Abstract

BackgroundThe association between the weight of school bag and Low Back Pain (LBP) amongst students remains under intense debate worldwide. This study aimed to estimate the prevalence of LBP amongst public high school students (14 to 19 years) in Kuwait and to investigate the association between LBP and the weight of school bags.MethodsAn analytical cross-sectional study using multistage cluster random sampling with probability proportional to size was conducted on a total of 950 public high school students from all governorates. Data on LBP were collected through face-to-face interviews using a structured questionnaire. A 0–10 Numeric Pain Rating Scale was used to rate the intensity of LBP. The students’ height and weight in addition to the weight of their school bags were measured using appropriate weight and height scales. Logistic regression was used to investigate the association between the weight of school bags and LBP while adjusting for potential confounders.ResultsThe estimated lifetime, 6-month, and 1-month prevalence of LBP were 70.3% (95% CI: 67.30–73.21%), 49.1% (95% CI: 45.83–52.28%), and 30.8% (95% CI: 27.81–33.78%) respectively, with significantly higher prevalence amongst females compared to males (p < 0.001). The absolute weight of school bag was not significantly associated with LBP neither in univariable nor multivariable analysis. The relative weight of school bag (as a percentage of the body weight) was significantly associated with LBP in univariable analysis but not in multivariable analysis. The perceived heaviness of school bag, however, was found to be significantly associated with LBP throughout the analysis (p < 0.001).ConclusionIn conclusion, LBP amongst high school students in Kuwait seems to be very common with a prevalence resembling that of high-income countries. Our data suggest that the perceived heaviness of school bag is far more important than the actual bag weight. Current recommendations about the weight of school bags, which are not supported by evidence, should be revised to take into account the students’ perceived heaviness of school bag.

Highlights

  • The association between the weight of school bag and Low Back Pain (LBP) amongst students remains under intense debate worldwide

  • We have demonstrated that LBP is common amongst adolescents in public high schools in Kuwait and that the absolute bag weight is not related to LBP

  • LBP amongst high school students in Kuwait seems to be common with a prevalence resembling that of high-income countries

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Summary

Introduction

The association between the weight of school bag and Low Back Pain (LBP) amongst students remains under intense debate worldwide. This study aimed to estimate the prevalence of LBP amongst public high school students (14 to 19 years) in Kuwait and to investigate the association between LBP and the weight of school bags. Low Back Pain (LBP) is not a life-threatening condition, it is a major cause of absenteeism from work and loss of productivity, in addition to severe implications on the quality of life [1]. LBP among adolescents associates with school absenteeism and loss of educability [3] in addition to the impact on quality of life. A previous study in Kuwait, reported the lifetime prevalence of LBP amongst high school adolescents to be 57.8% [8]. The results of the studies remain controversial, many studies showed that female adolescents experience more LBP than males [9,10,11]

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