Abstract
Background: Habitual school backpack carriage causes neuro-musculoskeletal vertebral, shoulder and hand pain; deviated posture compromised cardiopulmonary function and proprioception. Objective: Present a novel literature summary of the influence of backpack carriage associated with deviated cervical posture and compromised pulmonary function. Method: An electronic literature appraisal adopting the Preferred Reporting Items for Systematic Reviews, using Google Scholar, Science Direct, EMBASE, AMED, OVID, PubMed and Sabinet search engines, was instituted during 2009–2019. Key search words: schoolbag, backpack, carriage, cervical posture and children. The quality of the studies was assessed using the Downs and Black Appraisal Scale. Results: 583 records were initially identified which was reduced to 14 experimental and observational studies. A total of 1061 participants were included across the 14 studies, with an average age of 11.5 ± 1.3 years, body mass of 37.8 ± 6.6 kilograms (kg), height of 1.41 ± 0.05 meters (m), backpack mass of 5.2 ± 0.9 kg and percentage backpack mass to child’s body mass of 13.75%. The studies mean rating according to the Downs and Black Appraisal Scale was 76.3%. The average craniovertebral angle (CVA) was 53.9° ± 14.6° whilst standing without carrying a backpack was reduced to 50.4° ± 16.4° when loaded ( p < 0.05). Backpack loads carried varied from 5% – 30% of the participant’s body mass that produced a mean CVA decline of 3.5°. Conclusion: Backpack carriage alters cervical posture, resulting in smaller CVA and compromised pulmonary function. There is no consensus of the precise backpack mass that initiates postural changes. Girls’ posture begin changes when carrying lighter backpacks as compared to boys of the same age strata.
Highlights
Numerous investigations have been conducted in order to determine the effect of carrying school backpacks on children’s health and well-being (Dockrell, Blake & Simms 2016; Milanese & Grimmer-Somers 2010; Sharan et al 2015)
One study reviewed the effects of exercise rehabilitation in order to resolve deviated cervical posture caused by backpack carriage (Misra et al 2012), whilst another study compared traditional backpack loading with modified bag carriage (Leman et al 2013)
The empirical evidence indicates that craniovertebral angle (CVA) changes occur when a child carries a backpack, but they differ in opinions as to what percent mass of the backpack load produces a significant CVA change
Summary
Numerous investigations have been conducted in order to determine the effect of carrying school backpacks on children’s health and well-being (Dockrell, Blake & Simms 2016; Milanese & Grimmer-Somers 2010; Sharan et al 2015). Subsequent research attempted to determine safe school backpack loads, defining weights at which negligible pain, discomfort and cervical and postural deviations were produced (Arghavani et al 2014; Dockrell, Simms & Blake 2015; Khallaf et al 2016). The American Occupational Therapy Association recommends a load of 15% relative to the child’s body mass, whilst the American Academy of Pediatrics supports Voll and Klimt’s (1977) 10% load guideline prescription (Dockrell et al 2016). Habitual school backpack carriage causes neuro-musculoskeletal vertebral, shoulder and hand pain; deviated posture compromised cardiopulmonary function and proprioception
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