CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Back pain and poor posture have become increasingly common among adolescents,
especially secondary school students. Sedentary lifestyles, long hours of sitting in
classrooms, carrying heavy school bags, and improper sitting postures contribute
significantly to the development of musculoskeletal discomfort in this age group. Studies
have reported that the prevalence of back pain among school-aged children ranges from
20% to 70% globally, depending on the population studied and methods of assessment
used.
Adolescents are in a critical stage of physical growth and skeletal development; poor
posture habits adopted during this period may result in long-term spinal deformities or
chronic musculoskeletal problems in adulthood. Therefore, early preventive interventions,
such as back care education, are essential. Physiotherapists play a vital role in providing
health education on posture, ergonomics, and spinal health.
A classroom-delivered back care program is a structured educational and exercise-based
intervention designed to increase students’ awareness about good posture, safe lifting
techniques, and healthy activity habits. Such programs have been shown to improve
postural alignment, reduce discomfort, and enhance physical activity levels when effectively
implemented. However, in many schools, the inclusion of back care education in the
curriculum remains limited.
This study seeks to evaluate the effectiveness of a classroom-delivered back care program
on back pain, posture, and activity levels among secondary school students, providing
evidence-based support for physiotherapy-led school health interventions.
1.2 Statement of the Problem
Despite the high prevalence of musculoskeletal discomfort and poor posture among school-
aged children, there is still a lack of structured back care education in most secondary
schools. Many students are unaware of correct sitting, standing, and lifting postures,
predisposing them to back pain and musculoskeletal strain.
Existing studies have demonstrated the positive impact of ergonomics and posture training
programs, but most of these have focused on adults in occupational settings rather than
adolescents in classroom environments. There is, therefore, a need to evaluate whether a
physiotherapy-led, classroom-based back care program can effectively improve students’
posture, reduce the occurrence or risk of back pain, and enhance their daily activity levels.
1.3 Purpose of the Study
The purpose of this study is to determine the effectiveness of a classroom-delivered back
care program on back pain, posture, and activity levels among secondary school students.
1.4 Objectives of the Study
General Objective:
To evaluate the effectiveness of a classroom-delivered back care program on back pain,
posture, and activity levels in secondary school students.
Specific Objectives:
1. To assess students’ knowledge and awareness of back care before and after the program.
2. To evaluate the effect of the back care program on students’ posture.
3. To determine changes in the frequency or severity of back pain following the program.
4. To assess the effect of the program on students’ activity levels.
1.5 Research Questions
1. What is the level of back care knowledge among students before and after the program?
2. Does the classroom-delivered back care program improve students’ posture?
3. Is there any change in the frequency or severity of back pain after the program?
4. Does the program influence students’ activity levels?
1.6 Hypotheses
Null Hypothesis (H₀): There is no significant effect of a classroom-delivered back care
program on back pain, posture, and activity levels in secondary school students.
Alternative Hypothesis (H₁): There is a significant effect of a classroom-delivered back care
program on back pain, posture, and activity levels in secondary school students.
1.7 Significance of the Study
This study will be beneficial in several ways.
- For Students: It will improve their awareness of back care principles, posture correction,
and safe daily activities, helping to prevent long-term musculoskeletal problems.
- For Teachers and Schools: It will provide a basis for integrating back care education into
school health programs, thereby improving student wellbeing and academic performance.
- For Physiotherapists: It will contribute evidence supporting physiotherapy-led health
education in schools.
- For Policy Makers: The findings can inform policies that promote ergonomic practices and
physical health programs within the school system.
1.8 Scope of the Study
This study will be conducted among secondary school students aged 12–18 years within
selected schools. It will focus on assessing back pain prevalence, postural alignment, and
activity levels before and after the classroom-delivered back care program. The study will
not include students with pre-existing spinal deformities or musculoskeletal conditions
unrelated to posture or school activities.
1.9 Operational Definition of Terms
Back Care Program: A structured classroom-based education and exercise session designed
to promote awareness and practices that support spinal health.
Posture: The alignment and positioning of body segments while sitting, standing, or
performing activities.
Back Pain: Discomfort or ache felt in the upper, middle, or lower back due to
musculoskeletal strain or poor posture.
Activity Level: The degree of physical activity and engagement in movement during daily
school life.
Effectiveness: The extent to which the back care program achieves its intended outcomes,
such as improved posture and reduced back pain.