 20

Medication 27

Hot pack 12

29%

36%

16%

19%

YogaBrisk WalkingPranayamGym

Above graph shows 41% of housewives get relief by rest and 27% of

housewives get relief by medication (pain killers), 20% get relief by

massage and 12% get relief with hot packs.

GRAPH 8

1. Distribution of housewives on severity of pain

VAS % of housewives

1 to 3 mild 28

4 to 7 mod 68

8 to 10 severe 4

29%

36%

16%

19%

YogaBrisk WalkingPranayam

Above graph shows 68% of housewives have moderate pain, 28% have mild

pain & 4% have severe pain.

GRAPH 9

1. Distribution of housewives regularly exercising

Exercise % of housewives

Yes 19

No 18

8%

92%

Physiotherapy treatmentNot having Physiotherapy treatment

As above graph shows 51% of housewives are regularly exercise & 49% are

not exercising.

GRAPH 10

1. Type of exercise

Type of exercise % of housewives

Yoga 29

Brisk Walking 36

Pranayam 16

Gym 19

29%

36%

16%

19%

YogaBrisk WalkingPranayamGym

As the above graph shows 36% of housewives do brisk walking, 29% do

yoga, 19% go to the gym & 16% of housewives do Pranayam as exercise.

GRAPH 11

1. Distribution of housewives taking physiotherapy treatment

Physiotherapy treatment % of housewives

Yes 8

No 92

8%

92%

Physiotherapy treatmentNot having Physiotherapy treatment

As above graph shows 92% of housewives do not take any physiotherapy

treatment and 8% take physiotherapy treatment.

DISCUSSION

The study suggests that most of the housewives are having musculoskeletal

problems i.e. 68% housewives. (GRAPH 1)

As their job demands long hours of standing and bending work, the most

common problems seen are in the low back (19%) and knee (18%) (GRAPH

2) In prolonged standing, individual may attain a slouched posture leading to

decreased flexibility in upper abdominals, internal intercostals, hip

extensors, narrowing of IVF in lower lumbar spine, compressed blood

vessels thus leading to lack of blood supply to muscles in turn causing

fatigue and ultimately low back pain (Carolyn Kisner, hynn Allen Colby,

JAYPEE2002, 4S edition)

About 45%o of housewives are from the age group of 31-40yrs. (GRAPH 3)

This age group is more vulnerable for acute or sub acute pain to be

converting in to chronic due to the coming years of menopause which causes

wear and tear changes in the joints along with decrease in calcium in bones.

About 77% of housewives have domestic help. (GRAPH 4)

All the housewives having pain had intermittent type of pain and if proper

measures are not taken in early stages then it may progress to chronic type.

About 19% of housewives do market shopping and 18% do cooking.

(GRAPH 5)

About 68%) of housewives have dull aching nature of pain and 28% have

sharp shooting nature of pain (GRAPH 6) for which 41% of housewives take

rest and 27% take medications, mainly pain killers, whereas 20% prefer

massage & 12% take hot pack for relief of pain. (GRAPH 7)

About 68%) have pain in the moderate range and 28% have pain in the mild

range. (GRAPH 8)

About 51% of housewives do exercise but still have musculoskeletal

problems. This could be because of faulty posture for prolonged period or

incorrect exercising techniques. (GRAPH 9)

As an exercise routine 36% of the housewives do brisk walking. (GRAPH

10)

About 92%) of housewives do not take any physiotherapy treatment for their

musculoskeletal problems which suggests that there is very minimal

awareness of physiotherapy treatment in them. (GRAPH 11)

JOB DISCRIPTION:-

Long working hours involving more physical activities like sweeping,

wiping, cleaning, washing, repetitive bending, lifting weight and prolonged

standing.

JOB DEMAND:-

Good musculoskeletal and cardiopulmonary endurance.

Good muscular strength.

Multitasking.

Optimistic attitudes.

Mental stress.

Time management.

TASKANALYSIS:-

The job description suggests that the job necessitates

Cervical and lumbar spine flexions- extension.

Spinal rotations.

Hip flexion- extensions.

Knee flexion-extensions.

Shoulder flexion, abduction, elevation.

Elbow flexion-extension.

Complex hand function.

WORK SITE ANALYSIS:-

Working at various heights.

Activities like pulling, pushing.

Ventilation of room.

Intellectual task demands.

Exposure to various machines. (Food processors, washing machines, iron, telephone etc.)

HAZARD PREVENTION AND CONTROL

This is best achieved through ergonomic advice, since disorders are

problems and ergonomics is the solution.

Ergonomics is the science of fitting work place conditions and job demand

to the capability of the worker.

The ERGONOMIC PROGRAMME should be designed keeping in mind the

ergonomic principles

1) WORKING AT PROPER HEIGHTS:

Normally work should be done at elbow height, and lighter work above

elbow height. This helps maintaining the body in a natural posture and also

reduces stress on spine and knee. e.g. using brooms and floor wiper with

adjustable heights for cleaning.

: To vacuum, use a "fencer's stance." Put all your weight on one foot, then

step forward and back with the other foot as you push the vacuum forward

and back. Use the back foot as a pivot when you turn.

2) WORK AT PROPER POSTURES-.

Working in awkward postures physical stress and reduces strength. Placing

the body in optimal postures increases productivity and prevents injury.

E.g. When you wash dishes, open the cabinet beneath the sink, bend one

knee and put your foot on the shelf under the sink or on a small stool.

Lean against the counter so some of your weight is supported in front.

: When ironing, raise one foot a bit places it on a small stool to take some

strain off your aback.

3) REDUCE EXCESSIVE FORCES:

Excessive forces load the muscles cresting fatigue and potential for injury.

E.g. use power grips instead of pinch grips.

: Bend from the knee, not the waist. As you lift, hold the items as close to

your body as possible. If you have turn to place it, step in the direction of the

turn. That way, you are not twisting your body and straining your spine.

4) MINIMISE FATIGUE:

Overloading a person's capabilities contributes to overuse injuries, accidents,

poor quality and cost productivity. Good task design help to prevent

undesirable fatigue along with maximizing efficiency.

a) Minimizing Static Loading

E.g. Avoiding holding objects for long time. : change postures

frequently

b) Minimizing Metabolic Loading

To reduce overall exertion levels E.g.: Take frequent rest breaks.

: Intensity and duration of physical efforts should be limited

throughout the day.

5) REDUCE EXCESSIVE REPETIONS:

Excessive repetitions create wear and tear injuries to sensitive tissues and

joints. E.g.: use food processors instead of grinding manually. : use electrical

chopper instead of cutting manually.

6) MINIMISE CONTACT STRESS:

Since in addition to being uncomfortable it can inhibit nerve function and

blood flow.

E. g.: to prevent fatigue in low back and leg due to prolonged standing on

hard surfaces, use of cushioned insoles and soft footwear.

7) TROVIDE MOBILITY AND CHANGE OF POSTURE:

There is no single correct posture best for an entire work day. The body

needs postural change and mobility.

E.g.: alternate between sitting and standing.

8) TIME MANAGEMENT:

One should plan for hours of day to the task to be covered in proper manner

and remember to keep some spare time if more time required for a specific

task than planned. This will help to reduce mental stress. One can make

similar timetable for a week or month as per requirement.

OTHER POINTS TO BE CONSIDERED ARE:

a. Avoid hyper extending the neck or being in a forward head posture or

forward bent position for prolonged period.

b. Use firm mattress for sleeping purpose to prevent any extreme

stresses.

c. Pillow should be comfortable height and density to promote

relaxation.

d. If in tension producing situation, perform conscious relaxation

exercises.

e. Review the relationship of posture and pain; when experiencing pain,

check posture.

f. While talking on the phone, don't cradle the phone between your ear

and shoulder. That can lock up the spinal joints in the neck and upper

back, and cause pain. Instead, hold phone with your hand or use the

speakerphone.

g. While watching television or relaxing, don't use the sofa arm as a

pillow. The angle is much too sharp for your neck.

h. Use the cold pack if your back begins to hurt. Wrap an ice pack in a

towel moistened with warm water. The warmth gives way to gradual

cold, which likely will alleviate the discomfort.

i. If pain persists for more than a day or two or if you experience

numbness, tingling or weaknesses in your arms or legs, see a doctor.

PIT FALLS:

Small sample size.

No follow up to determine the effectiveness of the designed

ergonomic programme in concern with reducing the musculoskeletal

problems.

IMPOROVEMENT:

Large sample size.

Follow up to determine the effectiveness of the designed ergonomic

programme.

By a control group without any intervention compare the study with

the study group with long duration of study.

CONCLUSION

About 68% of housewives are suffering from musculoskeletal

problems.

The incidence is more in the age group of 31-40yrs i.e. 45%

The incidence of pain is highest in low back (19%) followed by knee

(18%), neck and heel (13%)

The incidence of musculoskeletal problems is almost same in

exercising and non exercising housewives.

BIBILOGRAPHY

1. Joint structure & Function - A Comprehensive Analysis - Pamela K.

Levengie -Cynthia Norkins

2. The Physiology of Joint -1. A. Kapanji

3. www.google.com Journal of Back & musculoskeletal rehabilitation

vol. 20, Nol-2007

4. Occupational therapy - Practice Skills - Corrain Willams

5. www.lib.bioinfo.pl/meid:211785 A research paper on risk assessment

of biomechanical loading during housework.

6. www.timeswellness.com/index.aspx?

Page=article&sectname=Bodv&sectid=l&conte

ntid=20070915200709151115278281dl88d35

Housewives in particular need to pay attention while working in the kitchen

and cleaning around the house. The average Indian countertop is around 30

inches high, which is either too high or too low for most housewives. The

result is excessive strain on the knees and back, resulting in arthritis and

backaches. Also, while cleaning the house, excessive strain is put on the

knee joint, again leading to arthritis.

Musculoskeletal problems in housewives

Name:

Age:

Add:

Wt: kg Ht: cm

BMI: kg/cm2

1. Type of work

a. Sweeping

b. Mopping

c. Washing

d. Cooking

e. Wringing

f. Drying

g. Ironing

h. Market Shopping

2. Do you have any domestic help? Yes/No

3. For what type of work?

4. Do you have any pain Yes/No

5. Site of pain

a) Neck

b) Upper back

c) Lower back

d) Shoulder

e) Elbow

f) Wrist

g) Fingers

h) Hip Knee

i) Ankle

j) Foot

k) Heel

6. Type of pain

a. Continuous

b. Intermittent

7. Nature of pain

a. Dull aching

b. Tingling numbness

c. Sharp shooting

d. Throbbing

8. Aggravating factors

9. Relieving factors

a. Rest

b. Massage

c. Medication

d. Hot packs

10. Visual analogue scale

11.Do you attribute your pain to any particular cause?

12.Do you have any children? Yes/No

13.How many?

14.Do you have any systemic illness?

a. Diabetes

b. Hypertension

c. Respiratory Condition

d. Osteoarthritis

e. Tuberculosis

f. Previous trauma

g. Cardiac condition

h. Rheumatoid arthritis

i. Dysmenorreah.

15. Are you on regular medications for the same? Yes/No

16. Do you exercise? Yes/No

17. What kind?

a. Yoga

b. Brisk walking

c. Pranayam

d. Gym

18. For how long?

19. Have you taken any physiotherapy treatment? Yes/No

20. What kind?

a. Exercise

b. Modalities

Ag

e

BMI Type DH Type Pai

n

Site Typ

e

Nature Age

S M W C W D Ir M Y/ S W M C Y/N N U L S E W F H K A Ft HI In D T SS Th Wrk1 40 17.1 1 1 1 1 1 1 Y 1 Y 1 1 1 1 1 1 1 1 1 1 12 31 21.6 1 1 1 Y 1 N3 43 2279 1 1 Y 1 Y 1 1 1 14 48 30.2 1 1 1 1 Y 1 Y 1 1 1 1 1 15 41 33.3 1 Y 1 Y 1 1 16 32 29.7 1 1 1 Y Y 1 1 17 34 21.4 1 1 Y 1 Y 1 18 30 22.7 1 1 Y 1 N9 41 24.8 1 Y 1 N10 39 17.0 1 1 1 1 1 N Y 1 1 1 1 1 111 38 30.2 1 Y 1 1 N 112 31 21.6 1 1 1 1 1 N Y 1 1 1 1 113 29 22.7 1 1 Y 1 N14 30 19.0 1 1 1 N Y 1 1 1 1 115 45 24.2 1 1 Y N 1 1 1 1 1 1 116 41 17.1 1 1 Y Y 1 1 1 1 1 1 117 50 24.4 1 1 Y N 118 43 23.1 1 1 1 Y Y 1 1 119 26 24.4 1 1 1 1 1 Y N20 35 21.4 1 1 1 Y N21 32 17.7 1 1 1 1 1 Y Y 1 1 1 1 122 45 24.3 1 1 1 Y Y 1 1 1 123 48 16.6 1 1 1 Y Y 1 1 1 1 124 31 21.6 1 1 N N 125 39 17.1 1 1 1 1 1 N Y 1 1 1 1 1 126 29 22.7 1 1 1 1 N N27 41 24.9 1 1 Y Y 1 1 128 45 24.3 1 1 Y N29 46 33.1 1 1 Y Y 1 1 1 1 1 130 37 20.1 1 1 1 1 Y Y 1 1 1 1 131 32 31.6 1 1 Y Y 1 1 132 29 19.2 1 1 1 Y Y 1 1 1 133 32 25 1 1 1 1 1 1 N Y 1 1 1 1 134 36 31.1 1 1 1 Y Y 1 135 42 23.0 1 1 Y N36 33 28.1 1 Y 1 N37 40 19.1 1 1 1 Y Y 1 1 138 31 19.1 1 1 1 Y 1 N 1 139 30 25.7 1 1 1 N Y 1 140 33 26.8

3

1 1 1 1 1 1 1 N Y 1 1 1 1 1 1

Relieving VAS

Systemic illness Med

Ex Type Pth Type

R Mg Md HF DM

HTN

RP OA RA Dy Y/N Y/N

Yg BW

Py Gy Y/N

EX Mod

1 1 1 1 5 1 Y Y 1 Y 1N Y 1 N

1 2 N N N1 1 5 1 Y N 1 1 N

1 5 1 N N N1 3 N N 1 N

2 1 N Y 1 NN Y 1 1 N

1 Y Y 1 1 N1 1 4 N N N

2 1 N N N2 N N N4 N Y 1 N

1 5 N N N1 6 1 N Y 1 N

1 1 1 1 1 Y Y 1 N5 1 Y Y 1 1 1 N

1 N Y 1 N 1N Y N 1

8 1 N N 1 Y 11 2 N N Y1 7 Y N N1 1 1 Y Y 1 N

7 N Y 1 N1 N Y 1 N

4 N Y 1 1 NN N N

3 N N N5 1 Y N N4 N N N3 N N N

1 6 N N N4 1 N Y 1 1 N

1 1 N N N1 N N N

5 N N N1 N Y 1 1 N

4 1 N Y 1 1 N1 7 N N N1 1 N Y 1 1 N