NCS University System
Department of Physical Therapy and Rehabilitation
Canal Road, Abdara, Peshawar Pakistan
TITLE:
PREVALENCE OF NECK PAIN AND FORWARD HEAD
POSTURE AMONG AUTO RIKSHAW DRIVERS AT PESHAWAR: A
DESCRIPTIVE CROSS-SECTIONAL
Name of Supervisor: Dr Aqsa Khan PT
Co-Supervisors:
Duration of Project: 6 month after approval
Institute: NCS University Peshawar, Department of Physical Therapy
Budget Required:
Nil
Name & Signature of Student/Scholar:
Name __________________________Signature: ____________
Name __________________________Signature: ____________
Name __________________________ Signature: ____________
Name __________________________ Signature: ____________
Name & Signature of the Supervisor: __________________________________
Name & Signature of Head of Institutional Research Committee: _______________________________
NCS University System
Department of Physical Therapy and Rehabilitation
Canal Road, Abdara, Peshawar Pakistan
1. TITLE
PREVALENCE OF NECK PAIN AND FORWARD HEAD
POSTURE AMONG AUTO RIKSHAW DRIVERS AT PESHAWAR: A
DESCRIPTIVE CROSS-SECTIONAL
2. INTRODUCTION
Pain is define as the unpleasant, sad, emotional feeling related with current experience or
potential tissue injury and described in term of such injury(1).Pain that is originated from
occipital area to the third thoracic vertebra and involving the medial borders of the both scapulae
as known as neck pain(2).Neck is common complaint in both genders (male and females)(3).It
has been reported that common neck pain is caused by mechanical and postural stress(4).Forward
Head Posture (FHP) is one of the most common unhealthy Posture(5).FHP is when the head is
moved forward from the body gravity line(6).In FHP the head is placed anterior to the trunk and
the center of gravity shifted in anteriosuperior direction, for this compensation the upper body
drifts backward and the shoulder slumps forward(7). The tragus of the ear was used for the
assessment of FHP. Head posture is marked normal, if the plumb-line through the tragus of the
ear, thus this displacement of tragus from the plumb will be measured as FHP. The assessment
was done in sagittal plane(8). Auto-rickshaw is design as small three wheeled, three seater, low
floor, light-weight taxi is of the most common means of transportation used by public(9). Like
other professional drivers Auto-rickshaw drivers also develop musculoskeletal disorder especially
Due to rough roads, long work time with poor posture, stuck traffic, poor ergonomics of autorickshaw and poor maintenance of the vehicle(10). A Study were reported (by Lakhwinder Pal
Singh, Department of Industrial and production Engineering, Dr. B. R. Ambedkar NIT, Jalandhar
India in January 2019) that auto-rickshaw drivers were exposed that 47.5% of the drivers
complain about the pain in the neck as consequence of prolonged exposure to vibration(11).
Studies were conducted in general papulation of workers recommended that the yearly prevalence
(annual report) of neck pain from 27.1 per cent in Norway to 33.7 per cent in the United
Kingdom and to 47.8 per cent in Quebec, Canada(12). A study was conducted in 2013 ((by Al
Mubed Md at Bangladesh Health Professions Institute, CRP) that prevalence of neck pain was
74.7% in bus drivers, in which 66.1% have neck pain due to forward flexion of neck(13). Study
was carried out that found a lifetime prevalence of neck pain in Hong Kong 69.3% (2091/3018).
NCS University System
Department of Physical Therapy and Rehabilitation
Canal Road, Abdara, Peshawar Pakistan
The prevalence of year 66.7 per cent (2005/3007). Pain in the neck after becoming driver was
59.7 per cent (1745/2923)(14).
There is a literature available on neck pain and FHP globally and locally but there was limited
literature on the prevalence of neck pain and FHP in Khyber Pukhtunkhwa Pakistan. Hence the
aim of current study is to create awareness among the auto-rickshaw driver’s wrong position or
posture they adopted during driving. Also to make awareness that sitting for prolong period of
time during driving may cause neck pain. Also to acknowledge them that setting for sustained
period of time in one position especially during driving can lead to forward head posture. Neck
pain actually incidentally, one the feasible way to prevent neck pain that improve physical
capacity of the muscles of nick and shoulder by exercises.
3. OBJECTIVE:
To find the prevalence of neck pain and forward head among auto-rickshaw drivers
4. OPERATIONAL DEFINITIONS:

Pain is define as unpleasant sensation cause by mental or physical stress or injury.

Neck pain is initiate from the occiput and extending to the upper back, medial borders of both
scapula up to third thoracic vertebra.

Forward head posture when the head changes its position from normal and moves forward from
the cervical spine the condition is termed as forward head posture.

Auto-rickshaw driver The person who drive a rickshaw
5. HYPOTHESIS:
NCS University System
Department of Physical Therapy and Rehabilitation
Canal Road, Abdara, Peshawar Pakistan
Not required in this study
6. MATERIALS AND METHODS:
6a. Study Design:
Descriptive Cross-sectional study
6b. Study Settings:

North Canal Road Pawaky

University town Peshawar

Board bazar Peshawar

Custom road Peshawar

Abdara road Peshawar
6c. Study Duration:
6 month after approval
6d. Sample Size:
134
6e. Sampling Technique:
Non probability purposive sampling technique
7. SAMPLE SELECTION:
7a. Inclusion Criteria:
Only male drivers will be included.
Individual age (18-50 yrs.)
7b. Exclusion Criteria:
NCS University System
Department of Physical Therapy and Rehabilitation
Canal Road, Abdara, Peshawar Pakistan
Patient with other comorbidities i-e refer from viscera’s
8. DATA COLLECTION PROCEDURE:
After obtaining approval the research graduate committee, permission from director NCS University
system Peshawar. Data will be collected from different auto-rickshaw drivers of Peshawar, who fulfil
eligibility criteria for the study. Data will be collected through direct interview proses byself structure
questionnaire.
9. DATA ANALYSIS PROCEDURE:
Data will be analyzed by SPSS version 25.0. Descriptive statistics (graphs and tables etc.) will be used to
analyze the research data.
10. BIBLIOGRAPHY:
1.
Merskey H. The Classification of fibromyalgia. Pain. 2008;135(3):315.
2.
Kashif M, Zafar M, Asif M, Munawar F. Prevalence of neck pain and adopted posture in drivers. Annals of Allied Health
Sciences. 2016;2(1):23-7.
3.
Green BN. A literature review of neck pain associated with computer use: public health implications. The Journal of
the Canadian Chiropractic Association. 2008;52(3):161.
4.
Binder A. The diagnosis and treatment of nonspecific neck pain and whiplash. Europa medicophysica. 2007;43(1):79.
5.
Yip CHT, Chiu TTW, Poon ATK. The relationship between head posture and severity and disability of patients with neck
pain. Manual therapy. 2008;13(2):148-54.
6.
Griegel-Morris P, Larson K, Mueller-Klaus K, Oatis CA. Incidence of common postural abnormalities in the cervical,
shoulder, and thoracic regions and their association with pain in two age groups of healthy subjects. Physical therapy.
1992;72(6):425-31.
7.
Kang J-H, Park R-Y, Lee S-J, Kim J-Y, Yoon S-R, Jung K-I. The effect of the forward head posture on postural balance in
long time computer based worker. Annals of rehabilitation medicine. 2012;36(1):98.
8.
Vakili L, Halabchi F, Mansournia MA, Khami MR, Irandoost S, Alizadeh Z. Prevalence of common postural disorders
among academic dental staff. Asian journal of sports medicine. 2016;7(2).
9.
Anil H, Arunima S. Noise Induced Hearing Loss in Autorickshaw Drivers in Bangalore: A Cross Sectional Study. Indian
Journal of Otolaryngology and Head & Neck Surgery.1-7.
10.
Mohokar AP, Deoke AR, Soaji AV. Prevalence & risk factors of musculoskeletal impairments among auto-rickshaw
drivers in a city of central India.
11.
Singh L. Musculoskeletal Disorders and Whole Body Vibration Exposure among Auto-Rickshaw (Three Wheelers)
Drivers: A Case Study in Northern India.
12.
Côté P, van der Velde G, Cassidy JD, Carroll LJ, Hogg-Johnson S, Holm LW, et al. The burden and determinants of neck
pain in workers: results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Journal
of manipulative and physiological therapeutics. 2009;32(2):S70-S86.
13.
Al-Mabud M. Prevalence of neck pain among the highway bus drivers: Department of Physiotherapy, Bangladesh
Health Professions Institute, CRP; 2013.
14.
Chiu TT, Lam PK. The prevalence of and risk factors for neck pain and upper limb pain among secondary school
teachers in Hong Kong. Journal of occupational rehabilitation. 2007;17(1):19-32.