Musculoskeletal Discomfort among Tahfiz Students in Kelantan: A Cross-Sectional Study Using the Cornell Musculoskeletal Discomfort Questionnaire

Abstract

Tahfiz educational institutions in Malaysia, especially in the state of Kelantan, show a unique learning practice of sitting cross-legged or kneeling on the floor throughout the learning process. Although this practice aligns with local culture and tradition, it can lead to physical discomfort and musculoskeletal system problems among students. This study aimed to assess the level and distribution of physical discomfort among tahfiz students using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). A cross-sectional study was conducted among 110 tahfiz students in Kota Bharu, Kelantan, selected through convenience sampling. Data on demographic characteristics and learning posture were collected alongside CMDQ measures covering discomfort location, frequency, severity, and impact on learning. Data were analyzed using SmartPLS 4 (version 4.1.0.9). Of the participants, 80.9% were male and 19.1% were female. The most frequently reported musculoskeletal discomfort was in the lower back (16.9%), followed by the waist (11.2%), the upper back (9.2%), and the lower right leg (8%). SmartPLS analysis revealed that only body weight was significantly associated with the level of musculoskeletal discomfort (β = 0.279, t = 2.214, p = 0.027), indicating that students with higher body weight experienced greater discomfort during prolonged floor-sitting. Lower back discomfort emerged as the most prevalent complaint, highlighting the ergonomic risks associated with traditional learning postures. This study provides novel evidence as one of the first ergonomic assessments conducted in a Malaysian religious education setting using the CMDQ. The findings underscore the need for targeted ergonomic interventions to reduce musculoskeletal discomfort and enhance students’ physical well-being and learning experience in tahfiz institutions.