Work 44 (2013) S73S81 S73

DOI 10.3233/WOR-121488
IOS Press

Measures of fit and discomfort for elementary

school children in Serbia
David Feathersa,, Sonja Pavlovic-Veselinovicb and Alan Hedgea
a
Department of Design and Environmental Analysis, Cornell University, Ithaca, NY, USA
b
Faculty of Occupational Safety, University of Nis, Nis, Serbia

Received 25 March 2011

Accepted 30 September 2011

Abstract.
BACKGROUND: Assessing physical ergonomic factors within the classroom environment creates new opportunities to support
designs that promote student well-being. Student-aged anthropometric data helps guide proper desk fit assessment, therefore
facilitating scholastic performance through the reduction of distractions such as physical discomfort.
OBJECTIVE: This study reports dimensions of fit between student anthropometry and the desk environment (classroom seating
conditions), for grade-school aged children in Serbia. Measurements of the children and their desks are compared to subjective
reports of discomfort.
PARTICIPANTS: Fifty-seven elementary school students, grade 2 (ages 78; n = 29) and grade 4 (ages 910; n = 28), were
enrolled in this study. All participants were from the same elementary school in the city of Nis, Serbia.
METHODS: Seventeen anthropometric measurements of students were collected using standard anthropometric instruments.
Eight measurements of student work desks and chairs were also collected. Students were evaluated by a physiatrist to assess health
issues and completed a novel questionnaire about musculoskeletal discomfort for different body parts. Student fit to the classroom
seat and desk was assessed structurally and subjectively. Data analysis included descriptive anthropometric measurements and
inferential statistics including Chi square analysis.
RESULTS: Results indicated age-related differences in body part discomfort for grade 2 and grade 4 students, arm discomfort
reported over 50% of second grade students, and neck/upper back discomfort was reported as the highest of all body parts (32%)
for students in the fourth grade.
CONCLUSION: Anthropometric variables and preliminary analysis of fit as it relates to reported discomfort are discussed, as
are external factors of backpack use and seated video/computer-game use. International comparisons of anthropometric data are
discussed and serve to inform new considerations of ergonomics research for school children.

Keywords: Primary school children, anthropometry, discomfort, musculoskeletal disorders

1. Introduction dent [1,3,20,27]. Moreover, supportive ergonomic de-

Scholastic performance for school children is at
times connected to government policy and demands
for improvement can upstage musculoskeletal concerns
of the young. Supportive ergonomic design should
complement the growth and development of the stu-
Corresponding author:
David J. Feathers, Ph.D., 2421 MVR Hall,
Department of Design and Environmental Analysis, College of Hu-
man Ecology, Cornell University, Ithaca, NY 14853, USA. Tel.: +1
607 255 7138; Fax: +1 607 255 0305; E-mail: djf222@cornell.edu.
sign should attempt to facilitate scholastic performance
through the reduction of distractions such as physical
discomfort [27].
There have been numerous studies investigating
school furniture designed for children [6,9,13,14,18,23,
26,33]. Recently, studies have investigated the match
of anthropometric dimensions, ergonomic concerns,
and musculoskeletal pain of students [3,4,8,10,21,25,
28,32]. Dimensions of fit between student anthropom-
etry and the school desk environment have been evalu-
ated, and specific anatomical areas have been discussed

1051-9815/13/$27.50 2013 IOS Press and the authors. All rights reserved
S74 D. Feathers et al. / Measures of fit and discomfort for elementary school children in Serbia

Table 1
Anthropometric dimensions and definitions used in the study
Anthropometric dimension Definition of the anthropometric measurement
Body Weight Student body weight in kilograms
Body Height (standing) Vertical distance from floor to the apex of head while standing (cm). [Same as, Stature, ISO 7250;
1996.]
Body Height (sitting) Vertical distance from seat pan to apex of head while seated (cm).
Eye Height (sitting) Vertical distance from seat pan to Dacryon while seated (cm). (Dacryon: landmark intersecting the
lacrimo-maxillary suture and the frontal bone.)
Shoulder Height Vertical distance from seat pan to Acromion while seated (cm).
Elbow Height Vertical distance from seat pan to the inferior portion of the Olecranon Process of the elbow (cm). [Same
as, Elbow Height Sitting, ISO 7250; 1996.]
Seat Height Vertical distance from floor to an adjustable seat pan. The seat pan measures the height from the floor to
the underside of the thigh (Femoris dorsalis), where the tibia and femur are at 90 degrees.
Knee Height Vertical distance from floor to the superior portion of the patella (cm).
Popliteal Height Vertical distance from floor to Popliteus (cm).
Thigh (Buttock-Knee) Length Estimated buttock-knee length from stature. [Same as, Buttock-Popliteal Length, ISO 7250; 1996.]
Foot Length Horizontal distance from heel to anterior-most portion of foot (cm).
Arm Length Horizontal distance from Acromion to Dactylion III (cm).
Forearm Length Horizontal distance from posterior portion of Olecranon of the elbow to the tip of Dactylion III, (Humero-
ulnar flexion at 90 degrees)
Shoulder Breadth Lateral distance from Left Acromion to Right Acromion (cm).
Elbow-to-Elbow Breadth Lateral distance from Left Lateral Humeral Epicondyle to Right Lateral Humeral Epicondyle (cm).
Hip Breadth Lateral distance from Left Anterior Superior Iliac Spine to Right Anterior Superior Iliac Spine (cm).
Center of Mass, Seated Mean body weight compared to Kroemer (2006) values. Value is the vertical distance of the seat pan to
the center of mass (mean).
Calculated from Snyder et al., 1977 (p. 539) section: Regression of Buttock-Knee Length with Stature.
Calculated from mean body weight (this sample) and mean center of mass table data from Kroemer, 2006; p. 188.

in relation to this fit. For example, Evans et al. [9]
found that thigh (buttock to knee) length was signifi-
cantly related (p < 0.05) to discomfort associated with
sitting for students aged 1216 years. Further reports
of mismatches of the student desk environment to the
lower extremity have been outlined for posterior knee
area concerns such as Popliteal height [4]. The reports
of long-term discomfort in the neck and upper torso
have also been associated with the desk environment
due to the static nature of desk tasks such as reading,
requiring sustained forward head and neck flexion [7,
21]. Upper extremity measures of discomfort show the
highest rates of discomfort are in the shoulder area [3]
but overall, upper extremity discomfort is not as high
as trunk and lower extremity measurements, and pain
prevalence increases as students get older [3].
Research centering on individually supportive er-
gonomic designs assumes that a country has the re-
sources and the administrative focus to buy and main-
tain a one-student-to-one-desk ratio. In many areas
in the world, school desks are shared between students
(two or more sharing a desk, see [4, p. 566], Fig. 4).
In some schools, students move between classrooms
and do not sit at an assigned desk, which causes all
students to use the same size furniture regardless of age
or grade level [29]. Further complicating the problem
of anthropometric fit, is a paucity of anthropometric
data for children in developing countries such as Ser-
bia to inform the ergonomic design of school furni-
ture. Here, as with other places throughout the world,
school children use the same school desks and chairs
from grade 1 through the grade 8 (6 to 15 years old).
While developing population-appropriate adjustability
would benefit the student [22], such adjustability needs
to be based on the anthropometric characteristics of the
school population.
This study addresses dimensions of fit between stu-
dent anthropometry and the school desk environment
for Serbian school children. The increasing use of com-
puters in all spheres of childrens lives may contribute
to issues of poor body posture, and associated muscu-
loskeletal symptoms [1,17,24]. In addition, improp-
er posture, improper seating, the inadequacy of school
desks, school chairs [13] and the excessive weight (4
to 9 kg) of school bags [2,5] may affect the emergence
of various forms of postural disorders and deformities,
and contribute to an increasing number of such disor-
ders. Serbian ergonomists do not have complete an-
thropometric datasets of Serbian schoolchildren, and
school furniture manufacturers in Serbia use outdated
regulations or recommendations, based on databases of
unknown origin.
The aim of this research was to investigate anthropo-
metric diversity of a sample of Serbian school children
 D. Feathers et al. / Measures of fit and discomfort for elementary school children in Serbia S75

Definition of measurement for school desk furniture
Furniture dimension
Work Surface (Desk) Height
Work Surface Length and Work
Surface Width (desk for two
students)
Knee Clearance Height
Seat Pan Height
Seat Pan Depth
Seat Pan Width
Back Seat Height
Table 2
Definition of measurement
Vertical distance of desk surface to floor (cm).
Work surface length is the lateral length of
the desk surface (cm).
Work surface width is the anterior-posterior
depth of the desk surface (cm). (not to scale)
Vertical distance of the inferior surface of the desk to the floor (cm).
Vertical distance of the seat pan to the floor (cm).
Horizontal (anterior-posterior) depth of the seat pan (cm).
Lateral width of the seat pan (cm).
Linear length of the seat back (inferior to superior) (cm).

the anthropometric dimensions and definitions used in

the collection of this data.
Thigh (Buttock-Knee) length and Center of Mass,
Seated (COMS) were not collected on site, rather,
these are calculations derived on the anthropometric
characteristics of this population and reference charts.

2.2. Measurement of the classroom desk

There were eight measurements of the standard two

student work desk (see Fig. 1) used for both grade 2
and grade 4 students. Table 2 lists the measurement
dimensions for the classroom desk.

2.3. Measurements of discomfort

Student posture was estimated by a Serbian physi-

Fig. 1. School desks used by Serbian students.
and to research the influence of the possible furniture-
student mismatch across school children ages. The de-
velopment of musculoskeletal discomfort, which may
ultimately result in musculoskeletal disorders are eval-
uated across school children age groups.
2. Methodology
2.1. Anthropometry
Serbian students (n = 57) in grade 2 (ages 78; n =
29) and grade 4 (ages 910; n = 28) of the Vozd Karad-
jordje elementary school in the city of Nis took part in
this study. There were fifteen anthropometric variables
measured using standard anthropometric instruments
and two derived measurements based on the anthropo-
metric characteristics of the population. Table 1 lists
atrist performing government-mandated health screen-
ing of children. These screenings include students be-
fore they enter the first grade age up to high school
graduation. In Serbia, school children typically have 10
systematic reviews throughout their school years, each
consisting of medical history, general physical exami-
nation (emphasizing the spine and feet), nutritional sta-
tus assessment, assessment of vaccine status, systemat-
ic dental examination, and assessment of health status
which guides the treatment (therapeutic, rehabilitative)
of the child, if needed. For this study, the physiatrist
visually assessed posture while the student was both
seated at the desk and standing, and coded this as either
a neutral good posture or a deviated bad posture.
The physiatrist also noted any visible deformities of the
students back in the standing position.
Students completed a novel questionnaire (see Fig. 2)
about musculoskeletal discomfort in different body
parts. This questionnaire asked basic questions of dis-
comfort and pain, perceived backpack weight, actual
backpack weight and usage of video games.
S76 D. Feathers et al. / Measures of fit and discomfort for elementary school children in Serbia

Table 3
Dimensions of fit and postural concerns for student and classroom desk
Anthropometric Classroom desk Associated postural concerns
dimension dimension
Eye Height Desk Height Reporting eye height in relation to desk height can serve as an indirect measure of neck and
trunk angle in relation to the desk surface.
Shoulder Seat Back The seat back should support the majority of the back, but still allow the shoulder to move
Height Height freely. A positive value characterizes an unsupported upper back at the shoulder level.
Shoulder Desk Height The desk height in relation to the shoulder characterizes arm movements distally (ability to
Height internal/external rotate; amount of arm flexion needed to perform desk tasks) and trunk flexion
anteriorly.
Center of Mass, Seat Back Postural support for center of mass in a seated position characterizes an opportunity to rest the
Seated Height inferior aspects of the center of mass. The height of the seat back should be superior to the
center of mass.
Center of Mass, Desk Height The height difference between the seated center of mass and the desk height characterizes
Seated basic sagittal trunk postural modeling.
Elbow Height Desk Height Elbow heights that are inferior to desk height will introduce arm flexion and/or trunk flexion
to bring the elbow above the height of the desk. Abduction and internal rotation of the arm
will place the elbow into working position for the forearm and hand on the desk.
Thigh (Buttock- Seat Pan Depth Seat pan depth exceeding thigh length may place pressure on the popliteal area distally, and
Knee) Length encourage sacral sitting proximally.
Popliteal Seat Pan Height Seat pan height exceeding popliteal height will not place the feet firmly on the ground. A
Height negative value characterizes a seat pan higher than popliteus.

QUESTIONNAIRE Musculoskeletal discomfort

1. Do you feel comfortable while using the school desks and chairs?
Yes No
2. While sitting in your classes, do you feel pain in your:
Neck?
Arms?
Shoulders?
Back?
Legs?
Buttocks?
3. Is your backpack too heavy? Yes No
4. Are you playing video games or games on computers in your
free time? Yes No
5. If the answer is Yes, how long do you play video games or
computer games each day?
Less than 1 hour
More than 1 hour
Fig. 3. Classroom desk accommodating two students sitting side-
Fig. 2. Musculoskeletal discomfort survey for students. by-side (second grade students shown here).

2.4. Dimensions of fit between student anthropometry 3. Results

and the classroom environment
3.1. Anthropometry
The student fit to the classroom seat and desk can
be assessed in a variety of ways. The selected dimen-
Seventeen anthropometric dimensions are reported
sions of student anthropometric measurements to the
in Table 4. Measures of, Thigh Length, and, Dis-
classroom environment are listed in Table 3.
tance from Seat Height to Center of Mass, Seated, are
2.5. Analysis calculated dimensions computed after the initial mea-
surement session.
Data was collected over 3 days and descriptive statis-
tics were performed on the anthropometric and the 3.2. Measurements of the classroom desk
questionnaire data. Inferential stats on the subjective
data was performed using Chi square analysis with The classroom desk in this study accommodates two
Yates correction for continuity (due to the small sample students sitting side-by-side at a shared desk with indi-
size). vidual chairs (see Fig. 3).
 D. Feathers et al. / Measures of fit and discomfort for elementary school children in Serbia S77

Table 4
Anthropometric dimensions for grades 2 and 4
Anthropometric dimension Grade 2 mean (S.D.) Grade 4 mean (S.D.)
Body Weight (kg) 29.15 (4.74) 35.82 (9.59)
Body Height (standing, cm) 131.31 (5.26) 144.97 (6.88)
Body Height (sitting, cm) 68.38 (2.29) 75.48 (3.16)
Eye Height (cm) 57.82 (2.87) 63.98 (6.11)
Shoulder Height (cm) 42.32 (2.77) 47.17 (2.79)
Elbow Height (cm) 18.52 (2.00) 20.08 (1.99)
Seat Height (cm) 36.38 (1.01) 40.23 (1.85)
Knee Height (cm) 40.99 (2.02) 46.82 (3.02)
Popliteal Height (cm) 35.96 (1.59) 39.89 (1.83)
Thigh Length (cm) * 36.8 to 43.4 (range) 46.2 to 50.1 (range)
Foot Length (cm) 20.23 (1.23) 23.01 (1.50)
Arm Length (cm) 55.21 (2.43) 61.51 (3.90)
Forearm Length (cm) 33.39 (1.59) 37.48 (2.64)
Shoulder Breadth (cm) 28.22 (1.22) 31.06 (1.94)
Elbow-to-Elbow Breadth (cm) 30.95 (2.74) 32.59 (3.32)
Hip Breadth (cm) 22.62 (1.80) 24.88 (1.88)
Distance from Seat Height to Center of Mass, Seated 39.83 (estimated) 43.35 (estimated)
Calculated from Snyder et al., 1977 (p. 539) section: Regression of Buttock-Knee Length with Stature.
Calculated from mean body weight (this sample) and mean center of mass table data from Kroemer (2006; p. 188).

Table 5
play video or computer games, and 36% of the grade 2
Furniture dimensions (cm)
and 28.6% of the grade 4 pupils play them longer than
Furniture dimension cm
1 hour every day.
Work surface height 76
Work surface length 130
Close to half of grade 2 students (52%) and 13.6%
Work surface depth 50 of the grade 4 students thought their desks and chairs
Knee clearance height 58 were not comfortable. The results of musculoskele-
Seat height 46 tal discomfort distribution by body area are shown in
Seat depth 40
Seat width 38 Fig. 4.
Back seat height 37
3.4. Contrasts between grade 2 and grade 4
Results of the dimension measurements of the furni- anthropometry and the classroom environment
ture are listed in Table 5.
Mean differences of anthropometry and classroom
3.3. Measurements of discomfort furniture are listed in Table 8 for both elementary grade
samples.
The students were given the musculoskeletal dis- Eye height compared to desk height: The difference
comfort questionnaire, and eighty-three percent (n = in eye height and the height of the desk is an important
47) students responded to the questionnaire about their consideration for neck discomfort, which was prevalent
school desks and chairs (n = 25 grade 2 students and in both age groups. Grade 4 students have an eye height
n = 22 grade 4 students). Student responses, by school to desk height discrepancy of almost 34 cm above the
grade, are listed in Table 6. desk on average, as compared to 28 cm for grade 2
Inferential statistics (Chi-square with Yates correc- students.
tion) were used to test response significance. Table 7 Shoulder height compared to seat back height:
lists a summary of analysis for the survey items, in- Shoulder height was superior to the seat back height for
cluding seat comfort and anatomical areas of reported both groups, but only by +5.32 cm for grade 2 students.
pain. This small amount of space may place limits scapular
In response to the questionnaire item, Is your back- motion, and may inhibit upper extremity movement.
pack too heavy? the majority of grade 2 students, Grade 4 students had a mean shoulder height to seat
76%, agreed that the backpacks were too heavy; this back height displacement of +10.71 cm which may
sentiment was shared with 95.5% of the grade 4 pupils. provide more scapular freedom.
In terms of other activities outside of school, 64% of COMS (Center of Mass, Seated) height compared to
the grade 2 pupils and 63.6% of grade 4 pupils regularly seat back height: The COMS calculated measurement
S78 D. Feathers et al. / Measures of fit and discomfort for elementary school children in Serbia

Table 6
Responses for the musculoskeletal discomfort survey for students
Question Grade 2 percentage agree/or/mean Grade 4 percentage agree/or/mean
1. Do you feel comfortable while using the school desks and 48% 14%
chairs?
2. While sitting in your classes, do you feel pain in your:
Neck 12% 32%
Arms 56% 27%
Shoulders 16% 27%
Back 32% 32%
Legs 20% 9%
Buttocks (Seat) 4% 14%
3. Is your backpack too heavy? 76% 96%
4. Are you playing video games or games on computers in your 64% 64%
free time?
5. If yes to question 4, how long do you play video games or 36% 29%
computer games each day? (Response [%] playing more than
1 hour)

Table 7
Chi square analysis summary table for inter-grade subjective reports
Survey item 2 DOF* P value (2-tailed) Statistical interpretation
Chair comfort 4.876 1 0.0272 significant
Neck Pain 1.688 1 0.1938 not significant
Arm Pain 2.683 1 0.0907 not significant
Shoulder Pain 0.342 1 0.5585 not significant
Back Pain 0.000 1 0.9894 not significant
Leg Pain 0.407 1 0.5237 not significant
Buttocks Pain 0.117 1 0.7319 not significant
DOF = Degrees of Freedom.

was also inferior to the desk height (grade 2 mean:

Fig. 4. Mean percentage of schoolchildren reporting discomfort by
body area.
was inferior to the seat back height (grade 2 mean:
16.25 cm; grade 4 mean: 14.43 cm) which may
play a role in trunk behavior and perceived discomfort
of the back area.
COMS height compared to desk height: The COMS
calculated measurement in relation to the desk height
9.25 cm; grade 4 mean: 7.43 cm) and may influ-
ence trunk kinematics in relation to desk-surface tasks.
For example, an increase in COMS height will likely
improve forward reaching ability and range of motion.
Elbow height compared to desk height: The height
of the elbow and COMS relative to the desk height
begin to describe some of the differences and potential
postural differences across these two grades of students.
The grade 2 students had an elbow height that was, on
average, 11.48 cm below the surface of the desk; and
grade 4 students had a mean displacement of 9.92
cm.
Thigh length compared to seat pan depth: The es-
timated thigh length in relation to seat pan depth for
grade two was between 3.2 and +3.4 cm. For grade
four, thigh length in relation to seat pan was between
+6.2 for the smallest student and +10.1 for the largest
student.
Popliteal height compared to seat pan height: The
seat height was greater than the respective average
Popliteal heights for both groups of students in grades
2 and 4. On average, therefore, students cannot touch
the floor with their feet while sitting. Instead, their
legs hang unsupported or they sit at the edge of the
 D. Feathers et al. / Measures of fit and discomfort for elementary school children in Serbia
Table 8
Mean displacement measurements assessing the fit of student and classroom desk
Anthropometric dimension Classroom desk dimension
Eye Height Desk Height
Shoulder Height Seat Back Height
Shoulder Height Desk Height
Center of Mass, Seated Seat Back Height
Center of Mass, Seated Desk Height
Elbow Height Desk Height
Thigh Length Seat Pan Depth
Popliteal Height Seat Pan Height
chair, which is places force on the Popliteal area and
the Tibial nerve [19].
3.5. Physiatrist expert ratings
Of the pupils who were examined by the physiatrist
(n = 47), poor posture was noted for 29 pupils (61.7%),
and six students were referred for rehabilitation pro-
cedures (12.8%) because of more serious disorders of
the spinal column. Physiatrist expert posture ratings
showed that the height of the upper surface of the desk
as well as the height of the chair seat were inadequate
to a greater degree for the grade 2 students, resulting
in a higher percentage (68%) of cases of bad posture
(evident/revealed), in comparison to 54.5% in the grade
4 pupils.
4. Discussion
Serbian students in grade 2 (ages 78) and grade 4
(ages 910), are similar in mean stature to Swedish
children [12]. The mean stature (standard deviation)
for Serbian children in this sample, ages 78 is 131.31
(5.26) cm, as compared to Swedish children, age 8, at
132.7 (5.7) cm [12]. Similarly, for ages 910, Serbian
students are 144.97 (6.88) cm, as compared to children
from Sweden, age 10, 142.8 (6.7) cm (Haeger-Ross
and Roesblad, 2002). For both age groups (78 and
910) children from the Netherlands have the high-
est mean stature [31], followed by Sweden, Portugal,
and France [16]. The population of Serbian students
measured in this sample is within this grouping of tall
children.
Subjective reports of back discomfort (32% for both
student grade samples in this study) highlight a mis-
match of student anthropometry of the lower extremity
and classroom furniture as found in former studies [9].
A seat pan depth exceeding a students thigh length
may encourage sacral sitting because the seat pan edge
is too far away from the seat back, forcing the student
S79
Mean (cm) displacement grade 2 Mean (cm) displacement grade 4
+27.82 +33.98
+5.32 +10.17
+12.32 +17.17
16.25 14.43
9.25 7.43
11.48 9.92
3.2 to +3.4 +6.2 to +10.1
10.04 6.11
to lean their trunk posteriorly to rest which results in a
posterior tilt of the pelvis [34]. Additionally, if the seat
pan depth exceeds thigh length, which was the case for
some students in grade two (range was between 3.2
and +3.4 cm), this could potentially compress the soft
tissues of the Popliteal area [19]. The Popliteal area
can be compressed vertically and horizontally. A seat
pan depth that exceeds thigh length will offer vertical
compression, whereas horizontal compression can arise
from a seat height that exceeds Popliteal height. Seat
height was greater than the respective average Popliteal
heights for both groups of students in grades 2 and
4. On average, therefore, students cannot to touch the
floor with their feet while sitting. Instead, their legs
either hang unsupported, which is places force on the
Popliteal area and the Tibial nerve [19], or they sit at
the edge of the chair. Tissue compression of both the
Popliteal area and the Ischial Tuberosities area may
contribute to perceived discomfort of the trunk and but-
tocks [34].
There were several differences among grade 2 and
grade 4. Over 50% of grade 2 students reported arm
discomfort as the most common complaint, followed
by back discomfort. The areas receiving the highest
ratings of discomfort for students in grade 4 were in the
neck and upper back regions. Grade two average elbow
height was 11.48 cm below the desk height and grade
four average elbow height was 9.92 cm below the desk
height. Arm discomfort can be generated by a number
of physical factors and may be partially explained by the
prolonged abduction and internal rotation the shoulder
(due to a lower elbow height than desk height) and
the awkward angles this places on the wrist (increasing
ulnar deviation) while performing desk activities such
as writing. In this study, both groups of students, on
average will have to abduct, flex and internally rotate
the arm to place the forearm and hand medially to
complete desk tasks. The lower the elbow height is
to the desk, the more abduction, flexion, and internal
rotation needed to place the distal upper extremity in a
suitable position for performing desk-surface activities.
S80 D. Feathers et al. / Measures of fit and discomfort for elementary school children in Serbia
In relation to upper extremity posture,the desk height
location in relation to the arm (humerus) can be calcu-
lated as a percentage of humeral length, starting distally
from the elbow. This calculation relates relaxed upper
extremity posture in relation to the desk. In this study,
the desk height location relative to the arm (humerus)
for grade 2 students was 50%, which will likely lead
to flexion, abduction and internal rotation of the arm to
place the elbow on the desk. Desk height relative to
arm (humeral) length of grade 4 students, which have a
higher relative shoulder height in relation to the desk,
were approximately 41% of the arm (humeral) length.
5. Conclusions
Access to adjustable, individually accommodating
work stations for school children is not widespread in
most countries and especially in developing countries
where the young carry a heavy burden of building and
creating the future of their nation. The evident variabil-
ity of the observed anthropometric dimensions makes
it difficult to design adjustable chairs for all of the
students in the Vozd Karadjordje elementary school.
This study represents a first step to accommodate these
school children and emphasizes the need for more an-
thropometric data of school children to better inform
ergonomic design of the school environment in Serbia.
The Serbian classroom desk design in this study in-
cluded a fixed desk shared by two students sitting on
individual, fixed height chairs. This design is not typi-
cal for a classroom in, for example, the United States,
where students are seated at their own desk which can
be height adjusted (usually at the start of the school
year) and chairs either are different sizes and approx-
imately matched to students or individually adjusted
for the student [13]. The mismatch between the stu-
dent and furniture dimensions may be different in a US
classroom than was found among the Serbian class-
rooms, and this deserves further study. It is reason-
able to consider that an increase in adjustability can re-
duce the mismatch of student and furniture dimensions,
however, when students across different grades use the
same desk over the same day, constant adjustments may
not be performed or may place the furniture at risk of
breakdown. Studies are needed to assess student-desk
adjustments in this dynamic environment.
It is possible to increase comfort by creating condi-
tions for individual adjustments, according to the needs
of each user. In the classroom environment studied,
both second and forth grade students used the same
desks. The optimal sitting, reading, and writing condi-
tions were not realized for most students as evidenced
in the reports of body discomfort for both grades.
If the fit of the child to their classroom furniture is
poor, then the child may be exposed to musculoskeletal
risks as evidenced by the high prevalence of complaints
of musculoskeletal discomfort found in this study. Ac-
cording to Grimes and Legg [11], child musculoskele-
tal risks may predispose adult musculoskeletal risks.
The poor fit between child and school desk environ-
ment may bring about awkward postures and may cre-
ate undesirable stresses on the childs maturing soft
tissues [13]. Ultimately, more studies are needed to
investigate the role of awkward postures and associat-
ed compensatory strategies in the contribution to adult
musculoskeletal disorders and habits of poor posture,
pain guarding behavior, and subjective reports of dis-
comfort. Brewer et al. [3] cautions that school environ-
ments may be so poorly suited for students that discom-
fort ratings may be underreporting pain and associated
discomfort.
More research is needed to address ergonomic con-
cerns of school children in developing countries. In this
study, the static/structural fit of child anthropometry
and classroom furniture was investigated, but did not
provide an exhaustive data set on the interaction of the
child and the desk environment. Future research should
better characterize the physical interaction of the child
with the classroom environment, such as assessing the
chair seat pan angle and seat back angle in relation to
classroom tasks and performance. Adjustable school
furniture design should consider growth changes during
the academic year, of which the dimensions of the child
can change considerably [30]. Additionally, dynamic
postural analysis would clarify the diversity of move-
ment behavior and set ergonomic design requirements
supporting the interaction of the child and classroom
environment.
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