Musculoskeletal Problems in School Children During the COVID-19 Pandemic

Overview

During COVID-19 pandemic, in the lockdown period, reduced physical activity and obesity were reported in children. In Turkey, face to face education was ceased after March 16, till the end of the previous academic year and education was tried to be substituted remotely. A temporary lockdown was implemented for children and young people under the age of 20, between April 3 and June 5 2020. At 45 days following the lockdown of children, 72% of the parents with children aged 6-13 years stated that their screen time had increased to a mean of 6.4 hours per day. Engaging more time in physical activity, and less in sedentary and leisure screen time was found to be associated with less anxiety during pandemic. Before 2020-2021 academic year, government and educators increased their preparedness for the second and third waves and improved the technological infrastructure. Depending on grades, preferences of the family, primary education continued remotely between November 2020 and July 2021. The aim of this study is to investigate whether musculoskeletal complaints are increased in school-age children during the pandemics and whether there is a relationship between the decreased level of physical activity, increased screen time, poor posture and musculoskeletal complaints.

A survey assessing musculoskeletal pain in children in the last 1 month, and associated factors including presence of non-ergonomic postures during online education was structured by two physiatrists and a public health specialist after the review of the relevant literature. Several paediatric pain and musculoskeletal assessment tools were reviewed. The survey consisted of a total of 66 questions including sociodemographic characteristics of the children and family (17 items), education hours, used technological device (7 items), screen time and physical activity (5 items), presence of musculoskeletal pain (27 items) and ergonomics (10 items). Questions regarding the musculoskeletal pain were constructed based on The Nordic musculoskeletal questionnaire extended version (NMQ-E) which was translated and validated into Turkish. Pain or discomfort questions experienced in the nine body parts with binary choices (yes or no) were used. The figure in NMQ-E was used to describe body regions (the neck, shoulder, upper back, elbow, wrist/hand, low back, hip/ thigh, knee, ankle/foot) and pain questions were structured accordingly on this body diagram. The questionnaire was created using the Qualtrics program. The survey was piloted among ten participants to ensure its readability and ease of completion. After obtaining permissions from Ministry of National Education of Turkey, survey link was shared with the school principles so that they distributed the survey to the guardians of children via smart phones or email. The survey will be available during two months and a reminder will be sent once a week.