How Not to Wear a School Backpack

Abstract

Orthopaedics| November 01 2008 How Not to Wear a School Backpack AAP Grand Rounds (2008) 20 (5): 58–59. https://doi.org/10.1542/gr.20-5-58 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation How Not to Wear a School Backpack. AAP Grand Rounds November 2008; 20 (5): 58–59. https://doi.org/10.1542/gr.20-5-58 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: pain, pressure-physical agent, shoulder region, skin, lower back, shoulder pads, shoulder pain Source: Macias BR, Murthy G, Chambers H, et al. Asymmetric loads and pain associated with backpack carrying by children. J Pediatr Orthop. 2008;28(5):512–517. This study from Children’s Hospital and Health Center, San Diego, described the contact pressures under backpack shoulder straps of children while they carried varying loads under different wearing conditions. Healthy young teens were recruited to carry a standard backpack loaded at 10%, 20%, and 30% of body weight (BW). Four different standardized backpack positions were tested for skin surface contact pressures under the shoulder straps utilizing sensors positioned under each strap. The backpack was placed with both shoulder straps equally adjusted for (1) a high back position between the scapula and above the pelvis as well as (2) a low back position resting on the pelvis with the shoulder straps equally adjusted. These high and low back positions were then tested with (3) the backpack carried over the left shoulder and with (4) the pack carried over the right shoulder. Contact pressures were measured while the child was standing as well as walking. Pressure thresholds greater than 30 mm Hg were assumed to occlude skin blood flow. The children rated their pain using the Borg Visual Analog Scale (BVAS: 0= no pain, 10=worst pain).1 Five girls and five boys participated. Subjects’ mean age, height, and weight were 13.2 years, 136.5 cm, and 62 kg respectively. For each of the four testing conditions the mean surface contact pressure was significantly higher with the use of one strap on the right shoulder compared to the left, with use of a low back position compared to high back position, and at 30% BW load compared to 10% or 20% BW. The least skin pressure was noted under the left shoulder strap (38 mm Hg SD ± 12 mmHg) for a 10% BW load, high back position, with both straps secured. The highest skin pressure was measured under the right shoulder strap (235 mm Hg SD ± 68) for a 30% BW load, low back position with only one strap secured. Perceived pain on the BVAS was significantly higher with the backpack in the low back position, with backpack loads of 30% BW compared to either 10% or 20%, and with use of one shoulder strap compared to two. The highest pain score (BVAS 6) was noted with a 30% BW load when one shoulder strap was used. At a 10% BW pack load the perceived pain score was <1, regardless of whether one or both shoulder straps were used. The authors conclude that children should carry backpacks in the high-back position with two straps placed over both shoulders to minimize high local pressures. Dr. Schwend has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. Although this study evaluated only 10 healthy volunteer children, it was well controlled for age and used rigidly applied testing conditions. A skin surface pressure... You do not currently have access to this content.