Methods and analysis

The researchers will use Analytical Cross-Sectional Study Design with the data collected from the UST-CRS PT students to understand health variables, evaluate the prevalence of health outcomes and identify population characteristics. Compared with other forms of observational research, cross-sectional studies do not establish a longitudinal interaction with participants.15 With this, this study aims to gather data from first to fourth year UST-CRS PT students, at one point in time to measure the correlation between ergonomic knowledge and their level of MSK discomfort during online classes.

Table 1 shows that participants must be either regular or irregular UST-CRS PT students from first to fourth year in the online class for the academic year 2023 to 2024. In addition, a study discovered unfavourable effects during 2 hours of prolonged sitting with clinically significant increases in discomfort to different parts of the body.16 With this, students who engage in at least 2 hours of prolonged sitting in synchronous and asynchronous online classes are eligible.16 In contrast, excluded are students who have taken a leave of absence, students with MSK discomfort before the implementation of online classes, students with MSK discomfort that may be due to other aetiology such as accidents, students whose other hobbies and sports cause discomfort with ≥2 hours of prolonged sitting postures such as visual arts and online gaming,2 17 and those with existing MSK conditions and/or other conditions unrelated to MSK that may cause discomfort15 to limit the effect of confounding factors on the findings.

Using the G*power tool to compute the effect size of 0.289 and the number of participants is adapted from a similar study exploring ergonomic knowledge and MSK disorders among students in India.18 Increasing 20% of the computed value to the total number of participants ensures leeway in case of withdrawal, thereby getting a sample size of 120, with a 95% CI and a 5% margin of error. This process will be performed through Quota Sampling wherein the researchers will divide the population of UST-CRS PT students into subgroups based on their year level, then determine the quota for each stratum. Lastly, the researchers will select the participants according to the inclusion and exclusion criteria.

The study will be conducted in the Philippines using an online platform. Online platforms ensure efficient and organised data collection and minimise the potential for clerical errors. The researchers will disseminate the recruitment materials via Facebook, which would be an effective platform given its massive audience, broad reach and student popularity. The researchers will give the consent form and survey through Google Forms to gauge who will participate. The researchers also aim to focus on UST as the primary school for the study, consulting students from CRS under the PT department. The researchers will conduct the study between the academic years 2022–2023 and 2023–2024. The recruitment and data gathering will start on June 2023 and will conclude on December 2023.

The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) measures the frequency of discomfort in a week and the level of discomfort experienced by an individual. The next portion of the questionnaire asks how discomfort affects participants' ability to carry out their activities. The questions in CMDQ include frequency and severity of MSK discomfort per region, including the neck, shoulder, upper back, upper arm, lower back, forearm, wrist, hip or buttocks, thigh, knee, lower leg and foot. Moreover, this assessment tool also asks how the pain or discomfort hinders or causes problems with their work. Additionally, this questionnaire indicates good psychometric properties and a validity score of 0.62–0.92 and reliability score (0.56–0.95, 0.59–0.97 and 0.60–0.94 for frequency, severity and interference scales) to determine the participants’ suitability to the study based on the inclusion and exclusion criteria which was also used to assess experience of discomfort in different parts of the body among Filipino college students during online classes.19 20

The second tool is an Ergonomic Knowledge Questionnaire composed of 35 items which aims to assess the level of knowledge of first–fourth year PT students on ergonomics. The Ergonomic Knowledge Questionnaire was used in Sirajudeen and Pillai’s study to assess computer professionals' knowledge of proper ergonomics in India. A study regarding the test–retest reliability of this 35-item questionnaire demonstrated fair (r=0.75) to high reliability (r=0.91) using the Pearson correlation coefficient.21 Moreover, another study on the questionnaire yielded a 0.98 overall content validity index, which signifies a good screening tool.22

As seen in figure 1, The researchers will initially acquire ethical approval from the UST-CRS Ethics Review Committee (ERC). Following this, the researchers will seek approval for the conduct of the study from the CRS office of the dean through a letter stating the purpose of the study, the reason researchers chose the PT students as the study’s participants and the request for obtaining the total number of students in the PT programme. The team will then conduct the recruitment process once approved by the dean’s office. The researchers will use recruitment materials such as posters and infographics containing the significance, benefits and risks of participating in the research. These would also include the eligibility criteria for participants to determine their suitability for the study. The researchers will also disseminate the Participant Information Sheet, Informed Consent Forms (ICF) and data privacy forms. Should any clarificatory questions arise on reading these forms, the participants are free to ask the researchers via email before consenting. The participants must submit a PDF file of their proof of enrolment to certify that they are a bonafide UST-CRS PT student for the academic years 2023–2024. Then, the three-part questionnaire will be distributed via Google forms and sent to participants' emails. The first part of the questionnaire, which collects the sociodemographic profile of the participants, will be disseminated. It will guide the final screening process to evaluate their eligibility to participate in the study. Then, the researchers will use Quota Sampling to gather the specific number of participants required to conduct the study.

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Figure 1

Data gathering procedures.

Following this, the ergonomic knowledge questionnaire will be the second part of the form that will determine the level of their knowledge regarding ergonomics. Afterward, answering the CMDQ will be the last part of determining the participants’ level of discomfort. The time allotment for answering the questionnaires is 10–15 min. It will be open for seven (7) days for participants to answer. Progress saving will be allowed by default. After which, the forms will be closed. Only two members of the researchers will have permission in Google Drive. In addition, the devices required to access the drive will be password protected. Access and storage of data will be permitted for five (5) years after the completion of the study and deleted afterward.

The study will use descriptive statistics to summarise the demographic data and the questionnaires' findings. To ensure confidentiality, personal data collected from participants will undergo initial coding, following the procedures outlined in the ICF. Afterwards, researchers will transfer and organise it in Microsoft Excel for the comparative analysis phase of the study. The researchers will get the frequency and percentage to analyse the data obtained from the sex and year level while mean and SD for the age, presented using tables and through visualised data using graphs and charts.

The CMDQ score will be analysed by summing the rating values based on the #2 scoring guidelines,23 while the EKQ score will follow the scoring guidelines established by the questionnaire’s author. Data will be analysed per year level using the Mean Measure of Central Tendency using Microsoft Excel V.16.72.

Furthermore, the researchers will analyse the correlation between the scores from EKQ and CMDQ using the Pearson Correlation Test in SPSS V.29 to determine the correlation between the two variables. They will analyse the correlation between the level of Ergonomic Knowledge and MSK discomfort with a CI of 95% and an α value of 0.05. Subsequently, a Pearson correlation coefficient (r) will provide data to determine whether they have a significant relationship wherein a r-value of greater than 0 (> 0) corresponds to a positive correlation and an r-value of less than 0 (< 0) coincide with the negative correlation of the two variables. A positive correlation refers to a direct relationship, indicating that as ergonomic knowledge increases among students, there is a corresponding increase in the occurrence of MSK discomfort, and vice versa. On the other hand, a negative correlation signifies an inverse relationship, suggesting that higher ergonomic knowledge aligns with a lower incidence of MSK discomfort among students, and vice versa. Furthermore, having a value ranging between 0 and 0.3 implies a weak strength while a value that ranges greater than 0.5 implies strong strength (table 2). These values will determine the relationship strength of the two variables that the researchers aim to obtain. Scatter plots generated with SPSS V.29 will be employed to visually interpret the correlation results and further determine whether the correlation has a significant relationship. The researchers will establish an alternative hypothesis stating the presence of a significant correlation between the two variables. Additionally, obtaining a p value lower than 0.5 signifies the need to reject the null hypothesis.