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 housewives

Yes 68
No 32

8%

Physiotherapy treatment
Not having Physiotherapy
treatment

92%

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 housewives
Neck 13
Upper back 8
Lower back 19
Shoulder 8
Elbow 5
Wrist 3
Finger 5
Hip 0
Knee 18
Ankle 3
Foot 5
Heel 13

19% Yoga
29%
Brisk Walking
Pranayam
Gym
16%

36%

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 housewives
20-30 20
31-40 45
41-50 35

19% Yoga
29% Brisk Walking
Pranayam
Gym

16%

36%

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 housewives

Yes 77
No 23

8%

Physiotherapy treatment
Not having Physiotherapy
treatment

92%

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 housewives

Sweeping 12
Mopping 7
Washing 13
Cooking 18
Wringing 8
Drying 12
Ironing 11
Market shopping 19

19%
29%
Yoga
Brisk Walking
Pranayam
16%
Gym

36%

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

19%
29%
Yoga
Brisk Walking
Pranayam
16% Gym

36%

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

19%
29%
Yoga
Brisk Walking
Pranayam
16% Gym

36%

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

19% Yoga
29% Brisk Walking
Pranayam
Gym

16%

36%

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%

Physiotherapy treatment
Not having Physiotherapy
treatment

92%

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

19%
29%
Yoga
Brisk Walking
Pranayam
16% Gym

36%

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%

Physiotherapy treatment
Not having Physiotherapy
treatment

92%

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 BMI Type DH Type Pai Site Typ Nature Age
e n
S M W C W D Ir M Y/ S W M C Y/N e
N U L S E W F H K A Ft HI In D T SS Th Wrk
1 40 17.1 1 1 1 1 1 1 Y 1 Y 1 1 1 1 1 1 1 1 1 1 1
2 31 21.6 1 1 1 Y 1 N
3 43 2279 1 1 Y 1 Y 1 1 1 1
4 48 30.2 1 1 1 1 Y 1 Y 1 1 1 1 1 1
5 41 33.3 1 Y 1 Y 1 1 1
6 32 29.7 1 1 1 Y Y 1 1 1
7 34 21.4 1 1 Y 1 Y 1 1
8 30 22.7 1 1 Y 1 N
9 41 24.8 1 Y 1 N
10 39 17.0 1 1 1 1 1 N Y 1 1 1 1 1 1
11 38 30.2 1 Y 1 1 N 1
12 31 21.6 1 1 1 1 1 N Y 1 1 1 1 1
13 29 22.7 1 1 Y 1 N
14 30 19.0 1 1 1 N Y 1 1 1 1 1
15 45 24.2 1 1 Y N 1 1 1 1 1 1 1
16 41 17.1 1 1 Y Y 1 1 1 1 1 1 1
17 50 24.4 1 1 Y N 1
18 43 23.1 1 1 1 Y Y 1 1 1
19 26 24.4 1 1 1 1 1 Y N
20 35 21.4 1 1 1 Y N
21 32 17.7 1 1 1 1 1 Y Y 1 1 1 1 1
22 45 24.3 1 1 1 Y Y 1 1 1 1
23 48 16.6 1 1 1 Y Y 1 1 1 1 1
24 31 21.6 1 1 N N 1
25 39 17.1 1 1 1 1 1 N Y 1 1 1 1 1 1
26 29 22.7 1 1 1 1 N N
27 41 24.9 1 1 Y Y 1 1 1
28 45 24.3 1 1 Y N
29 46 33.1 1 1 Y Y 1 1 1 1 1 1
30 37 20.1 1 1 1 1 Y Y 1 1 1 1 1
31 32 31.6 1 1 Y Y 1 1 1
32 29 19.2 1 1 1 Y Y 1 1 1 1
33 32 25 1 1 1 1 1 1 N Y 1 1 1 1 1
34 36 31.1 1 1 1 Y Y 1 1
35 42 23.0 1 1 Y N
36 33 28.1 1 Y 1 N
37 40 19.1 1 1 1 Y Y 1 1 1
38 31 19.1 1 1 1 Y 1 N 1 1
39 30 25.7 1 1 1 N Y 1 1
40 33 26.8 1 1 1 1 1 1 1 N Y 1 1 1 1 1 1
3
Relieving VA Systemic illness Me Ex Type Pth Type
S d
R Mg Md HF D HT RP OA RA Dy Y/N Y/ Yg B Py Gy Y/ EX Mod
M N N W N
1 1 1 1 5 1 Y Y 1 Y 1
N Y 1 N
1 2 N N N
1 1 5 1 Y N 1 1 N
1 5 1 N N N
1 3 N N 1 N
2 1 N Y 1 N
N Y 1 1 N
1 Y Y 1 1 N
1 1 4 N N N
2 1 N N N
2 N N N
4 N Y 1 N
1 5 N N N
1 6 1 N Y 1 N
1 1 1 1 1 Y Y 1 N
5 1 Y Y 1 1 1 N
1 N Y 1 N 1
N Y N 1
8 1 N N 1 Y 1
1 2 N N Y
1 7 Y N N
1 1 1 Y Y 1 N
7 N Y 1 N
1 N Y 1 N
4 N Y 1 1 N
N N N
3 N N N
5 1 Y N N
4 N N N
3 N N N
1 6 N N N
4 1 N Y 1 1 N
1 1 N N N
1 N N N
5 N N N
1 N Y 1 1 N
4 1 N Y 1 1 N
1 7 N N N
1 1 N Y 1 1 N