CHAPTER IV

RESULTS AND DISCUSSION

This chapter includes the findings obtained by analyzing the data through
different quality control tools.

POSTURAL RISK FACTORS CAUSING WORK RELATED MUSCULOSKELETAL

DISORDER

Physical exposures to work related musculoskeletal disorders were assessed by

using Rapid Upper Limb Assessment (RULA) technique. According to this a score is
calculated for the posture of each body part such as upper arm, lower arm, wrist, wrist
twist, neck, trunk, and legs. A score of 1 indicated the best or most neutral position, e.g.
arms by sides, elbows approximately 90° flexion, wrist in neutral position, forearms mid-
way between pronation and supination, neck in 10° flexion, trunk and legs sitting and
well supported. A score of 4 indicated the worst position: e.g., shoulder flexion above
90° or flexion between 45° and 90° and abduction. The combine individual scores for
shoulder, elbow and wrist gave score A and those for neck, trunk and leg gave score B.
Muscle use in each packaging worker position were attributed a score of 1 and force
exerted 0 or 1 because they are static postures without loading or with loading of 2 of 10
kg. These scores are added to scores A and B to obtain scores C and D, respectively
(TABLE). And based on the design of the RULA method, each combination of scores C
and D (a number of 1-7) called grand scores. Low grand scores (1 or 2) indicate
acceptable working posture (action level 1). For grand scores of 3 or 4, further
investigation is needed and changes may be required (action level 2). Prompt
investigation and changes are required soon for scores of 5 or 6 (action level 3). Finally,
immediate investigation and changes are required for grand score of 7 (action level 4).

ARM AND WRIST SCORE

The total arm and wrist scores are divided into upper position score, lower arm
position score, wrist position score and wrist score. The possible upper arm scores are
1 through 6. Only 20 percent of the respondents obtained a score of 1. The remaining
80 percent of the respondents scored 2. None of the respondents scored either 3,4,5 or
6. This indicates upper arm position was slightly abducted with flexion of 15° to 45° but
however the movements are continuous. The possible lower arm score from 1 to 3.
None of the respondents scored 1 and majority of the respondents (88%) scored 2.
Only 12 percent respondents scored 3. The lower arm score indicating flexion less than
60° and up to 100°. (TABLE #)

Table #. Distribution of sample by arm and wrist scores (N=30)

 Upper Lower Wrist Wrist Posture Muscle Force/load Final arm
arm arm score twist score in use score and wrist
score score score table a score score
Scores Scores Scores Scores Scores Scores Scores Scores
1 2 2 3 2 3 1 2 2 3 1 0 1 3 4 5
N 6 24 27 3 24 6 12 18 12 18 30 9 21 3 9 18
% 20 80 90 10 80 20 40 60 40 60 100 30 70 10 30 60

The possible wrist score varies from 1 through 4. Many of the respondents (80%)
obtained wrist position score 2 and few respondents (20%) scored 3. It indicated that
many of them placed in extension status and made angle rather than 15°. The possible
wrist twist score ranges from 1 to 2. In the present investigation most of the respondents
(60%) scored 2 and the remaining scored 1. This indicates wrist twist at or near end of
range rather than in mid range. The different possible posture scores in table A vary
from 1 through 9. In the study maximum respondents (60%) obtained score 3 and 40
percent scored 2. This score indicates the posture where the medium musculoskeletal
loading occurred (table #).
The possible muscle score are o and 1. All the respondents (100%) were working
under static positions more than a minute with repetitive actions. This posture lead them
to get score 1. The possible lead scores vary from 0 to 3. In the present study the
majority of the respondents (70%) were carrying 2 to kg hence scored 1. Only (30%) of
the respondents were not involve in carrying loads/applying force and thus obtained
score 0. The final wrist and arm score was obtained from posture score, muscle sue
score and load score. About half of the respondents (60%) obtained score 5, and 30
percent of the respondents obtained score 4 and only 10% obtained score 3. This
indicates the medium to high risk levels for the wrist and arm pats in the body due to
awkward positions (TABLE #)

NECK, TRUNK AND LEG SCORES

The total neck trunk and leg scores are divided into neck position score, trunk
position score and leg position score. The possible neck scores are 1 through 6. In the
present investigation majority of the respondents (60%) scored 3 and the remaining
respondents obtained a score of 2 (40%). The possible trunk position scores from 1 to
6. Majority of the respondents (70%) obtained score 2 and (30%) of respondents score
3. These scores indicate that the neck and trunk of the respondents were in flexion,
rotation or side bending. The possible legs scores are 1 and 2. Majority of the
respondents score (80%) obtained score 1 and (20%) scored 2. The different possible
posture scores in table B vary from 1 to 9. In the study comparatively larger sample
(60%) obtained posture score 4 followed by 20% score 2, 10 percent score 5 and 10%
percent score 3. From the scores it van be concluded that neck, trunk amd leg position
need to be improved while working (TABLE#)
Table #. Distribution of sample by neck, trunk and leg scores (N=30)

Neck score Trunk Leg score Posture score in Muscle Force/ Neck, trunk and leg
score table B used load score
score score
Scores Scores Scores Scores Scores Scores Scores
2 3 2 3 2 3 2 3 4 1 0 1 3 4 5 6 7
N 18 12 9 21 24 6 18 9 3 30 9 21 3 3 6 15 3
% 60 40 30 70 80 20 60 30 10 100 30 70 10 10 20 50 10

The possible muscle use scores on RULA are 0 and 1. All the respondents
(100%) scored 1 due to static position more than a minute with repetitive actions. The
possible load scores are 0 to 3. The majority of the respondents (70%) were carrying
loads more than 2 to 10kgs and hence obtained a score of 1. Only 30 percent of the
respondents were not involved in carrying or applying force, hence scored 0. The final
neck, trunk and leg score was obtained from posture B, muscle use score and load
score. Comparatively larger number of the respondents (50%) obtained score of 6,
followed by 20% scored 5, 10% scored 7, 10% with score of 4 and 10% score 3. This
indicates high risk levels for the neck, trunk and leg parts in the body (table#)

MUSCULOSKELETAL SYMPTOMS IN NECK

Respondents were asked to indicate the presence of musculoskeletal symptoms,
musculoskeletal disorders and loss of physical functioning region.

Table #. Distribution of the sample by the presence of musculoskeletal symptoms

in neck (N=30)
Musculoskeletal symptoms in neck Frequency(N) Percentage (%)
Yes No Total Yes No Total
Feeling of pain/stiffness 25 5 30 83.33 16.67 100
Occurrence of spasm/cramps 19 11 30 63.33 36.67 100
Feeling of numbness 23 7 30 76.76 23.33 100
Feeling of pain radiating from neck to shoulder 17 13 30 56.67 43.33 100
 musculoskeletal symptoms in neck
25
20
15
10
5
0
YES
NO

When a person is exposed to musculoskeletal discomforts over a period of time

the chances of developing musculoskeletal disorder are more. Among the respondents
83.33 % of the respondents were experiencing the feeling of pain/stiffness followed by
63.33% of the respondents suffer from occurrence of spasm/cramps, 76.67% were
experiencing the feeling of numbness and last is 56.67% suffer from feeling of pain
radiating from neck to shoulder.

MUSCULOSKELETAL SYMPTOMS IN SHOULDER

Table #. Distribution of the sample by the presence of musculoskeletal symptoms

in shoulder (N=30)
Musculoskeletal symptoms in shoulder Frequency(N) Percentage (%)
Yes No Total Yes No Total
Feeling of pain/stiffness 27 3 30 90 10 100
Appearance of swelling 18 12 30 60 40 100
Occurrence of spasm/cramps 16 14 30 53.33 46.67 100
Feeling of soreness 20 10 30 66.67 33.33 100
Feeling of pain radiating from shoulder to upper 28 2 30 93.33 6.67 100
limb
 Musculoskeletal disorder symptoms in
shoulder
30

25

20

15

10 YES
NO
5

0
feeling appearance of occurrence of feeling of feeling pain
pain/stiffness swelling spasms/cramps soreness radiating from
shoulder to
upper limb

Among the respondents 93.33% of the respondents were experiencing the

feeling of pain/ radiating from shoulder to upper limb, followed by 90% feeling
pain/stiffness, 66.67 % for feeling of soreness, 60% for appearance swelling and
53.33% for occurrence of spasm/cramps.

Musculoskeletal symptoms in upper limb

Table #. Distribution of sample by presence of musculoskeletal symptoms in

upper limb (N=30)

Musculoskeletal symptoms in upper limb Frequency(N) Percentage (%)

Yes No Total Yes No Total
Feeling of pain/stiffness 29 1 30 96.67 3.33 100
Appearance of swelling 21 9 30 70 30 100
Occurrence of spasm/cramps 23 7 30 76.67 23.33 100
Feeling of numbness 12 18 30 40 60 100
Feeling of soreness 9 21 30 30 70 100
Feeling of heaviness 17 13 30 56.67 43.33 100
Tingling sensations in finger 16 14 30 53.33 46.67 100
Feeling of pain radiating from shoulder to upper 24 6 30 80 20 100
limb
 Musculoskeletal symptoms in upper limb
30
25
20
15
10
5
0
NO
YES
YES
NO

Among respondents 96.67% were experiencing the feeling of pain/stiffness in

shoulder, followed by radiating from upper limb to back which is 80% of the
respondents, 76.67% for occurrence of spasms/cramps, 70% were experiencing the
appearance of swelling, 56.57 % and 53.33% for feeling of heaviness and tingling
sensations in finger, lastly 40% and 30% for feeling of numbness and soreness.

Musculoskeletal symptoms in back region

Table #. Distribution of sample by the presence of musculoskeletal symptom in

lower limb (N=30)
Musculoskeletal symptoms in back region Frequency(N) Percentage (%)
Yes No Total Yes No Total
Feeling of pain/stiffness 28 2 30 93.33 6.67 100
Appearance of swelling 19 11 30 63.33 36.67 100
Occurrence of tenderness/cramps 20 10 30 66.67 33.33 100
Feeling of numbness 14 16 30 46.67 53.33 100
Feeling of soreness 18 12 30 60 40 100
Feeling of pain radiating from back to lower 23 7 30 76.67 23.33 100
limb
 Musculoskeletal symptoms in back region

feeling of pain from back to lower limb

feeling of soreness

feeling of numbness
NO
occurrence of tenderness/cramps YES

appearance of swelling

feeling of pain/stiffness

0 5 10 15 20 25 30

Among the respondents 93.33 % suffering from back pain/stiffness followed by

feeling of pain from back to lower limb with 76.67%, 66.67% for occurrence of
tenderness/cramps, 63.33% for appearance of swelling, 60% for feeling of soreness
and 46.67% for feeling of numbness.

Musculoskeletal symptoms in lower limb

Table #. Distribution of sample by the presence of musculoskeletal symptoms in

lower limb (N=30)

Musculoskeletal symptoms in back region Frequency(N) Percentage (%)

Yes No Total Yes No Total
Feeling of pain/stiffness 22 8 30 73.33 26.67 100
Appearance of swelling 10 20 30 33.33 66.67 100
Occurrence of tenderness/cramps 12 18 30 66.67 33.33 100
Feeling of numbness 16 14 30 53.33 46.67 100
Feeling soreness 25 5 30 83.33 16.67 100
Tingling sensations in toes 30 0 30 100 0 100
 Musculoskeletal symptom in lower limb

30
25
20
15
10
YES
5
NO
0

Among the respondents 100% of the respondents suffer from tingling sensations
in toes, 83.33% experiences soreness, pain/stiffness encountered by almost 73.33% of
the respondents, 66.67% feel the occurrence of tenderness/cramps, 53,33% feel the
numbness in feet and 33.33% experience the appearance of swelling.