Prevalence of Musculoskeleton Pain among occupational motorcyclist and its impact on work efficiency and long term health care in Peshawar: A Cross-sectional Study

doi:10.21203/rs.3.rs-1937798/v1

Objective

Motorcycle has been one of the vital modes of transportation worldwide. It is quite difficult to identify the musculoskeletal disorders among the occupational motorcyclists that affect muscular discomfort among motorcyclist due to not much research having been carried out on the motorcyclist. The purpose of this study was to have a better understanding of the musculoskeletal disorders among occupational motorcyclist due to motorcycle riding.

Methods

Research based on cross sectional studies and keywords that related to the musculoskeletal disorders might cause discomfort among occupational motorcyclist. The research screened covered male population over 18 years of age. In order to identify and classify research studies, specific keywords were identified and used in order to guide the discovery of relevant studies.

Results

As overall research shows that from age 25 to 40 years the ratio of motorcyclists are having more musculoskeletal disorders up to 82% of population riding a motorcycle during work time.

Conclusion

This review was done to relate musculoskeletal disorders among occupational motorcyclist, as 28 years old are more prone to have musculoskeletal disorders while riding a motorcycle.

Musculoskeletal Disorders

Discomfort

Motorcyclist

Motorcycle

Occupational

Bike Riders

Motorcycles are the dominant mode of transport for large number of people in many middle and low-income countries and the rapid growing sector of motor vehicles sales worldwide(1). Interesting problem to ergonomists shown by the motorcycle in that it is, a constrained workstation in which there is very slight available adjustment to suit the riders different needs(2).Musculoskeletal pain touch all ages, its frequency increases with age and reoccurs most time (3). Population studies show that at least 15% children of school age and adolescents 30% complain of pain in their arms, legs or back. These results in a huge number of visits to pediatric primary care clinics (PPCC), children aged 3–14 years have 6% and adolescents have 10%. MSP is the third leading cause of PPCC consultation in children 11 years and older(4). Muhammad WaqasFaiz et al conducted a research study to find the MSK pain in traffic wardens in Lahore. The prevalence of MSK pain was 65.7%. Different body regions were included, most common areas of pain were neck, shoulders, arm/hand, upper back lower back, knees, foot (5). Mohamad Kharmizi Mohd Said Et al concluded that relieving the discomfort we should have to improve the ergonomics and further research studies should be done (6).The prevalence of LBP among physical therapy in Pakistan is high due to treating large number of patients, performing different manual therapy techniques, working in same position for a long time, transferring or lifting dependent patients and repetition of tasks (7). Majority of the riders favored looks and style, ignoring physiological comfort and safety which leads to road accident and occupational related MSK pain (8). The modifiable risk factors for LBP at occupational motorcylist include obesity, tobacco smoking and sedentary lifestyle, drug dependence. Other modifiable factors are occupation-related poor posturing, bending, stooping, prolonged sitting, twisting, and lifting of heavy loads (9). Bodily discomfort of occupational motorcyclist is linked with biomechanical factors such as joint angles, stresses, postures, muscular contractions, and pressure distribution while seating (10). The factors discover occurrences of spinal pain are, among others, long time maintained static position, WBV and awkward sitting positions. During riding the motorcycle neck pain occurs in about 23.1% of general population, which places it on the second place after LBP factors may also appear (11). In addition, the reduced maximum forefoot pressure and increase in foot comfort may help to reduce any pressure-related issues that affect the joints, bones, or soft tissues of motorcyclists (12). In the case of motorcycles, the problem of low back pain could be more severe with absence of backrest for both driver and the passenger (13). the motorcyclists tend to adopt a variety of postures during their riding process in order to balance the equilibrium of stresses in their body (14). WRMD is a term used in all work related musculoskeletal pain and is defined as “regional impairments of the tendons, muscles, joints and nerves that are similar with work-related mechanical trauma”. The common WRMDs between medical professionals and occupational motorcyclists are “pain in low back, “ shoulder, neck, hand, wrist, elbow, and upper back" (15)(12). preventing WMSDs is National priority in many countries as they are observed one of the most broadly reported problems ergonomists confront in the workplace around the globe (16). Long exposure in a high level of WBV can lead to motion sickness, headaches and fatigues. Meanwhile HAV is defined as a vibration transmitted from hand-held equipment such as handlebar and steering wheel into the hand-arm of operators (17). Load carriage tasks place additional stress on the musculoskeletal system of the carrier creating a risk for musculoskeletal injury as such as occupational bike riders who carry load in the form of bags behind them while work (18). Hemorrhoids are common disease among the commercial motorcyclists (19). The purpose of this research is to present the findings on the prevalence of MSK disorders among professional motorcyclists in Peshawar and its impact on proper work efficiency and long term health care. It is also a road safety concern as there may be cases where MSDs or discomfort experienced by the motorcyclists during riding might influence their postural behavior and concentration, thus endangering themselves and other road users. Hence, the need of this study is vital to better improve the health quality of a population as well as the safety of the motorcyclists.

Study Design:

Design of this study was descriptive cross sectional study.

Study Settings:

This study was conducted all on prevalence of musculoskeletal pain in occupational motorcyclist

Careem Peshawar
Food Fries Peshawar
TCS Peshawar
Pizza hut Peshawar.

Sample Size:

The sample size of this study was 377

Sampling Technique:

The technique used in this study was convenience sampling technique

Study Duration:

The duration of this study was 6 months from January to June 2021 after the approval of Institutional ethics committee (IEC) of NCS University System Peshawar, Pakistan.

SAMPLE SELECTION:

Inclusion Criteria:

The following were included in this study:

All occupational motorcyclists of Peshawar
Only male will be included.
People of more than 18 years will be included.
Minimum duration of daily motorcycle riding should be 06 hours
Experience of the bike riding occupation should be six months

Exclusion Criteria:

The following were excluded from this study:

Non-Occupational motorcyclists of Peshawar.
Age less than 18 years female

A total of 377 occupational motorcyclist having age 18 years above were included in the study, at Peshawar from January to June 2021. The mean age of participants who was having trouble and wasn’t having any trouble related to ADL’s was 31.59 ± 6.657 and 1.16 ± .366 respectively. The minimum percentage is of age 19 years (0.8 %) and maximum percentage of 8.8% in 28 years of age.

The number of participants who have neck pain is 157 (41.6%) and those who were not having neck pain 220 (58.4%). Shoulder pain were recorded in 56 participants (14.9%). Pain recorded in elbow, wrist , upper back , hips, ankles of occupational motorcyclist were 11.4% , 31.8%, 21,8%,5.6%, 13.5% respectively. Occupational motorcyclist were found to be more prone toward lower back pain with the positive ratio of 50.4% having frequency of 190 out of 377 participants while knees were least effected with percentage of 5.3%.

The severity of pain were recorded at occupational motorcyclist using numeric pain rating scale (NMRS). Those with no pain were 15.6%, those with mild were 28.6%, moderate 50.7% and severe pain were 5%. Table 4.13 shows the severity of pain recorded in occupational motorcyclist.

Table 4.1 Statistics

The following table 1 shows the statistics of the questionnaire that was conducted from the occupational motorcyclists.

Table 4. 2 Overall percentage

The following table shows the age of the motorcyclists and there frequency, percent, valid percent and cumulative percentage.

The minimum percentage is age of 19 years which shows (.8%) and maximum percentage of (8.8%) in 28 years of age.

Age
Valid		Frequency	Percent	Valid Percent	Cumulative Percent
	18 to 30	160	42.4	42.4	42.4
	30 to 40	161	42.7	42.7	85.1
	40 to 50	52	13.8	13.8	98.9
	50 or above	4	1.1	1.1	100.0
	Total	377	100.0	100.0

Table 4. 3 Prevention from work

Table no. 3 shows that how many percent motorcyclists have been prevented from carrying out normal activities, The number of people that says "Yes" shows (84%) and the number of people with answer "No" shows (15.9%)

During the last 12 months have you been prevented from carrying out normal activities (e.g. job, housework, hobbies) because of this trouble in:
Valid		Frequency	Percent	Valid Percent	Cumulative Percent
	yes	317	84.1	84.1	84.1
	no	60	15.9	15.9	100.0
	Total	377	100.0	100.0

The present studies determine that occupational motorcyclists have the Musculoskeletal Disorders in the following regions of the body. The commonly affected area of the body are Neck (42%), Lower Back (51%), Wrist (26%), Upper Back (22%), other areas that are involved while riding a motorcycle that causes discomfort are Shoulders (20%), Hip region (3%), Knees (2%) and Ankles (18%).

The studies shows that mostly the occupational motorcyclists who have Musculoskeletal Disorders the severity of the pain on Numeric Pain Rating Scale (NPRS) that the occupational motorcyclists are mostly having Moderate pain therefore (51%). It also shows that some occupational motorcyclists have Mild Pain (29%) and Severe Pain (4%). Some Occupational Motorcyclists around (17%) have recorded no pain.

The Studies also shows that the maximum probability of having a Musculoskeletal disorder in last 12 months’ time period of an occupational Motorcyclists having 28 Years of age around (90%). Around (82%) of MSK disorders recorded in occupational motorcyclists of age 30 Years. (80%) of MSK disorders in 32 years of age, 25 Years of age shows (42%) MSDs probability, Age of 40 years shows (61%), The Age from 19–24 years shows (23%) of MSK disorders due to riding a bike, And a very low probability of (22%) is found in age around 41 to 55 years in last 12 months of time period.

In comparison to Holman Opsina Mateus studies who conducted his studies on discomfort in motorcyclists in 2019 we came to know that in lower back region the level of discomfort, disease or pain is (64%) while in our studies it shows (50.4%). If we talk about Upper back it is (37%) in other studies and (21.8%) present. Almost same frequency was recorded in other studies as compare to this study about neck pain region in motorcyclists which shows (43%) percent of neck pain. Elbow shows (51%) in previous studies while (11.4%) in present studies. Wrist shows (23%) in previous studies while (31.8%) was recorded in recent studies. Hip region shows (11%) in previous studies while (5.6%) in recent. Knee pain recorded in other studies is (11%) while in recent studies it shows (5.3%). Pain in ankle region was (9%) in older studies while now it is recorded as (13.5%) (12).

From this it shows that the level of lower back pain is decreased recently in upto 10% and Upper back pain is decreased upto 4%. The Elbow pain is decreased remarkably upto 40% as compared to previous studies. Hip pain is decreased upto 5% and the knee pain is also decreased upto 5% while ankle pain is increased upto 3% in recent studies.

In other studies conducted by Nur Athirah Diyana BT Mohammad Yusof it shows that riding a bike for a prolong period of time it will cause back pain and with the addition of whole vibratory body motion it includes specific parts like shoulders, wrist, hand, knee, thighs, upper back, lower back, ankles and legs. Same is mentioned in our results due to riding a bike for prolong period of time it causes musculoskeletal disorders which we mention earlier. Riding back posture refers to the possibility of developing any of the musculoskeletal disorder in the region mentioned above(17).

In studies conducted by SHWETA SATISH DEVARE (2015) mostly the region which was affected in traffic police bike riders was neck area lower back region and upper back region which was 38% in lower back and 36% in upper back while in recently obtained result the pain in that region is increased upto 20% as mentioned in the lower back and upper back tables above(21).

To conclude, a high prevalence of musculoskeletal disorders exists among the occupational motorcyclist which affects the day to day activities of more than one-third of them. These results indicate that most of the motorcyclist adopts positions which frequently result from pain in the Wrist and low back regions, so these regions are most commonly affected. Other areas are also affected which include shoulders, Upper back, elbow, and ankles. This study is also important for to advice the occupational motorcyclists to correct their posture while riding a motorcycle which will help them in reducing the chances of having Musculoskeletal Disorders, also they should be guided by having a separate department where they motorcyclists are guided on how to prevent from acquiring these abnormal changes occurrence in their bodies. From this studies we came to know that there is increased in the pain in ankle region which is up to (13.5%) presently study and decrease in the pain ratio of lower back and upper back region. The fact is that neck region pain is similar to other studies which are (43%). There is a huge difference between elbow pains in previously conducted studies in the recent studies it is decreased a lot.

By seeing all these facts and figures we should start preventing pain in all these regions by providing special support and posture correction guidance.

Financial support and sponsorship

No funding was received for conducting this study.

Conflict of Interest

There were no conflicts of interest.

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Table 4.13: [the severity of pain recorded in occupational motorcyclists]


Pain
Severity of Pain (NPRS)		Frequency	Percent	Valid Percent	Cumulative Percent
	None	59	15.6	15.6	15.6
	Mild	108	28.6	28.6	44.3
	moderate	191	50.7	50.7	95.0
	severe	19	5.0	5.0	100.0
	Total	377	100.0	100.0

Prevalence of Musculoskeleton Pain among occupational motorcyclist and its impact on work efficiency and long term health care in Peshawar: A Cross-sectional Study

Status:

Version 1

Abstract

Objective

Methods

Results

Conclusion

Figures

Introduction

Material/Subjects/Patients and methods

Results

Discussion

Conclusion

Declarations

References

Tables

Status:

Version 1