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21 April 2023: Clinical Research  

Examination of Musculoskeletal System Disorders and Ergonomic Conditions in the Work Environment of Academics Providing Distance Education During the COVID-19 Pandemic: Controlled Study

Abdulkadir Aydın1ABCDEF*

DOI: 10.12659/MSM.939901

Med Sci Monit 2023; 29:e939901




BACKGROUND: This study aimed to evaluate whether the incidence rate of musculoskeletal system disorders changed owing to the increase in the time spent on the computer by academics who did or did not provide distance education during the COVID-19 pandemic.

MATERIAL AND METHODS: The Cornell Musculoskeletal Discomfort Questionnaire was used to assess musculoskeletal discomfort experienced in the past 1 week. In addition, the Occupational Safety and Health Administration (OSHA) Computer Workstations Evaluation Checklist was used to assess the ergonomic structure of the work environment. The questionnaire assessed musculoskeletal system disorders and collected demographic characteristics.

RESULTS: The study group included 184 (101 male, 83 female) academics who provided distance education, whereas the control group included 82 (44 male, 38 female) academics who did not provide distance education. The mean ages of academics in the study group and control group were 37.46±7.34 and 41.26±10.06 years, respectively. Although computer-based work environment ergonomics were similar (P>0.05) in both groups during the pandemic, the incidence rate of musculoskeletal disorders was significantly high in the study group (P<0.001). These disorders were mostly seen in the neck, back, and waist regions (P<0.001).

CONCLUSIONS: The results suggested that the incidence rate of musculoskeletal disorders increased in academics who provided distance education during the COVID-19 pandemic.

Keywords: COVID-19, ergonomics, musculoskeletal pain, Teaching, Male, Humans, Female, Adult, working conditions, Pandemics, Education, Distance, Occupational Diseases, Musculoskeletal Diseases, Musculoskeletal System


Coronavirus disease (COVID-19), which rapidly spread across the globe, led to more than one-third of the world becoming housebound [1], living socially isolated lifestyles [2], and undergoing numerous fundamental changes in daily habits. A state of emergency was declared in Turkey in March 2020, and people gradually adapted to the restrictive measures on fundamental rights, such as restrictions on free movement and social gatherings; suspension of all public cultural, recreational, and sports activities; and suspension of classroom teaching activities. The radical changes in the way of performing tasks and conducting lifestyle during the pandemic physically and psychologically affected academics [3]. Work-related musculoskeletal system disorders are the musculoskeletal injuries or disorders in the muscles, nerves, tendons, joints, cartilage, and spinal cord caused by risk factors associated with the workplace [4]. It has been reported that musculoskeletal system disorders are modern epidemic health diseases seen in all ages, sexes, and social groups [5]. Studies have reported that musculoskeletal pain is experienced by active and intensely working individuals, and it is commonly seen in the areas associated with the spine, such as the lower back, neck, and back [6,7]. Previous reports have suggested that musculoskeletal system disorders are common among agricultural workers, office workers, healthcare professionals, and academics [8,9]. Academics have to stand for a long time and have to stand in a stationary position while preparing and delivering computer-based trainings and courses during their professional lives [10].

There has been an increase in the use of computers in the work environment in the last 2 decades, which has led to changes in the per capita workload in organizations and the emergence of new risk factors for workers [11]. It has been reported that using computers for long hours can negatively affect the health of employees and expose them to high psychological stress; additionally, employees can experience pain in the wrist, waist, neck, and back regions while working [12]. The underlying causes of this pain can be continuous usage of a keyboard and mouse for data entry, working in a static position for a long time, incorrect posture while working, and not using ergonomic conditions in the workplace [10]. Therefore, ergonomic risk analysis is needed to help in ergonomically organizing workspaces for protecting the employee health and making workspaces suitable [13].

The aim of ergonomics is to eliminate or minimize physical problems and enhance the performance of employees [14]. Academics working in universities usually work on computers for long durations at an intense pace and spend most of their day at a desk [15]. Just like workers in other occupational groups, academics can be adversely affected by ergonomic, biological, physical, chemical, chemical, psychosocial, and other environmental and individual risk factors in their work environments [16]. The COVID-19 pandemic created an environment of uncertainty for higher education institutions, students, and academics; administrators of higher education institutions were also negatively affected by these uncertain conditions [17].

It can be inferred from the previous studies that academics are exposed to musculoskeletal system disorders due to difficult, stressful, long, and exhausting work hours. Since the unfavorable conditions of the COVID-19 pandemic have exacerbated their situation, an increase in the incidence rate of musculoskeletal-related pain is inevitable. In addition, academics use computers for preparing presentations, e-learning activities, research, and publications. Therefore, it is understood that working in ergonomic arrangements in the work environment will not exacerbate the musculoskeletal system disorders in academics. Therefore, we aimed to evaluate the musculoskeletal disorders and ergonomic conditions in the workplace of academics at Dicle University in Diyarbakir (Turkey) during the pandemic.

Material and Methods


The numerical variables are presented as mean±standard deviation and categorical variables are presented as number and percentage (%). The conformity of the data to a normal distribution was evaluated using the Kolmogorov-Smirnov test. The chi-square test was used for analyzing categorical variables. The t test and Mann-Whitney U test were used for analyzing normally and non-normally distributed data, respectively. The hypotheses were 2-tailed, and P≤0.05 was considered statistically significant.


The mean age of 184 (83 females, 101 males) academics in the study group was 37.46±7.34 years, whereas the mean age of 82 (38 females, 44 males) academics in the control group was 41.26±9.06 years (P>0.05). The dominant hand of the academics in the study group (91.8%) and control group (89.0%) was the right hand (P>0.05). The total body mass index (BMI) scores of both groups were similar (P>0.05). Upon examining the included academics in terms of their academic titles, the participation percentages of professors, associate professors, and research assistants were found to be significantly higher (P<0.05) in the study group than in the control group, whereas the participation percentages of doctor lecturers, lecturers, and instructors were found to be significantly higher (P<0.05) in the control group than in the study group. The percentages of academics having an ergonomic work chair, doing exercises regularly, and exercising at the workplace were similar in both groups (P>0.05). The workload during the pandemic, length of sitting time each day, infection of coronavirus during the pandemic, daily computer usage time, uninterrupted work time on the computer, and time spent on the computer during the COVID-19 pandemic were significantly higher (P<0.05) in the study group than in the control group (Table 1).

The CMDQ subscores (neck, upper back, lower back, hip, right upper arm, left upper arm, right lower leg, and left lower leg), which were used to evaluate the musculoskeletal disorders of the academics, were significantly higher (P<0.001) in the study group than in the control group. Therefore, the academics in the study group experienced pain, aches, and discomfort in all joints (especially in the lower back, neck, and upper back) more frequently in the past 1 week than those in the control group. In addition, the musculoskeletal discomfort experienced by the academics in the right upper and lower extremities was significantly higher (P<0.05) than the musculoskeletal discomfort in the left upper and lower extremities. However, no statistically significant difference (P>0.05) was found between the 2 groups in all dimensions of the OSHA scale (sitting postures, keyboard/input devices (mouse), monitor, work area, and total score), which was used to evaluate the ergonomic structure of the work environment (Table 2).

In the study group, musculoskeletal pain in body parts was experienced by 79.1% of academics in the neck, 71.1% in the upper back, 68.6% in the lower back, 56.3% in the hip, 61.4% in the right upper extremity, 45.0% in the left upper extremity, 38.7% in the right lower extremity, and 36.4% in the left lower extremity. In the control group, musculoskeletal pain was experienced by 63.2% academics in the neck, 45.4% in the upper back, 44.0% in the lower back, 33.1% in the hip, 46.5% in the right upper extremity, 40.2% in the left upper extremity, 32.4% in the right lower extremity, 32.1% in the left lower extremity (Figure 2).



It has been emphasized that musculoskeletal pain negatively affects the quality of life, productivity, and work performance of academics and creates a heavy economic burden on the institution owing to costs associated with the sick leave taken by academics [37]. Therefore, the prevention of musculoskeletal disorders is of great importance. Previous studies have revealed the high prevalence of musculoskeletal system disorders in academics, irrespective of the pandemic. It has been shown that musculoskeletal disorders in academics can hamper their work efficiency and quality of life, increase health costs and economic burden on the institution they work for, and lead to academics distancing themselves from work. Therefore, it may be possible to prevent musculoskeletal disorders by reducing the course load, providing an appropriate work environment, and promoting preventive and rehabilitative neck, lower back, shoulder, hip, and knee isometric, isotonic, and isokinetic exercises that can be performed at the desk and at home, designed according to the demographic characteristics of academics.


There are several limitations of this study. First, owing to the COVID-19 pandemic, some interviews that should have been conducted face-to-face were conducted on telephone or via e-mail. Second, the number of academics in the study group and control group could not be standardized. Third, the questionnaire used in the study had subjective questions. Fourth, not many studies in the literature reported musculoskeletal system disorders in academics during the COVID-19 pandemic period.


This study revealed that musculoskeletal system disorders were prevalent among academics who provided distance education during the pandemic. Musculoskeletal system disorders were commonly seen in the neck, upper back, lower back, and shoulder regions and in the joints of the lower and upper extremities. It was appreciable that both groups worked in a suitable workplace environment.


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