How to cite:
Ni Nyoman Devi Yani Prabashanti, I Putu Gede Adiatmika, Susy Purnawati.
(2021). Changes of Work Condition and the Mc Kenzie Ergonomic
Intervention Could Decrease of Musculoskeletal Disorder and Work
Fatigue Among “Dodol” Industry Workers with Low Back Pain. Journal
Eduvest. 1(10): 1190-1195
E-ISSN:
2775-3727
Published by:
https://greenpublisher.id/
Eduvest – Journal of Universal Studies
Volume 1 Number 10, October 2021
p- ISSN 2775-3735 e-ISSN 2775-3727
CHANGES OF WORK CONDITION AND THE MC KENZIE
ERGONOMIC INTERVENTION COULD DECREASE OF
MUSCULOSKELETAL DISORDER AND WORK FATIGUE AMONG
“DODOL” INDUSTRY WORKERS WITH LOW BACK PAIN
Ni Nyoman Devi Yani Prabashanti, I Putu Gede Adiatmika, Susy Purnawati
Udayana University
E-mail: [email protected]
ARTICLE INFO ABSTRACT
Received:
September, 26
th
2021
Revised:
October, 16
th
2021
Approved:
October, 18
th
2021
An unergonomical working condition could cause low back
pain due to wrong position. For those condition affected
to work production and the worsens is disability. This
study aims to change of work condition by gave break
time actively with the solution placed of water and all
tools equipment distance, and prevention with McKenzie
ergonomic intervention to decrease of musculoskeletal
disorders among ‘dodol’ industry workers. This
experimental study used treatment by subject design and
there were 12 samples study. Period 1 of this study is
working condition of process mixing “dodol” without any
intervention given by researcher, meanwhile period 2
samples already work with changes strategy based on
ergonomic and washing out period, also adaptation held
in along period. Low Back pain was measured by Oswestry
Disability Index (ODI) and productivity based on
comparison product in a day, and score for low back pain
measured per work time. Data was analysed with SPSS
ver.16 and α=0,05. Results of this research that there was
significant difference statistically among variable, and
difference of mean is 7,33 or there was decreased of
Ni Nyoman Devi Yani Prabashanti, I Putu Gede Adiatmika, Susy Purnawati
Changes of Work Condition and the Mc Kenzie Ergonomic Intervention Could Decrease
of Musculoskeletal Disorder and Work Fatigue Among “Dodol” Industry Workers with
Low Back Pain 1191
musculoskeletal disorders 10% from 54,31±0,79 to
45,04±0,88. The conclusion of this study that changes of
work condition with ergonomic basic could decrease
musculoskeletal disorders among “dodol” industry
workers with low back pain syndrome at Penglatan,
Buleleng Regency.
KEYWORDS
Changing of work’s condition, Musculoskeletal Disorders, Low
Back Pain
This work is licensed under a Creative Commons
Attribution-ShareAlike 4.0 International
INTRODUCTION
A famous “Dodol” home industry in Buleleng was at Desa Penglatan. Their
product “dodol” had been exported to abroad and foreigner was like it. Process of make
“dodol” still used traditional tools and equipment including fire, mixer that was called
“suit” and they still used wooden either fuel. Process of making “dodol” divided to
process of making flour, then coconut cream and all of those boiled along with brown
sugar, sugar palm, mixing of glutinous rice flour, “injin” flour and coconut cream. Next
process was mix of all those ingredients for 5 hours and that must continue by the
workers, and they will do that in static position. There was “dodol” dough around 27 kg
and all need to mix continuing. A worker usually did 6 times for dough with standing
static position and used tool to mix it that size was not ergonomic, therefore worker do
that in bad posture and affect to musculoskeletal disorders.
The problems from “dodol’ industry, hot environment could reach 30 degrees
Celsius, noise from flour maker and coconut cream maker reach 94,29 dB and attention to
wooden on the fire settings. This situation if continue could affect mental health of
worker, uncomfortable and musculoskeletal disorders among them. A recent study stated
that worker dominant standing position and squatting static and while they standing there
were flexion movement of cervical, rotate of shoulder, flexion lumbar and bending to
lateral, twisting of spine and this movement was repetitive especially movement of
elbow. If this position continuing, that will affected muscle strength of Upper extremity,
overload of back and caused back muscle unstable and reduce muscle strength, and due to
repetitive movement there will spasm around back muscle and caused low back pain.
Based on Nordic Body Map (NBM) to measure musculoskeletal disorders in 7 samples,
there are pain (21,4%). Another study stated that workers who pain at right shoulder
(27%), low back (45%0, left shoulder (21%) and lower extremity (13%) and all workers
in that study felt pain and had uncomfortable in extensor muscle and flexor lumbosacral.
Work condition which not find an ergonomic standard eventually will cause low
back pain and could overcome with changing the condition in the form of arrange their
break time between work hours, changing of water position and flour maker tools, also
changing position of coconut cream maker distances 2 meters from them so they have
walk little to have that. The prevention strategy was given them the Mckenzie ergonomic
intervention. The principle of MzKenzie exercise was changing posture and decrease of
hyper lordosis lumbar spine, improve strength muscle flexor and stretch of extensor group
muscles that was stated at recent study by (Jumiati, 2015). This exercise was one of back
exercise that effective to change the posture and reduce musculoskeletal disorders, also to
increase mobility of spine. Effect of this exercise could decrease of work fatigue due to
Eduvest – Journal of Universal Studies
Volume 1 Number 10, October 2021
1192 http://eduvest.greenvest.co.id
blood circulation and it will affect to muscle cell healing optimal. In this study, all of
intervention could affected work condition will give effective, comfort, safety, health and
efficient that was decreasing indicator of musculoskeletal disorder among “dodol”
industry at Penglatan, Buleleng Regency. This area study rarely to intervent, so this
appoarch hopefully will help them.The observational study by researcher before found
the problem among the workers and try to apply change work condition and use
ergonomic exercise to decrease the symptomps.
RESEARCH METHOD
This study was experimental study with treatment by subject design conducted in
another time period. Study was in “Dodol” home industry at Penglatan Village, Buleleng
Regency and 8 weeks period study from December 2020 – March 2021. There were 12
samples chosen and given treatment by researcher. Low Back Pain was measured by
Nordic Body Map (NBM) questionnaire. Analysis data used SPSS ver.16 with value
α=0,05.
RESULT AND DISCUSSION
Mean of age samples was 39±7,786.( table nya diisi karakteristik and Mean of
work period samples was 9±3,143 with range in 5-15 years. Humidity at the working
station is the highest number and as well as the temerpature. That show there were
significant differences statistically after period 2 (p<0,05) (Showed in table 1.)
Table 1. Comparability test work condition
Variable
Period 1
P value
Mean±S
D
Temperature (°C)
29,35±0
,85
0
,078
Humidity (%)
70,00±7
,87
0
,079
Light Intensity (lux)
298,92±
59,50
0
,593
Noise (dBA)
75,78±4
,05
0
,203
Analysis data musculoskeletal period 1 and period 2 found significant difference
statistically with p value < 0,05 in post data, and difference of mean was 7,33 or
decreasing musculoskeletal disorders around 10%.
Table 2 Analysis Data Musculoskeletal Disorders
Pre
Post
P
value
Period 1
35,46±1,72
54,31±0,79
0,002*
Period 2
35,13±0,79
45,04±0,88
0,000*
P value
0,390**
0,002**
Ni Nyoman Devi Yani Prabashanti, I Putu Gede Adiatmika, Susy Purnawati
Changes of Work Condition and the Mc Kenzie Ergonomic Intervention Could Decrease
of Musculoskeletal Disorder and Work Fatigue Among “Dodol” Industry Workers with
Low Back Pain 1193
There was Decreased of musculoskeletal disorders prof on the picture and shown
on the chart that period 2, area back, gastrocnemius or lower extremity, shoulder, arms
and fingers. MzKenzie exercise and changing work condition gave relaxation effect due
to stretching of antagonist muscles, and caused isometric along autogenic inhibition
(GTO). After changing of work condition, there was decreased of blood circulation and
help cell muscle to healing therefore, there was decreased of accumulation fatigue and
musculoskeletal disorders among “dodol” workers with low back pain condition.
(Showed at picture 1)
Picture 1. Chart of musculoskeletal disorders
Workers who age 20-50 years had physical ability stronger and they had good
productivity, meanwhile workers who age more that 50 years had weak physically and
impacted to their productivity. That mean, as older there was bone degeneration and
necrosis of tissue, it will made scar tissue and decrease of stability and elasticity of bone
and muscle (Hadyan, 2015). Work period was risk factor that affected of risk worker to
have musculoskeletal disorder especially them who work with strength (Rivai, 2014).
Environmental condition was another risk that could effect on musculoskeletal disorder
among workers. Based on Sedarmayanti (2009) stated that risk factor from physical work
were humidity, air circulation, lighting, noise and mechanical vibration. Data from
Menaker (2018) work condition in all period in this study was showed ideal condition
that need to applied by this industry.
Musculoskeletal disorders were caused by muscle contraction that effected of
increasing load in muscle therefore there were obstruction in blood circulation in blood
vessels. Decreasing of blood circulation had risk to static contraction. Muscle energy
could made mitosis cell and there was ion calcium accumulation could necrosis of cells.
This static contraction which long period based on Daryono (2016) could affected of
pathology process resulting pain.
Workers who had in static position in long period and with those work
environment was not health and not meet ergonomic standard. This condition will cause
of problem and longtime standing static position made them to balance their body which
caused work load static among lower extremity muscles and caused blood clot there with
risk kyphosis of spine and low back pain.
This work methods that caused work position uncomforted and happened in long
period with those mixing movement and repetitive could cause problem in
musculoskeletal. While work, as human being will be found position and adapt with
system. Those condition caused musculoskeletal disorders especially low back pain
symptoms. To solve that problem, we need to know what is criteria for work ideally; (1)
muscle contraction static less, (2) static position relax always better (Sutajaya, 2018).
0
10
20
30
40
Back Gastroc Shoulder Arm Fingers
39,2
32,1
25
17,8
10,7
32,1
21,4
14,2
10,7
7,1
Musculoskeletal Disorders
pre post
Eduvest – Journal of Universal Studies
Volume 1 Number 10, October 2021
1194 http://eduvest.greenvest.co.id
Mckenzie exercise was one of back exercises proven could changing posture and
decrease of musculoskeletal disorders, also increasing mobility of spine while work.
Meanwhile, operationally, aims of give this exercise were to stretch back muscle
(extensor muscle) and this exercise prioritize extension movement to have strength and
stretch muscle along extensor and lumbosacral joint, resulting reduce of pain (Moldovan,
2012). Stretching muscle to resting length and had circulation optimal to the brain made
this condition decrease of work fatigue. This intervention to change work condition
including the break time active and McKenzie exercise will the best ergonomic solution
that change of layout, exercise and stretching effected to relaxation spasm muscle,
stretching of antagonist muscles. Stretching of antagonist muscle had from isometric
contraction of muscle and change in work condition with addition McKenzie exercise.
Those could increase relaxation and decrease pain along spasm.
Based on stated McKenzie (2000), McKenzie aims to decrease of pain and
functional activity to mobile maximal from lower back, or maximal movement of the
body. Besides that, stretching of muscles to resting length condition could gave blood
circulation maximal to brain and help reduce of work fatigue also increasing of focus
(Ganong (2008). McKenzie effected to relaxation spasm muscle due to of stretching
antagonist muscles and gave isometric contraction resulting of decreasing the pain.
McKenzie ergonomic intervention and work condition changes within took break time
active while working and distances 2m of water position and the flour and coconut cream
maker made workers had been better. This changes use ergonomic approach with total
decrease of musculoskeletal around 5,24% among craftsman at Kediri, Tabanan
Adiatmika (2007). Therefore, this intervention had been known good to ergonomic and
work condition changes prooven could decrease musculoskeletal disorders.
CONCLUSION
Based on the analysis and discussion it can be concluded that changing of work
condition within ergonomic could decrease of musculoskeletal disorders in “dodol”
workers industry with low back pain at home industry Penglatan Village, Buleleng
regency around 10%.
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of Musculoskeletal Disorder and Work Fatigue Among “Dodol” Industry Workers with
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