In a nation-wide survey conducted by Brainfeed, 67 percent students in India have reported of experiencing back pain, dry eye syndrome and insomnia as a result of incorrect ergonomics. In the cover story for July 2020, educators, medical experts and students share their opinions and experiences with online classes and most importantly,
Health on the line
The hoopla around online classes is understandable but in three months its effect on health of students is raising concern. The Brainfeed survey covered all 14 major cities in India shows the lack of awareness and not maintain correct ergonomics the major reasons for health issues. 352 students and parents were part of the survey. More than 60 per cent of the students who took to online classes during the lockdown developed some kind of health problem that included upper-lower back pain, wrist pain, dry eye syndrome, headache, insomnia and behavioural changes.
When a child is at ease the attention power increases. Studies have confirmed when in a comfortable position, child’s concentration levels are better.
The Global Burden of Disease Study estimated that low back pain is among the top 10 diseases and injuries that account for the highest number of DALYs (One Disability-Adjusted Life Year can be thought of as one lost year of “healthy” life) worldwide. Further, back pain is also amongst the highest reasons for employees taking leaves.
As medical experts suggest that the roots of spinal disorders lay in childhood, if correct ergonomics are ensured, the number of people developing back problems could be reduced. This in turn could have great economic benefits, a reduction in days lost from work and a reduction in the amount of people suffering from back pain effectively resulting in a cost saving for the government as well as a healthier workforce.
“The use of smartphones, laptops and everything electronic has skyrocketed beyond imagination and rightly, parents are concerned about it,” says Lt Col A Sekhar (R), Soldier, Educationist. “The Brainfeed survey hits right at the heart of the problem. Is there an issue? Of course there is.”
Dr Neeta Bali, Director and Principal, G D Goenka World School, Gurugram agrees, “When students are sitting for a long time, it affects their posture adversely because they are sitting consistently with little movement. It affects the back resulting in back pain. It is inevitable that there will be back pain because of restricted movement.”
41.8 percent of students in India spend more than four hours in a day online. Only 10.6 percent maintain less than an hour of online exposure in a day. “I use laptop and sometimes smartphone for online classes,” shares Khushi Bhatt, Class XII student of Evergreen Sr Sec School, Delhi. “I use it for 5 -7 hours continuously depending on my school and coaching schedule and sometimes I do face problems like headache, eye strain and maintaining posture.”
“Today, due to COVID, everybody is in lockdown, and since we are in lockdown, the entire system for education has changed and there have been a paradigm shift- now, kids are more glued to mini screens,” says Dr Sumant S K, Co-Founder of Physionize Advance Physiotherapy & Posture Care Centre and CEO of Sportanix Healthtech Pvt Ltd, Bhopal. “They are bound to have musculoskeletal disorders which mean their muscles and bones both are getting affected.”
In the survey, as much as 61.3 percent students (and parents) confessed that they are unaware about the possibility of incorrect ergonomics causing Repetitive Strain Injury, Musculoskeletal Disorders (MSDs) and Cumulative Trauma Disorder.
Explaining further, Dr Sumant adds, “A simple example is a carpal tunnel syndrome which can be a simple wrist pain. People who are using lot of mouse and they are constantly keeping their hand extended, are bound to have carpal tunnel syndrome or some inflammation in their tendons. Not only the muscles part, it affects the spinal posture too because they are building a hunch in their neck or in their mid-back. While children are learning, they forget about the posture and that can be one of the reasons for MSDs, headaches, migraines, stiff neck, trigger fingers, etc. All these affect their entire health such as obesity in the form of metabolic disorder because their physical activity is totally shunned while they are sitting in front of the computer. This even affects their circulatory system. With uncomfortable sitting, they are also hampering their ability to learn and developing stress. ”
“Sitting is the new smoking” – Dr Sumant S K, Posturologist and Physiotherapist
Though it’s a very big statement, but while we are talking about their posture, I need to explain and I need to put this across that how hazardous a sitting can be. When you are sitting you are actually hampering your metabolic function which leads to metabolic disorders which are at par what happens to a smoker.
As children have started depending on online classes, online training, online meetings, online games and even online parties with friends, it has become important to take note of their study habits, sitting postures, physical environment and their comfort. Kanak Gupta, Director, Seth M R Jaipuria Schools Group asserts, “Families have had to make do with lack of child-friendly workstation furniture at home, sharing devices and being in close proximity with each other. As Coronavirus looks at being our guest until a vaccine is found, hybrid learning too is here to stay. I’d strongly recommend we make arrangements to make the most of the same.”
“The solutions are not easy,” claims Lt Col A Sekhar. “They have to be done with a mixture of understanding, appreciation of ground realities and strict compliance converting itself into discipline. The schools have to be very focused on giving them only limited amount of online work and time. The parents have to work hard at ensuring that that time is followed in letter and spirit.”
“We need to understand, guide and ensure how kids are maintaining discipline between their learning and sitting with respect to their posture,” advices Dr Sumant. “Probably everybody doesn’t have access to ergonomics furniture at home.” Suggesting a cost efficient comfortable workstation, he elaborates, “It can be a simple chair-table, modified with cushions, pillow or even some upliftment to that particular furniture. Basically, we need to ensure the keyboard and monitor height. If kids are using mobile phones, please try to buy mobile stands so that the distance from the screen of two to two and a half feet is maintained.”
Dr Bali opines, “Most of these times, children need to keep their eyes moisten. They should consult a good eye specialist and if they are feeling discomfort, they should find out what kind of moistening agent should be used in the eyes if they are going to be sitting in front of the laptop, staring at the laptop screen for a long time. There are some kinds of glasses which protect the lens. These are not meant for students who have weak eyesight. These are glasses which deteriorate the adverse affect of glaring at the screen from a longtime.”
If arranging anti-glare glasses is not possible, focus on optimum lighting. Their brain will function well and their eyes will be less strained, Dr Sumant adds. He shares in detail the correct ergonomics to be followed for a child while attending online classes. “A 90 degree position should be maintained while sitting and even the arms should be at 90 degree. Screen should be at eye level so no strain on the neck is caused. Shoulder should be down. Elbow at the level of the keyboard. Here’s an interesting fact- our calf muscles in lower limbs act as a peripheral heart of our body which pumps blood upward. Children’s chair-desk combination should be as per their height. Feet and the back should be totally supported. Teach students to take regular breaks and fuel with some exercises (as demonstrated in the video). Simple breathing and eye exercises are important. Students should be made aware of recognizing if they are feeling any sort of discomfort and inform elders.”
“In terms of furniture, parents can arrange chairs that help in some kind of movement like stretching their back or rocking chairs. Another option of a comfortable platform can be also be arranged where children can stand on it. So, sometimes children can use it as a stand table. It is not necessary that we define one particular place for them, we can have multiple places.” One may consider comfort, but I have a preference for standing workstations over seated/sleeping ones, Kanak Gupta agrees. This ensures no back pain and no dullness.
If possible, someone should supervise their posture and breaks, states Dr Sumant. Exemplifying this, Gupta shares, “I generally take pictures of my daughter to show her what posture she’s taking.”
Talking about the responsibility of an educator, Dr Bali avers, “It is important that both teachers and students realize that during the online classes the classes should be so planned that they allow children to move periodically. There should be breaks between the classes which allow children to move, get up, stretch themselves, take a little walk and refresh themselves before they come back to online teaching where they need to sit, listen and interact. To prevent them from harming their lower backs, it is very important that the classes are so timed that there are periodic breaks.”
The Principal of DLF Public School, Ghaziabad, Seema Jerath, shares how her school has ensured to maintain correct ergonomics in pre and during pandemic scenario. “Firstly, morning of Yoga and evening of fitness is our daily mantra. Every class has to do Yoga once in a week. In addition to that there are open Yoga classes every morning. Even parents and teachers join. In evening, we have a large fitness team to conducted fitness sessions. Secondly, we have mandatory active breaks. A curated list of ideas for active breaks is shared with teachers that can be used throughout the day. These breaks are incorporated as per the ratio 40:15. Every 40 minutes of class was followed by a 15 minutes of a break. Teacher conducts some kind of fun activity during this. For eg., music is played and teacher asks to ‘touch your knee, touch your shoulder, clap, clap, tap’. We find opportunities to ensure some kind of kinesthetic sessions for students including boxing moves or stress relief activity like laughing together.
Sometimes, if in between the class teacher feels the content is heavy and there’s a need for an active break, she takes one. Activities vary from 5 minutes to 10 minutes. Then students are asked to sit for some time with their eyes closed.”
Active Break Ideas by Seema Jerath, Principal, DLF Public School, Ghaziabad:
Fake it till you make it
Activity: Laughing together. You start with your artificial laugh and then after few minutes, you actually start to laugh. This acts as a stress buster.
Magic Word Game
Activity: If the chapter on National Movement is being taught, whenever the word ‘national’ comes, everybody will jog or if the chapter is of photosynthesis, whenever the word ‘plant’ comes, everybody will jump. Child gets the opportunity to enjoy a kinesthetic experience
In the pandemic scenario, the school has given some SOPs to parents to manage studies at home. “Guidelines like students should not be sitting on the floor or sitting on the bed. It has to be a table and chair, footrest, back support and other ergonomics. We have created something called ‘sit-up tall’, ‘shoulders down’ and ‘both the feet planted on the floor’- based guidance. We also insisted that somewhere children must walk, whether inside the house, in the balcony or if there’s a cycle or there’s a treadmill but somewhere some opportunity for cycling is recommended. If not, then they can depend on Yoga classes which we are continuing through virtual Apps. To limit the screen time, the average duration of online classrooms in a day ranges from 20 minutes in the nursery, 30 minutes to 45 minutes for the oldest children. Our active breaks now include eye, shoulder and back exercises,” shares Seema Jerath.
In India, 78.1 percent students are spending most of their online time for education. Evidently, a sense of urgency is pushing us to address the incorrect ergonomics amongst millions of our students.
Remember ergonomics is not a static activity, states Kanak Gupta and the success of these measures boils down to this very point. We can’t simply set it up and forget it. We would need to check on the arrangements at home and keep providing variety to the children.
Lt Col A Sekhar emphasizes on collaboration asserting that once you open the doors to smartphones and communications of that nature, speaking to friends, interacting with friends, going into other websites, it’s natural that the student at home is both angry and anxious. It has to be a collective effort. Will the schools get the balance right? Will the parents get the balance right? Will the students get the balance right? In all of this, the key is- understanding, laying down of expectations, guidance, counselling and a genuine give and take with a spirit of trust. That will work, nothing else will.
Anirudh Gupta, CEO, DCM Group of Schools shares his insights on taking care of postural health of children
In the present era of technology, children are always glued to their screens binge watching web series, playing online games, etc. With the transition to virtual learning due to COVID, the screen time of students has increased even more.
This has led to an increase in health problems faced by children. Many have complained about ear pain and have sighted dryness in eyes. In addition to these problems, certain observations have been made about the way students are attending their online classes. Many have been found to attend these classes while lying on their beds. This not only deteriorates the quality of child’s learning but also amounts to health issues- eye problem because of inappropriate angle and also back pain due to incorrect posture while learning. The survey conducted by Brainfeed itself has shown that more than 66% of students have experienced back pains, headaches, dry eye syndrome, insomnia, etc. as a result of maintaining incorrect ergonomics while online learning.
Hence, it is vital and more so at present times, that students maintain a proper posture while studying. To maintain correct ergonomics while learning at home, it is the responsibility of each stakeholder – parent, student and school to do their bit so that health is not compromised and each student progresses with his learning curve unabatedly.