Abstract
Back-carrying of children is a culturally accepted method of transport and safekeeping of babies in many cultures. Developmental consequences related to back-carrying practices have not been directly investigated. This study determined the relationship between frontal and transverse plane lower limb (LL) development, and back-carrying practices, in black Setswana-speaking children. In 691 2- to 9-year-old Setswana-speaking children, the tibiofemoral angle, intermalleolar distance, femoral anteversion angle (AVA) and tibial torsion angle (TTA), were measured to determine LL development. Back-carrying practices were recorded with a questionnaire and Classification and Regression Tree (CART) was used for the analyses. Significant (p < 0.001) relationships, between back-carrying practices and LL development, were discovered. Statistically significant greater genu valgum (F(5, 690) = 7.2, p < 0.001), greater internal TTAs (F(9, 684) = 17.8, p < 0.001), and smaller AVAs (F(13, 685) = 5.1, p < 0.001) were observed in children back-carried more frequently than children back-carried less frequently. There are relationships between back-carrying practices and LL development in both the frontal and transverse plane. However, the genu valgum, internal TTA and smaller AVA noted in more frequently back-carried children is still within normal limits, thus no educational intervention in back-carrying methods or durations is required. Further research should determine the exact back-carrying practice factors (age until which the child is back-carried) impacting lower limb development the greatest.
Highlights
Introduction iationsSouth African children of black ethnicity are generally back-carried (BC) by their mothers, with the aid of blankets or towels [1,2,3]
The data were obtained within the larger project, i.e., Lower Limb Development and Gait Kinematics of Back-Carried Setswana Children
When children are BC (Figure 1), the Classification and Regression Tree (CART) reveals a larger valgus TFA, which corresponds with results by Golding [4], who observed a constant valgus force produced on the lower limb (LL) at the knee compared to nonBC children
Summary
Introduction iationsSouth African children of black ethnicity are generally back-carried (BC) by their mothers, with the aid of blankets or towels [1,2,3]. The child’s legs are either placed spread around the mother’s back or left hanging down on the mother’s back, while the blanket or towel envelops the child’s back and buttocks and is tied at the mother’s front. The latter method (legs hanging down) is usually utilised in early infancy. Mothers from a lower socio-economic status will back-carry (BC) their child for extended periods, as long as eight (intermittent) hours per day, while working or travelling on foot, to keep the child safe [1,3]. BC restricts head, upper and lower limb (LL) movements and limits crawling of the child
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