INTRODUCTION:
Back ground of the study: The maintenance and promotion of health is achieved through different combination of physical, mental and social well being. Health is a positive quality of life which helps us to live life to in fullest and serve our fellowmen to the best of our ability. Health is an elusive word. Most people who consider themselves healthy are not. And many people, who are suffering from some known disease, may be relatively healthy. Health is a concept which does not merely related to absence of disease, of healthy working of organs, or having good thoughts. Health is a holistic concept. It relates to a person as a whole. The state of one's health is reflective of an individual's ability to meet life's challenges and maintain his or her capacity for optimal functioning. This requires the various aspects of one's makeup i.e. mental, physical and biochemical, to maintain a level of functioning that has a positive influence and support for one another. Low back pain that lasts at least one day and limits activity is a common complaint. Globally, about 40% of people have LBP at some point in their lives, with estimates as high as 80% of people in the developed world. Approximately 9 to 12% of people (632 million) have LBP at any given point in time, and nearly 25% report having it at some point over any one-month period. Difficulty most often begins between 20 and 40 years of age. Low back pain is more common among people aged 40–80 years, with the overall number of individuals affected expected to increase as the population ages. Exercise appears to be useful for preventing low back pain. Exercise is also probably effective in preventing recurrences in those with pain. Low back pain is "pain and discomfort, localized below the costal margin and above the inferior gluteal folds, with or without leg pain". Low back pain is usually categorized in three sub types: acute, sub- acute and chronic back pain. This subdivision based on the duration of the back pain. Acute low back pain is an episode of low back pain for lesser than 6 weeks, sub -acute low back pain between 6 and 12 weeks and chronic low back pain for 12 weeks or more. Mckenzie therapy distraction prayer, relaxation, guided imagery, music, and bio feedback, range of motion exercise, strengthening exercise, aerobic exercise, spinal manipulation, mobilization techniques, acupressure, transcutaneous electrical nerve stimulation, yoga, lumbar support, traction are examples. Physical approaches aim to provide pain relief, correct physical dysfunction, after physiological responses, and focus on associated pain -related immobility. A central tent of the Mckenzie method is that self healing and self treatment for the patient's pain relief and rehabilitation.
NEED FOR THE STUDY:
Pain in the soft tissue of the back is extremely common among adult. In the United States, the national arthritis data work group review national survey data showing that each year some 15% of adults report frequent back pain or pain lasting more than two weeks. Back pain is wide spread in many countries, and is associated with substantial financial costs and loss of quality of life. In Canada, Finland and United States, more people are disabled from working as a result of musculoskeletal disorders- especially back pain- than from any other group diseases.
Reviews of low back pain epidemiology have implicated an overlapping set of occupation exposures such as lifting, force full movements, awkward postures, whole – bodyvibration and perhaps psychosocial stressors. However, such exposures are rarely assessed in surveillance activities on a large scale, and thus data are not available for risk assessment calculation at the global level. An alternative strategy was applied this assessment using occupation as a proxy for specific combination of physical and psychosocial stressors. The reference group comprised professional and administrative works. The other risk categories were defined as follows: low exposure: clerical and sale workers, moderate exposure: operators and service workers: high exposure: farmers, school teachers and staff nurses.
Low back pain is well documented as an extremely common health problem; it is the leading cause of activity limitation and work absence throughout much of theworld and it causes an enormous economic burden on individuals, families, communities industry and government.
A woman is the nucleus of the family, especially in rural India. The daily work schedule of rural women is very arduous and demanding in nature. In addition to household and agriculture works, the other time spends as energy - demanding activity for rural women is care of life stock, which is not only strenuous, but also repetitive and makes them over burdened as well as leading them a continuous health risk. The non neutral posture of the trunk frequently adopted by women is risk for developing low back pain. Lack of facilities with their traditional techniques like drawing water from the wells, carrying heavy loads on their back may lead to back pain.
OBJECTIVES:
· To assess the level of low back pain among school teachers in both experimental and control group.
· To evaluate the effectiveness of McKenzie therapy on low back pain among school teachers in experimental group.
· To find out the association between the post test level of low back pain among school teachers with their selected demographic variables and clinical variables.
HYPOTHESES:
· H1: There will be a significant difference between pre test and post test level of low back pain among school teachers in experimental group.
· H2: There will be a significant difference between post test levels of low back pain among school teachers in experimental and control group.
· H3: There will be a significant association between the post test level of low back pain among school teachers and their selected demographic variables.
MATEIRAL AND METHOD:
The study was conducted at selected schools at KanyaKumari district. The population of the study were school teachers with low back pain and who inclusion criteria. Purposive sampling technique was used to select the samples for the study. The total number of sample were 60 (i.e.) 30 in each group. The data collection tool used in this study consists of demographic variables, clinical variables and Oswestry low back pain questionnaire to assess the low back pain among school teachers. Validity of the tool was obtained from 5 experts. Reliability was tested using test re-test method.
RESULTS AND DISCUSSION:
The data was analyzed and presented under the following sections. section I: Frequency and percentage distribution of the level of low back pain among school teachers according to the demographic variables in experimental and control group. Frequency and percentage distribution of the level of low back pain among school teachers according to the clinical variables in experimental and control group.
Section II:
Distribution of pre test and post test level of low back pain among school teachers in experimental and control group.
Section III:
Comparison of pre test and post test level of low back pain score among school teachers in experimental group and control group.
Comparison of post test level of low back pain score among school teachers in experimental group and control group.
Section IV:
Association between the post test level of low back pain among school teachers in experimental and control group with their selected demographic variables and clinical variables.
SectionI:
Frequency and percentage distribution of the level of low back pain among school teachers according to the demograhic variables in experimental and control group. Distribution of school teachers who had low back pain according to theage majority of them 14 (46.7%) in the experimental group and control group belong to the age group 41 – 50 years. Interestingly 9 (30%) belong to the age group 31 – 40 years in both the groups Regarding education majority 14(46.7%) of them were holding B. Sc, B. Ed degree in experimental group whereas in the control group majority 13(43.3%) of them were holding M. Sc, B. Ed degree. Marital status shows that 22 (73.3%) of them were married in both the groups. Considering the type of family majority 16 (53.3%) in experimental group and 18 (60%) in control group were from nuclear family.
Percentage distribution of level of low back pain among school teachers according to their education:
Percentage distribution of level of low back pain among school teachers according their BMI
Dietary pattern shows that majority of them 24 (80 %) in experimental group and 23(6.7%) of them in control group were non vegetarian.
With regard to work experience majority 12 (40%) in experimental group and 13 (43.33%) of them in control group have5 – 10 years of experience.
Regarding habit of doing exercise in both groups 8 (26.7%) of them were doing mild exercise and 7 (23.3) of them were doing moderate exercise only. But 12 (40%) teacher in experimental group and 11 (36.7 %) teacher in control group do not do any exercise.
Frequency and percentage distribution of the level of low back pain among school teachers according to the clinical variables in experimental and control group:
Predicts that with regarding BMI in experimental group14 (46.7%) of them had 18.5- 24.9 where as in control group 13 (43.3) have the BMI between 15.5 – 18.5
Regarding associated diseases in experimental group majority 8 (26.7 %) of them having pelvic inflammatory disease and other associated diseases. In control group majority 9(30 %) were having pelvic inflammatory disease and 8 (26.7%) were having others associated diseases. Nearly half of them 14 (46.7 %) in experimental group and 12 (40%) in control group have the low back pain for 2 – 3 years.
Section II: Distribution of pre test and post test level of low back pain among school teachers in experimental and control group.
|
Test |
Level of low back pain |
experimental group |
control group |
||
|
|
% |
F |
% |
||
|
Pre test |
Mild Moderate Sever |
0 14 16 |
0 46.7 53.3 |
0 16 14 |
0 53.3 46.7 |
|
Post test |
Mild Moderate Sever |
13 17 0 |
43.3 56.7 0 |
0 16 14 |
0 53.3 46.7 |
describes that before the intervention of Mckenzie
therapy in experimental group 14(46.7%) of school teachers had moderate low
back pain and 16(53.3%) had sever low back pain. After the Mckenzie therapy, only
13(43.3%) of school teachers had mild low back pain and 17 (56.7%) school
teachers had moderate low back pain and none of them had severe low back pain.
In the control group 16(53.3%) school teachers had severe low back pain, 14(46.7%) had moderate low back pain in pre test and there was no change in post test.
Section III
Comparison of pre test and post test level of low back pain score among school teachers in experimental group and control group.
Table 2: (N= 60)
|
Groups |
Test |
Mean |
SD |
MD |
Paired ‘t’ test |
Level of significant |
|
Experimental group
|
Pre test |
29.03 |
9.6 |
10.6 |
15.04 |
0.001* |
|
Post test |
18.5 |
9.2 |
||||
|
Control group |
Pre test |
28.1 |
10.1 |
0.4 |
1.18 |
0.857# |
|
Post test |
27.7 |
10.6 |
*significant at 0.001 level
# not significant
To compare the mean pre test and post test score of low back pain school teachers in experimental and control group, the null hypothesis was stated as follows:
H 01 -The mean post test level of low back pain will not be significantly lower than the mean pre test level of back pain in experimental group who had low back pain
The hypothesis was tested using paired ‘t’ test method.
The table 2 summarizes that mean post test score in experimental group was 18.5 which was less than the mean pre test low back pain score 29.03. The obtained paired ‘t’ value is 15.04 was statistically significant at 0.001 level. This indicates the mean difference of 10.6 was true difference and has not occurred by chance.
The above the finding fail to support the null hypothesis. Hence the research reject to null hypothesis and accept the research hypothesis. This proves that due to the effect of Mckenzie therapy. The mean post test low back pain score in school teachers who had low back pain in experimental group had marked reduced.
In pre test low back pain score in control group 28.1 and the post test score is 27.7. The obtained t value 0.4 and statistically not significant at P 0.001 level.
TABLE 3: Comparison of post test low back pain score among school teachers in experimental group and control group. (N =60)
|
Group |
Mean |
S D |
Mean Difference |
‘T’ Test |
Level of significance |
|
Experimental group |
18.46 |
9.22 |
8.26 |
3.64 |
0.001* |
|
Control group |
27.73 |
10.58 |
*significant at 0.001 level
To compare the mean post test score of low back pain among school teachers in experimental and control group, the null hypothesis was stated as follows:
H02 - The mean post test level of low back pain among school teachers in experimental group will not be lower than the mean post test level of back pain in experimental group The hypothesis was tested using ‘t’ test method.
Table 4 depicts that in the experimental group the mean post test low back pain score 18.46 were lesser than the post test pain score of the control group on 27.73. The obtained ‘t’ value 3.64 was statistically significant at p >0.001 level. This in dictates the mean difference of 8.26 was true difference and has not occurred by chance. The above findings fail to support the null hypothesis. Hence the researcher rejects the null hypothesis and accepts the research hypothesis.
Section -V
Association between the post test level of low back pain among school teachers in experimental; group and control group with their selected demographic variables and clinical variables association between post test level of low back pain and their selected demographic variables like age, education, marital status, BMI, associated disease, type of family, dietary pattern, habit of doing exercise, duration of low back pain, work experience, the null hypothesis was stated as follows:
Ho3: There will not be significant association between the post test score of low back pain among school teachers and selected demographic variables and clinical variables.
The above table predict that the demographic variable such as age (χ2 value 9.99 df 2) work experience ( χ2 value 10.2 df 2 )which is significant at p <0.05 level where as other demographic variables are not significant at p <0.05 level.
The above the findings partially support the null hypothesis. Therefore the research partially rejects the null hypothesis and accepts the research hypothesis for accepts age and work experience.
Limitation:
· The study was conducted among school teachers who had low back pain with out any complications from selected schools at kanyakumari district. So generalization done with caution.
· This study was conducted among samples only from two schools
RECOMMENDATION
· A similar study can be conducted in large setting.
· A similar study can be conducted to assess the effectiveness of Mckenzie therapy on low back pain among nurses.
· A similar study can be replicated to other schools.
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Received on 19.02.2019 Modified on 20.03.2019
Accepted on 17.04.2019 © A&V Publications all right reserved
Int. J. Nur. Edu. and Research. 2019; 7(2):200-204.
DOI: 10.5958/2454-2660.2019.00044.9