RESEARCH PROPOSAL

KNOWLEDGE, ATTITUDE TOWARDS LOW BACK PAIN AND ITS OCCURRENCE AMONG PRE-UNIVERSITY COLLEGE STUDENTS IN URBAN MANGALORE-A SURVEY.

MASTER OF PHYSIOTHERAPY IN MUSCULOSKELETAL DISORDERS AND SPORTS (MPT-MSS)

MS. MICHELLE EMELIA LOBO.

DEPARTMENT OF PHYSIOTHERAPY

FATHERMULLERMEDICALCOLLEGE

MANGALORE-575002

RajivGandhiUniversity of Health Sciences, Karnataka

Bangalore

ANNEXURE II

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. / NAME OF THE CANDIDATE AND ADDRESS / MS.MICHELLE EMELIA LOBO
DEPARTMENT OF PHYSIOTHERAPY,
FATHERMULLERMEDICALCOLLEGE,
MANGALORE-575002
2. / NAME OF THE INSTITUTION / FATHERMULLERMEDICALCOLLEGE,
MANGALORE (DEPARTMENT OF PHYSIOTHERAPY)
3. / COURSE OF STUDY AND SUBJECT / MASTER OF PHYSIOTHERAPY
(MUSCULOSKELETAL AND SPORTS PHYSIOTHERAPY)
4. / DATE OF ADMISSION TO THE COURSE / 26-06-2009
5. / TITLE OF THE TOPIC:
KNOWLEDGE, ATTITUDE TOWARDS LOW BACK PAIN AND ITS OCCURRENCE AMONG PRE-UNIVERSITY COLLEGE STUDENTS IN URBAN MANGALORE-A SURVEY.
6.
7.
8. / Brief resume of the intended work:
6.1 Need for the study
Low back pain has been recognized as a common condition that affects public health in adults and adolescents. Adolescent back pain is a worldwide concern. In India nearly 60% of the population has significant low back pain at some point in life 1. Many studies have reported that there is a high rate of occurrence of low back pain in a young population2,3,4,5. In a study done on Danish population it showed that most of the individuals experience back pain before the age of 20 yrs 6 and lifetime incidence being significant in 15 yrs and above in the united kingdom2.
It is likely that young people, in the phase of physical and mental development, are more susceptible to the influence of toxic substances like smoking, depression, stress, anxiety and these factors have been found to be associated with low back pain 6,7. One of the main reasons for stress in the Pre University College(PUC) students is concerning academic issues. Such psychological issues can play a role in the etiology of pain7.
Easy access to technology also poses a potential risk to the development of low back pain in adolescents as the time spent browsing internet, playing digital games, viewing television has markedly increased as a leisure time activity 8.
Height growth is an alleged risk factor for low-back pain (LBP) in early adolescence 9 . The age of growth spurt in Indian adolescents is at 14 yrs in boys and 12.5 yrs in girls 10 . So to state, the occurrence of low back pain in a wide age range will not be justified. For the purpose of grouping and to avoid mixed results, pre-university college students in urban area will be considered in this study who are in their late adolescence period.
A previous history and earlier onset is predictive and associated with back problems as adults. Early intervention before the onset of disease is the best method of prevention. So it is clear that if primary prevention or interventions at first onset are to become a reality, young populations have to be targeted 6,8.
Low back pain should be viewed as a medical disorder and it should receive the most beneficial care at optimal times but the problem in developing countries is the
ignorance to report for early treatment 11.Therefore adequate knowledge and a positive attitude towards low back pain is necessary for primary or secondary prevention. Since there is dearth of information regarding low back pain in a young age group in this region the aim of this study is to find the knowledge, attitude towards low back pain and its occurrence in PUC students.
Operational definition:
  1. Low Back Pain is defined as the pain localized between the 12th rib and the inferior gluteal folds, with or without leg pain 12.
  2. Occurrence in this study refers to the number pre-university college students having low back pain .
  3. Knowledge in this study refers to the amount of information about low back pain among the pre-university students in urban Mangalore .
  4. Attitude in this study refers to the behaviour towards low back pain among pre-university college students in urban Mangalore.
  5. Pre-University college (PUC) is an intermediate course of duration two years after standard 10, conducted by state education boards inIndia .
  6. Urban area is defined as
(a) all statutory places within a municipality, corporation, cantonment
board or notified town area committee etc.
(b) A place satisfying the following three criteria simultaneously,
  • A minimum population of 5,000;
  • At least 75 percent of male working population engaged in Nonagricultural pursuits .
  • And a density of population of at least 400 per sq km (1,000 per sq mile)14.
Research Question:
  1. What is the level of knowledge and attitude towards low back pain among pre-university college students in urban Mangalore?
  2. What is the occurrence of low back pain among pre-university college students in urban Mangalore?
  3. Is there an association between occurrence, knowledge and attitude towards low back pain among pre-university college students in urban Mangalore?
Hypothesis:
  1. There is aadequate knowledge and an favourable attitude towards low back pain among pre-university college students in urban Mangalore.
  2. There is a significant occurrence of low back pain among pre-university college students in urban Mangalore.
  3. There is association between occurrence, the level of knowledge and attitude towards low back pain among pre-university college students in urban Mangalore.
6.2 Review of literature:
Debbie Ehrmann Feldman and co workers 9reported that a previous history and earlier onset of low back pain are associated with chronic low back pain in adults,implying that prevention of back pain in youth may contribute to prevention of back pain in adulthood.
Ville M. Mattila and co workers 3have stated thatLow back pain (LBP) is common among adolescents and it has been estimated that one-fifth of adolescents suffer from recurrent severe LBP. They found daily smoking and poor success in school were some of the risk factors associated with low back pain in a cohort of 72,378 adolescents (57,408respondents, response rate 79%) aged 14–18 years.
Lise Hestbaek and colleagues 6 have reported that with more than half of the population experiencing low back pain (LBP) before the age of 20, research must focus on young populations. Lifestyle-factors might be important elements of prevention, since they are modifiable in nature.
Leboeuf-Yde C and co-workers 4conducted a cross-sectional study in a Danish population of individuals 12-41 years of age. Their study showed that by the ages of 18 years (girls) and 20 years (boys) more than 50% had experienced at least one low back pain episode. They concluded that prevention of low back pain needs to be focused on childhood and adolescence.
Ville M. Mattila and colleagues 15 reported that the roots of LBP lie in adolescence and early adulthood.
Khan MY and Siddiqui MA 5 studied the prevalence of low back pain in computer users and how different age groups behave under prolong sitting posture on axial loading against time. They proved in their study that Low back pain in computer users is more common in the younger age group (16-18 yrs) with a second surge (23-30 yrs).
6.3Objectives of the Study:
  1. To find out the knowledge and attitude towards low back pain among pre-university college students in urban Mangalore.
  2. To find out the occurrence of low back pain among pre-university college students in urban Mangalore.
  3. To find out the association between occurrence, the level of knowledge and attitude towards low back pain among pre-university college students in urban Mangalore.
Materials and methods:
7.1Source of data:
Subjects will be recruited from four co-education pre-university colleges in urban Mangalore.
7.2Methods of collection of data:
Study design:
A cross-sectional survey
Sample size and Sampling Procedure :
Four co-education pre-university colleges in urban Mangalore will be selected using multi-stage sampling technique. 600 students of both gender will be recruited from these four colleges using the stratified sampling technique.
Inclusion criteria:
  1. Co-educationPre-university college students in urban Mangalore.
  2. Both genders.
Methods:
The study will be conducted after obtaining ethical clearance and permission from the concerned authorities . Four pre-university colleges will be selected with multi-stage sampling technique. The students fulfilling the inclusion criteria will then be recruited using the stratified sampling technique, belonging to both genders and from all four colleges.A total of 600 students will be recruited for the study.
A self-administered questionnaire will be prepared and validated by experienced physiotherapy faculty of various institutions. The questionnaire will be designed to find out the occurrence, knowledge and attitude towards low back pain among pre-university college students in urban Mangalore. After validation the printed
questionnaire will be handed over to the students from four pre-university colleges in urban Mangalore which have been selected. A consent form will accompany each questionnaire. The collected data will be statistically analyzed.
Measurement Tools:
  1. Self-administered questionnaire.
Statistical Analysis:
Data collected will be analyzed using Mean, Median, Frequencies, Percentages, Standard deviations ,Chi square and Karl pearsons co-efficient.
7.3 Does the study require any investigation or intervention to be
Conducted on patients or animals?
No
7.4 Has ethical clearance been obtained from your institution in case of
7.3?
Yes
List of References:
  1. Koley S, Singh G ,Sandhu R. Severity of Disability in Elderly Patients with Low Back Pain in Amritsar, Punjab.Anthropologist 2008;10(4):265-268.
  2. Burton A.K, Clarke R.D, McClune T.D, Tillotson K.M. The natural history of low back pain in adolescents. Spine 1996October;21:2323-8.
  3. Mattila V.M, Saarni L, Parkkari J, Koivusilta L, Rimpelä . Predictors of low back pain hospitalization– A prospective follow-up of 57,408 adolescents.Journal of the International Association for the Study of Pain 2008 September 30. 139(1):209-217.
  4. Leboeuf-YdeC, Kyvik K. O, Videman T. At what age does low back pain become a common problem: A study of 29,424 individuals aged 12-41 years. Point of View. Spine 1998;23:228-234.
  5. Khan M.Y, Siddiqui M.A. Prevalence of Low Back Pain in Computer Users.Pak Journal Med Sci 2005June;21:159-63.
  6. Hestbaek L, Leboeuf-Yde C, Kyvik K.O. Are lifestyle-factors in adolescence predictors for adult low back pain? A cross-sectional and prospective study of young twins.BMC Musculoskeletal Disorders 2006March;7:1-8.
  7. Linton, Steven J. A Review of Psychological Risk Factors in Back andNeck Pain. Spine 2000;25( 9 ):1148-1156.
  8. Hakala P.T, Arja H. R, Lea A. S, Jouko J. S. Frequent computer-related activities increase the risk of neck–shoulder and low back pain in adolescents. Adolescent health2006;16: 536–541.
  9. Feldman D.E, Shrier I, Rossigno M, Abenhaim L.Risk Factors for the Development of Low Back Pain in Adolescence. American Journal of Epidemiology 2000November;154:30-36.
  10. Poussa M.S, Markku M.H, Jorma T.S,Mauno H.K, Kirsti A, Hurmerinta , Maunu J. N. Anthropometric measurements and growth as predictors of low-back pain: a cohort study of children followed up from the age of 11 to 22 years. European Spine Journal 2005 August;14:595-598.
  11. HauspieR.C, DasS.R, Preece M.A, Tanner J.M.A longitudinal study of the growth in height of boys and girls of West Bengal (India) aged six months to20 years. Annals of Human Biology1980;7( 5):429-440.
  12. Sharma S.C, Singh R, Sharma A.K, Mittal R.Incidence of low back pain in workage adults in rural North India.Indian J Med Sci 2003;57:145-7.
  13. Krismer M., Tulder M.V. Low back pain (non-specific). Best Practice & Research Clinical Rheumatology 2007; 21:77-91.
  14. Census of India –census data 2001 [
  15. Mattila V.M., Sahi T, Jormanainen V andPihlajamäki H. Low back pain and its risk indicators: a survey of 7,040 Finnish male conscripts. European Spine Journal 2008January;17:64-69.
9. / SIGNATURE OF THE
CANDIDATE
10. / REMARKS OF THE GUIDE
11. / NAME AND DESIGNATION OF
11.1 GUIDE
11.2 SIGNATURE
11.3 SIGNATURE
11.4 HEAD OF THEDEPARTMENT
11.5 SIGNATURE / MR. KANAGARAJ. R
ASSOCIATE PROFESSOR
DEPT OF PHYSIOTHERAPY
MR.NARASIMMAN S.
ASSOCIATE PROFESSOR
DEPT OF PHYSIOTHERAPY
12. / 12.1 REMARKS OF THE
CHAIRMAN AND PRINCIPAL
12.2 SIGNATURE

CONSENT FORM

From :

Ms.Michelle Emelia Lobo

M.P.T. PG (Musculoskeletal and Sports Physiotherapy)

Department of Physiotherapy

FatherMullerMedicalCollege,

Mangalore-575002

You are requested to be a part of this research study, which is a part of the curriculum for the course of M.P.T. run by the Rajiv Gandhi University of Health Science. The purpose of the study is to find out the knowledge,attitude towards low back pain and its occurrence among pre-university college students in urban Mangalore. A questionnaire will be given to you kindly fill the same. Your identity will remain confidential.

You are requested to sign this consent form.

I, ______voluntarily agree to participate in this research study. I am fully aware of the procedure that will be carried out.

Date : Signature of the participant,

Sample Questionnaire For The Survey

A. Demographic Data:

Age: Gender:

B. Occurrence :

Do you have back pain in the area as shown in the picture?

a. yes b. no c. sometimes.

Since how long do you have low back pain?

a. less than six weeks b. 6weeks-3 months. C. more than three months.

Do you feel that your low back pain is extending down to your legs?

a. most of the times b. sometimes c. never.

Do you have low back pain most of the days, since the past 6 months?

a. yes b. no, only sometimes c. never had low back pain in the past 6 months

Did you have low back pain when you were in high school?

a. yes b. no c. I don’t remember .

Do you involve yourself in sports?

a. yes b. no c. occasionally.

How many hours do you spend browsing the internet, playing computer games, or watching television?

a. less than 5 hrs/ day b. more than 5 hours/ day c. more than 42 hrs/ week.

C. Knowledge :

Which is beneficial for low back pain?

a. rest b. Medications C. Continuing daily activities within tolerable limits.

Can being overweight/obese be a reason for low back pain?

a. yes b. no c. maybe

Smoking is one of the causes for low back pain?

a. yes b. no c. maybe.

Medicines are the only cure for low back pain?

a. yes b. no c. maybe.

D. Attitude :

I think I won’t get low back pain because I am too young for it.

a. strongly agree b. agree c. disagree d. strongly disagree

A few days of bed rest will help reduce my back pain

a. strongly agree b. agree c. disagree d. strongly disagree

My parents have back pain, so even I might get it and there is nothing I can do about it. a. strongly agree b. agree c. disagree. d. strongly disagree

Do you think the way of sitting can affect the back?

a. strongly agree b. agree c. disagree d. strongly disagree

I think the way I carry my bag affects my back ?

a. strongly agree b. agree c. disagree d. strongly disagree