Prevalence of Wrist Pain Among Painters

By

Kahkishan Toor

for

Doctor of Physical Therapy

Under Supervision of

Dr. Sameen (Qualification)

Akhtar Saeed Medical and Dental College

University of Health Sciences
 UNIVERSITY OF HEALTH
Title of Research Project:
SCIENCES, LAHORE
Synopsis submitted for:
Doctor of physical therapy

University Registration Number:

Name of Research Supervisor Signature: Date:

Name of Head of Department Signature: Date:

Name of Principal Signature: Date:

Institutional Ethical Review Committee Signature Date

TABLE OF CONTENTS

Sr. No. Contents Page No.

1 INTRODUCTION
2 LITERATURE REVIEW

3 HYPOTHESIS

4 OBJECTIVES

5 OPERATIONAL DEFINITIONS

6 MATERIAL AND METHODS

7 DATA COLLECTION

8 DATA ANALYSIS

9 OUTCOME UTILIZATION

10 REFERENCES

11 ANNEXURES

11.1 ETHICAL CONSIDERATIONS

11.2 CONSENT FORM (ENGLISH)

11.3 CONSENT FORM (Urdu)

11.4 GANT CHART

11.5 PROFORMA/ QUESTIONAIRE

LIST OF ABBREVIATIONS
Abbreviations Full Form
CTS Carpal Tunnel Syndrome
ORCA Organization readiness to change assessment
NMQ Nordic Musculoskeletal Questionnaire

1. INTRODUCTION
Wrist pain is a common clinical problem observed mainly with occupation-related and is strongly
correlated to carpal tunnel syndrome which is a pathological peripheral mononeuropathy occurring
due to increase in the flexor retinaculum pressure in the carpal tunnel progressing towards pressure
damage of median which ultimately causes sensory and motor failures in the area innervated by
median nerve (DIN (2020). Repetitive strain injury for painters commonly affects some part of the
arm including: the fingers, wrist, forearm, elbow, shoulder. Sometimes pain is also seen in neck or
upper back region (Tyrrell, 2016).
There are various internal plus external risk factors which are determined but most ordinal
demonstrated are increased age, body mass index and gender female. In the work-related risk
components, it is found that association of force with frequency plus the period of physical exertion
are the main risk factors that increased the risk of carpel tunnel syndrome (Garg et al., 2012). Many
acute cases are sprains or contusions following a minor injury, or tendinitis following an episode of
overuse. These problems generally resolve within weeks with rest, temporary immobilization and
symptomatic pain relief. Wrist pain that does not resolve after six weeks to three months is usually
considered as chronic and a challenge to the physician (Liao et al., 2013).
A systematic approach to assessment and provides numerous advantages to immediately focusing
on the primary site of pain or using a variable assessment approach for each patient included in
basic clinical examination. The primary advantage is improved recognition of pathology, allowing
the clinician to explain the reason for pain and/or dysfunction to the patient, thereby providing
reassurance and building clinician-patient rapport (Porretto-Loehrke et al., 2016). Patients with
wrist pain commonly present with an acute injury or spontaneous onset of pain without a definite
traumatic event. A fall onto an outstretched hand can lead to a scaphoid fracture, which is the most
commonly fractured carpal bone. 30-percent of scaphoid fractures alone can be missed by
convention X-ray imaging (Shehab and Mirabelli, 2013). When evaluating a patient with radial
wrist pain, clinicians need to consider a number of possible etiologies, including systemic disease,
referred pain to the radial aspect of the wrist, and local tissue dysfunction. A commonly considered
local tissue dysfunction in patients with radial wrist pain is De Quervain syndrome or stenosing
tenosynovitis of the first dorsal compartment (Moore and medicine).
Wrist pain may vary, depending on the cause. For example, osteoarthritis pain is often described as
being similar to a dull toothache, while carpal tunnel syndrome usually causes a pins-and-needles
feeling or a tingling sensation, especially at night. The precise location of your wrist pain also
provides clues to what’s behind your symptoms. Not all wrist pain requires medical care. Minor
sprains and strains usually respond to ice, rest and over-the-counter pain medications. But if pain
and swelling last longer than a few days or become worse, see your doctor. Delayed diagnosis and
treatment can lead to poor healing, reduced range of motion and long-term disability (Mayo)
(2020).
The most common complications, which greatly reduce the functional ability of distal parts and
entire upper extremity after injury and immobilization, are the tunnel syndromes, complex regional
pain syndrome (Suddeck atrophy), Dupuytren’s contracture, and improper healing of bone
fragments. Peripheral nerves, which are located in narrow anatomical canals, are more susceptible
to trauma. Excessive flexion or extension, traction owing to fractures, soft tissue compression,
hematoma, and later on – scar tissue, friction, and trauma owing to callus during active movements
lead to posttraumatic tunnel syndromes (Byrchak et al., 2020).
Correct diagnosis and management of ulnar-sided wrist pain can present a significant problem for
the physical therapist. Among the causes of pain to be considered during the process of differential
diagnosis are ulnar nerve injury, intercarpal instability, extensor carpi ulnaris tendon subluxation,
tenosynovitis, triangular fibrocartilage complex injury, ulnar impaction syndrome, ulnar artery
thrombosis, or potentially fractures of the regional osseous structures such as the ulnar styloid
process, triquetrum, or hamate. Hook of the hamate fractures may be particularly difficult to
identify because of the base of the hook of the hamate not being well visualized with the usual
radiographic views and a lack of distinguishing findings on clinical examination. Understanding
and integrating the patient's history, clinical examination findings, and diagnostic imaging
indications and results are important for optimal decision making and patient management
(O'Grady and Hazle, 2012).
This study is an effort to find the association of work-related musculoskeletal wrist pain among
painters. This research will be considered as a result of an excessive incidence of wrist pain among
painters. The main aim is to determine the prevalence of wrist pain in painters and increase their
postural awareness.

2. LITERATURE REVIEW
Din et al., studied the association of work-related musculoskeletal wrist pain and carpel tunnel
syndrome among painters. A sample size of 187-painters irrespective of gender and age was
included using non-probability sampling technique. Data was collected through a self-
administrated questionnaire and on the basis of pain rating Visual Analog Scale. Painters were
categorized into different categories viz painters who were Normal/Healthy (having no pain and/or
numbness and tingling sensation in wrist or hand), Painters having only pain without any numbness
and tingling sensation in wrist or hand, painters having any numbness and tingling sensation in
wrist or hand alone without any pain. The results of this study have shown that the prevalence of
wrist pain among painters in 49.7%, while 12.9% painters were reported to have only symptoms of
numbness and tingling sensation while 19.8% were having pain, numbness, and tingling sensation
at the same time. CTS was detected in 37(19.8%) painters and it was significantly associated with
painters having pain, numbness and tingling sensation at the same time, as Reverse Phalen’s test
was positive in all these subjects (Hamed et al.) (2020).
Vitelli et al., studied the upper limb risk assessment in painters. The objective of this research was
to provide guidelines for the reliable assessment for a variety of ergonomics exposures in non-
routinized work situations. Workers and masters determined the painting activities and tasks in
cooperation with a taxonomic framework of 875-painters.  OCRA Checklist method for evaluation
of biomechanical upper-limb overload was used by a valid questionnaire to assess the risk of
specific tasks. Observations were conducted for three different days and for the whole duration of
activity. It was concluded that twenty-four tasks were analyzed, and, globally, 75% were
considered at medium-high level of risk of developing an upper limb musculoskeletal disorder,
mainly due to high frequency of action and awkward postures indicating the necessity of
intervention to reduce the risk in this specific sector. It was also observed that awkward postures of
the wrist are also common in tasks involving the use of brush. The presence of a risk is confirmed
from health data which show a high prevalence of upper limb – musculoskeletal disorders,
especially for the district that came out as the more overloaded in this specific job and is much
more evident for workers with longer length of service. Shoulder results the most overloaded
district, according to previous evaluations of upper limb biomechanical overload in painters.  The
studied focused interventions are necessary to know deeply risks involved in this specific job and
intervene to reduce them by ergonomically preventive strategies (Vitelli et al.).
Narducci et al., did a systematic review on the musculoskeletal and associated conditions in the
professional artists. It was documented that between 73.4-87.7% of professional painters suffer an
occupational-related musculoskeletal disorder during their careers. It was established that chronic
injuries were due to overuse or misuse; awkward bad posture was leading to majority of
musculoskeletal injuries. The cause of these type of injuries is very vast and includes postural
deficits, changes in awkward postures during painting. Most conditions can be managed with
conservative treatment, interventional methods may be necessary in many cases (Narducci, 2020).
Brandfonbrener conducted a case study on thumb pain in a painter. A 49-year-old white female
professional painter and professor of artistic paintings at a Community Painting College in
Brimingham. The past summer it noticed that her right thumb was tender after delivering a lecture
which soon became bilateral. The study concluded that there was a strong correlation of painting
with thumb pain and devised a ergonomical, and a physical therapy plan of care for the patient to
decrease and minimize the pain (Brandfonbrener et al., 2004).
Murray et al., conducted research to find the prevalence of occupational related wrist pain among
the painters. A sample size of 566-participants was calculated and included in the study using non-
probability convenient sampling. Nordic Musculoskeletal Questionnaire was used to evaluate the
pain in the participants. It was concluded that wrist pain in painters is very common and when they
occur, they can devastate the painter, as hand and wrist are so much related to their occupation
(Murray and Cooney, 1996).
Dehghan et al., conducted a study on prevalence of musculoskeletal wrist pain among a group of
Iranian painters. The aim of this study was to evaluate the rate of wrist pain among the painters in a
sample of Iran. Sample size of 99-participants were included in this study by signing an informed
consent and filling the Nordic musculoskeletal questionnaire. All subjects who had a work
experience of more than 1-years and 3-16 hours/day work duration were included in this study
according to the inclusion criteria. Findings of this research proved that 59.5% shoulder pain,
54.5% neck pain, 38.4% wrist pain among the total population of the painters taken as sample. It
was concluded that more than half of the cases suffer from the shoulder or neck pain and
simultaneously with wrist pain. It was further noted that resting time between the work had a
serious impact on preventing work-related musculoskeletal disorder in painters. Thus, painting is a
occupation with high-risk to develop musculoskeletal pain and disorders, mainly due to the
repeated bad and unsafe postures during working hours (DEHGHAN et al., 2003).
Barghout et al., studied the risk factors and prevalence of musculoskeletal disorders among the
Jordanian labor painters. The aim of the study focused to find the prevalence of musculoskeletal
disorders symptoms (hand/wrist, neck, shoulder, and back pain) among labor painters. A random
sample of 200-painters were personally interviewed using a self-administrated questionnaire related
to their musculoskeletal pain. Most participants that were included in this study suffered from one
or more of the musculoskeletal disorders which is approximately 86%. Back pain (56%), neck pain
(47%), shoulder pain (39%), and hand/wrist pain (26%). It was concluded that musculoskeletal
disorders are very common in Jordanian painters and there seems to be need for further postural
awareness among the labor painters (Barghout et al., 2011).
Adedoyin et al., studied the association between musculoskeletal pain associated with the painters
in the Nigeria. An online structured form of Nordic Musculoskeletal Questionnaire was submitted
to obtain information from six federal university campuses in Nigeria. 1041-Questionnaires were
analyzed using descriptive statistics. Findings included that shoulder pain, neck pain, and wrist pain
were the highest pain complain with 74%, 73%, and 67% respectively. The results of this found
that musculoskeletal complaints among the painters is very common and maybe attributed to bad
ergonomics among the painters (Adedoyin et al., 2005).
Borhany et al., studied the musculoskeletal problems among the artistic painters. The study was
carried out to see the frequency of musculoskeletal problems in artistic painters. 18-50 years of
painters were selected that worked for more than 3 hours per day. After a verbal consent, they were
given Nordic musculoskeletal questionnaire. People that had previous diagnoses musculoskeletal
problems were excluded. Total number of participants were 154, out of which 80.3% suffered from
musculoskeletal problems, affecting at least one of the four anatomical sites; neck, shoulder, wrist,
or fingers. It was concluded that musculoskeletal symptoms among artistic painters is very
common and a proper use of equipment is necessary (Borhany et al., 2018).
Baabdullah et al., conducted a cross-section study to find the association between painters and
finger pain. A total of 387-painters were enrolled via convenient sampling in the study after taking
informed consent. They were given a self-administrated questionnaire along with Numerical Pain
Rating Scale. It was found that 76.4% suffered from finger pain that was radiating from wrist.
Heavy use of equipment can cause subclinical effects on the human hand. It was concluded that
good postural awareness and proper ergonomical principles should be thought to the painters to
avoid this high risk of wrist pain (Baabdullah et al., 2020).
A study conducted by the Crawford et al., to determine the validity and reliability of the Nordic
Musculoskeletal Questionnaire. Using a test-retest methodology the reliability of the NMQ ranged
from 0-23%. NMQ found a range of 0-20% disagreement between validity tested against clinical
history. It consists of two-sections, Section 1: a general questionnaire of 40-forced-choice items
identifying areas of the body causing musculoskeletal problems while Section 2 focuses on the
additional questions related to the musculoskeletal system problems (Crawford, 2007). The
questionnaire is available from the original paper by Kuorinka et al.
Literature gap was observed on the basis of lack of studies that focused specifically on the wrist
pain among painters. The study will find out the prevalence of wrist pain among painters which is
poorly determined. A small number of researches were conducted on wrist pain among painter. To
help address this gap, I am conducting this research to solely look into the prevalence of wrist pain
in the painters.

3. HYPOTHESIS
Null Hypothesis:
Wrist pain is not significantly common in painters.

Alternate Hypothesis:
Wrist pain is significantly common in painters.
 4. OBJECTIVES
To investigate the prevalence of wrist pain among the painters.
 5. Operational Definitions
Wrist Pain
Pain, tingling sensations, or numbness localized in the area of wrist that may also radiate down to
the fingers and may be caused by a number of reasons like fracture, injury, chronic degenerative
disease, rheumatoid arthritis, osteoarthritis, and carpal tunnel syndrome.
 6. MATERIALS AND METHODS

6.1: SETTING: Lahore

6.2: DURATION: 6 months

6.3: STUDY DESIGN: Cross-sectional design

6.4: SAMPLE SIZE:

6.5 SAMPLING TECHNIQUE: Non probability convenience sampling technique

6.6: SAMPLE SELECTION

6.6.1: Inclusion criteria:

 Age 25-40
 Painters with 1-year of experience
 Absence of psychological disorder
 Painters with no serious chronic disease
6.6.2: Exclusion criteria:
 Any specific pathology
 Age less than 25 and more than 40
 Any previous spinal surgery or deformity
 Degenerative diseases
 7. DATA COLLECTION

Methodology:
It is a cross-sectional study design that will be applied to study the prevalence of wrist pain in the
painters. The sample size calculated is ___. Informed consents will be given to the participants and
all the positive and negative aspects of the research will be declared to the participant. Nordic
Musculoskeletal Questionnaire and Numerical Pain Rating Scale with be used to collect the data.
Data will be analyzed using SPSS version 23.0 and interpreted with measure of frequency.
Tools:
Numerical pain rating scale.
Nordic Musculoskeletal Questionnaire.
 8. DATA ANALYSIS

The data will be analyzed using SPSS version 21 quantitative variables will be presented using
mean, standard deviation, range, histograms. Categorical variables will be presented as
frequencies, percentages, cross tabulations and bar chart, pie chart. Parametric tests to be used
according to study.

Independent sample t-test will be used to analyze effect of both interventions. P value of 0.05 or
less will be considered significant.
 9. OUTCOME & UTILIZATION
The result and outcome of study will be used to help develop prevention, ergonomical, and proper
techniques to determine the prevalence of wrist pain in painters.
10. REFERENCES
ADEDOYIN, R. A., IDOWU, B. O., ADAGUNODO, R. E., OWOYOMI, A. A., IDOWU, P. A. J.
T. & CARE, H. 2005. Musculoskeletal pain associated with the use of computer systems in
Nigeria. 13, 125-130.
BAABDULLAH, A., BOKHARY, D., KABLI, Y., SAGGAF, O., DAIWALI, M. & HAMDI, A. J.
M. 2020. The association between smartphone addiction and thumb/wrist pain: A cross-
sectional study. 99.
BARGHOUT, N. H., AL-HABASHNEH, R. & AL-OMIRI, M. K. J. J. M. J. 2011. Risk factors
and prevalence of musculoskeletal disorders among Jordanian dentists. 45, 195-204.
BORHANY, T., SHAHID, E., SIDDIQUE, W. A., ALI, H. J. J. O. F. M. & CARE, P. 2018.
Musculoskeletal problems in frequent computer and internet users. 7, 337.
BRANDFONBRENER, A. G., AMADIO, P. C. & KALISH, R. J. M. P. O. P. A. 2004. Thumb
pain in an instrumental musician. 19, 181-185.
BYRCHAK, V., DUMA, Z., ARAVITSKA, M. J. J. O. P. E. & SPORT 2020. Effectiveness of the
active physical therapy in restoring wrist and hand functional ability in patients with
immobility-induced contracture of the wrist joint complicated by median nerve entrapment
owing to distal forearm fracture. 20, 3599-3606.
CRAWFORD, J. O. J. O. M. 2007. The Nordic musculoskeletal questionnaire. 57, 300-301.
DEHGHAN, M. F., AMIRI, Z. & RABIEI, M. 2003. Prevalence of musculoskeletal pain among a
group of Iranian dentists,(Tehran-1999).
DIN, M. U. 2020. Association of Work Related Musculoskeletal Wrist Pain and Carpel Tunnel
Syndrome among Painters in Lahore.
GARG, A., KAPELLUSCH, J., HEGMANN, K., WERTSCH, J., MERRYWEATHER, A.,
DECKOW-SCHAEFER, G., MALLOY, E. & ERGONOMICS, W. H. S. R. T. J. 2012. The
Strain Index (SI) and Threshold Limit Value (TLV) for Hand Activity Level (HAL): risk of
carpal tunnelsyndrome (CTS) in a prospective cohort. 55, 396-414.
HAMED, S. A., ZOHEIRY, I. M., WAKED, N. M. & MAHMOUD, L. S. E.-D. Effect of
Neurodynamics Nerve Flossing on Femoral Neuropathy in Haemophilic Patients: A
randomized controlled study.
LIAO, J. C.-Y., CHONG, A. & TAN, D. J. S. M. J. 2013. Causes and assessment of subacute and
chronic wrist pain. 54, 592-598.
MAYO Wrist pain - Symptoms and causes.
MOORE, J. S. J. J. O. O. & MEDICINE, E. 1997. De Quervain's tenosynovitis: stenosing
tenosynovitis of the first dorsal compartment. 990-1002.
MURRAY, P. M. & COONEY, W. P. J. C. I. S. M. 1996. Golf-induced injuries of the wrist. 15,
85-109.
NARDUCCI, D. M. J. P. I. P. A. M. P. 2020. Musculoskeletal and associated conditions in the
instrumental musician. 197-239.
O'GRADY, W. & HAZLE, C. J. I. J. O. S. P. T. 2012. Persistent wrist pain in a mature golfer. 7,
425.
PORRETTO-LOEHRKE, A., SCHUH, C. & SZEKERES, M. 2016. Clinical manual assessment of
the wrist. Journal of Hand Therapy, 29, 123-135.
SHEHAB, R. & MIRABELLI, M. H. J. A. F. P. 2013. Evaluation and diagnosis of wrist pain: a
case-based approach. 87, 568-573.
TYRRELL, K. 2016. Artists and Repetitive Strain Injury (RSI). MAKING A MARK.
VITELLI, N., BATTEVI, N. & CARISSIMI, E. Upper Limb Risk Assessment in Painters.

11. ANNEXURES

11.1: ETHICAL CONSIDERATIONS:

The rules and regulations set by the ethical committee of Akhtar Saeed Medical and Dental College
will be followed while conducting the research and the rights of the research participants were
respected.

 Informed consent will be taken from all the participants.

 All information and data collection will be kept confidential.
 Participants will remain anonymous throughout the study.
 The subjects will be informed that there are no disadvantages or risk on the procedure of the
study.
 They will be informed that they are free to withdraw at any time during the process of the
study.
 Data will be kept secured.
11.2: CONSENT FORM IN ENGLISH:

You are invited to participate in a research study conducted by Kahkishan Toor, entitled,
Prevalence of Wrist Pain Among Painters.

Risks and Discomforts

No risks and any sort of discomfort is associated with research.
Protection of Confidentiality
I will do everything to protect your privacy. Your identity will not be revealed in any publication
resulting from this study.
Potential Benefits
Participation in this research will let you to help us in concluding the importance of two physical
therapy tools.
Voluntary Participation
Your participation in this research study is voluntary. You may choose not to participate and you
may withdraw your consent to participate any time. You will not be penalized in any way should
you decide not you participate or to withdraw from this study.
CONSENT
I have read this consent form and have been given the opportunity to ask questions. I
give my consent to participate in this study.

Participant’s Signature __________________ Date: ___________________

‫‪11.3 CONSENT FORM IN URDU:‬‬

‫ریسرچ سٹڈی میں شرکت کا دعوت نامہ‬

‫‪.‬میں ‪-----------------‬آپکو اس ریسرچ میں شمولیت کی دعوت دیتی ہوں‬
‫‪:‬ریسرچ کا عنوان‬
‫‪-‬نقصانات اور تکلیف‪ :‬اس تحقیق سے کسی قسم کے نقصان یا تکلیف کا اندیشہ نہیں‪o‬‬
‫‪-‬ممکنہ فوائد‪ :‬آپکو ایک اہم تحقیق میں حصہ لینے کا موقعہ دیا جاۓ گا‬
‫رازداری کا تحفظ‪ :‬ہم آپ کی معلومات کے تحفظ کے لیے وہ سب کچہ کریں گے جو ہم کر سکتے ہیں۔ تحقیق کے متعلق‬
‫اکٹہی کیی گيی تمام معلومات کو انتہا ئی خفیہ رکھا جاے گا۔ ڈیٹا انٹری اور تجزیے کے دوران آپ کے متعلق وہ تمام‬
‫معلومات جن سے آپ کی شناخت ہو سکتی ہو کو ختم کر دیا جاے گا۔ اس تحقیق کے نتیجے میں شائع ہونے والی کسی بھی‬
‫اشاعت میں آپ کی شناخت کو ظاہر نہیں کیا جاے گا۔‬

‫ر‪f‬ض‪f‬ا‪f‬ک‪f‬ا‪f‬ر‪f‬ا‪f‬ن‪f‬ہ‪ f‬ش‪f‬م‪f‬و‪f‬ل‪f‬ی‪f‬ت‪ f:f‬ا‪o‬س‪ o‬ت‪o‬ح‪o‬ق‪o‬ی‪o‬ق‪o‬ی‪ o‬م‪o‬ط‪o‬ا‪o‬ل‪o‬ع‪o‬ہ‪ o‬م‪o‬ی‪o‬ں‪ o‬آ‪o‬پ‪ o‬ک‪o‬ی‪ o‬ش‪o‬ر‪o‬ک‪o‬ت‪ o‬ر‪o‬ض‪o‬ا‪o‬ک‪o‬ا‪o‬ر‪o‬ا‪o‬ن‪o‬ہ‪ o‬ہ‪o‬ے‪o‬۔‪ o‬آ‪o‬پ‪ o‬ک‪o‬و‪ o‬ش‪o‬ر‪o‬ک‪o‬ت‪ o‬ن‪o‬ہ‪ o‬ک‪o‬ر‪o‬ن‪o‬ے‪ o‬ا‪o‬و‪o‬ر‪o‬‬
‫ک‪o‬س‪o‬ی‪ o‬ب‪o‬ھ‪o‬ی‪ o‬و‪o‬ق‪o‬ت‪ o‬پ‪o‬غ‪o‬ی‪o‬ر‪ o‬و‪o‬ج‪o‬ہ‪ o‬ب‪o‬ت‪o‬ا‪o‬ن‪o‬ے‪ o‬ا‪o‬س‪ o‬ت‪o‬ح‪o‬ق‪o‬ی‪o‬ق‪ o‬م‪o‬ی‪o‬ں‪ o‬ش‪o‬م‪o‬و‪o‬ل‪o‬ی‪o‬ت‪ o‬ک‪o‬و‪ o‬چ‪o‬ھ‪o‬و‪o‬ڑ‪o‬ن‪o‬ے‪ o‬ک‪o‬ا‪ o‬ا‪o‬خ‪o‬ت‪o‬ی‪o‬ا‪o‬ر‪ o‬ہ‪o‬ے‪o‬۔‪ o‬ش‪o‬ر‪o‬ک‪o‬ت‪ o‬ن‪o‬ہ‪ o‬ک‪o‬ر‪o‬ن‪o‬ے‪ o‬ی‪o‬ا‪ o‬ا‪o‬س‪o‬‬
‫م‪o‬ی‪o‬ں‪ o‬ش‪o‬م‪o‬و‪o‬ل‪o‬ی‪o‬ت‪ o‬ک‪o‬و‪ o‬چ‪o‬ھ‪o‬و‪o‬ڑ‪o‬ن‪o‬ے‪ o‬ک‪o‬ی‪ o‬ص‪o‬و‪o‬ر‪o‬ت‪ o‬م‪o‬ی‪o‬ں‪ o‬آ‪o‬پ‪ o‬ک‪o‬ے‪ o‬خ‪o‬ال‪o‬ف‪ o‬ک‪o‬و‪o‬ئ‪o‬ی‪ o‬ک‪o‬ا‪o‬ر‪o‬و‪o‬ا‪o‬يی‪ o‬ن‪o‬ہ‪o‬ی‪o‬ں‪ o‬ک‪o‬ی‪ o‬ج‪o‬ا‪o‬ے‪ o‬گ‪o‬ی‪o‬‬
‫درجذیل معلومات تحقیق میں شامل ہونے کے لیے پڑھیں اور ان کا جواب دیے گیے خانوں میں درج کریں۔‬
‫میں نے معلوماتی شیٹ جو کہ تحقیق کی وضاحت کر رہی ہے کو سمجھ لیا ہےاورمجھے تحققیق کے سواالت کرنے کا‬
‫موقع دیا گیا تھا۔‬
‫میں سمجھ گيی ہوں کہ میری شرکت رضاکارانہ ہے اور یہ کہ میں کسی بھی وقت اپنا ارادہ بدل سکتی ہوں اور تحقیق سے دستبردار‬
‫‪.‬ہوسکتی‬
‫میں سمجھ گیی ہوں کہ میرے جوابات خفیہ رکھے جاءیں کے۔ میں محقیقیين کو اس بات کی اجازت دیتی ہوں کے وہ جوابات‬
‫کو جانچ سکیں۔‬
‫میں سممجھ گی ہوں کے معلومات میرے نام کے بجاے نمبر کی صورت میں محفوط کی جائيں گی۔ تا کہ میں نتائج کی‬
‫اشاعت کے دوران کسی بھی طرح سے شناخت نہ کیا جا سکوں۔ میں اس بات سے رضامند ہوں کے جو معلومات مجھ سے‬
‫لی جائہيں گی وہ تحقیق میں استعمال ہوں گی۔‬
‫میں اوپر بتایی گی تحقیق میں شامل ہونے کے لیے رضامند ہوں اور محقیقین کو اپنا پتہ تبدیل‪ o‬ہونے کی صورت میں مطلع‬
‫کروں گی۔‬

‫رضا مندی‪:‬ميں نے يہ اجازت نامہ پڑھا ہے اور مجھے سوال پوچھنے کا موقع ديا گيا ہے۔ ميں اس سٹڈی ميں شرکت کے‬
‫راضی ہوں۔‬
 ‫___________ شرکت کنندہ کا نام __________________ دستخط____________________ تاريخ‬

Months

01 02 01 02
September October- December January-
Activity (2022) November (2022) February
(2022) (2023)
Synopsis submission
& Synopsis defense

Data Collection

Data analysis &

interpretation

Thesis compilation &

submission

‫____________ اجازت لينے والے کا نام ________________ دستخط ____________________تاریخ‬

11.4: Plan of Work (Gant Chart)

11.5: Questionnaire

First Name: Last Name:

Age: Occupation: ____________________

Patient Gender: Marital Status:

Address:

Group:

Phone No:

Diagnosis:

Previous Medical Treatment:

Past Surgical History:

Duration of pain:

Nordic Musculoskeletal Questionnaire

Numerical Pain Rating Scale
Pain In Wrist (Yes/No): _________
Severity of Pain: _______
.