School Backpack Research Articles

Web-based survey usefulness for studying the influence of school bags and backpacks on back and neck pain in children and adolescents - pilot study in a medium-sized town

A total of 380 questionnaires were submitted with no logical errors and highly probable answers from 220 girls (average age 13.4 years old) and 160 boys (average age 13.7 years old). The back and neck pain was mentioned by 49% of adolescents (51% of girls and 46% of boys). Thoracic and lumbar pain was mentioned by 39 girls (10%) and 100 boys (26%). The reported pain occurred intermittently (72.5%), mostly during the day (63%). Some respondents mentioned that pain occurs when they carry their bags on their shoulders (7%) or when they carry their backpacks (19%). Girls more likely carry bags (youth style), and boys prefer backpacks or rucksacks. Girls usually carry bags on the same shoulder. Of the total respondents, 65% were pain-free while being physically active 2-4 hours per week outside of the school physical education program (p<0,01).

Relative Weights of the Backpacks of Elementary-Aged Children

The purpose of the study was to describe the range of relative backpack weights of one group of elementary-aged children and the extent to which they exceeded recommended levels. A second purpose was to explore whether gender and age help predict the relative weight of children's backpacks. Ninety-five 8- to 12-year-old elementary school students (56% girls; 88% car or bus riders) participated. Their school backpacks were weighed, and their age, gender, and mode of transportation to school were recorded. Only 40% of the sample carried backpacks that were less than 10% of their body weights. Five percent of the students' backpacks exceeded 20% of their body weights. Neither age group nor gender significantly predicted relative backpack weight or relative weight levels. Recommendations are made for ways to reduce the weight these young children carry.

Back Problems Due To Heavy Backpacks in School Children

Students and backpacks are a common sight today. Backpacks come in all sizes, colors, fabrics, and shapes and help children’s of all ages express their own personal sense of style. Many packs feature multiple compartments that help students stay organized while they carry their books and papers from home to school and back again. Backpacks are, though, they can strain muscles and joints and may cause back pain if they're too heavy or are used incorrectly. Many students carry school backpacks that exceed 10 percent to 15 percent of their body weight, which puts them at risk for back pain and related disorders. Improper backpack use can also lead to poor posture. Girls and younger kids may be especially at risk for backpack-related injuries because they're smaller and may carry loads that are heavier in proportion to their body weight. Carrying backpacks increases the risk of back pain and possibly the risk of back pathology. The prevalence of school children carrying heavy backpacks is extremely high. The daily physical stresses associated with carrying backpacks cause significant forward lean of the head and trunk. It is assumed that daily intermittent abnormal postural adaptations could result in pain and disability in school going children. American Occupational Therapy Association (AOTA) and the America Academy of Pediatrics advise that students should carry no more than 15% or 10-20% of their bodyweight. Key WordsBackpack, back pain, children, prevalence, posture

Awareness of Parents about Characteristics of a Healthy School Backpack.

The issue of knowledge on school backpacks among parents has received little attention. The objectives of this study were to assess school backpack carriage and its consistency with parents' knowledge about children friendly school backpacks. This was a randomized cross-sectional study. Totally 307 elementary school children and 250 parents were recruited to assess parental knowledge about standard school backpacks in 2010. Data collection were carried out on an unscheduled day in order to, children and their par¬ents prepared school backpacks based on their own previous habits and behaviors. All statistical analyses were performed using version 16.0 of the statistical software package SPSS Results: Approximately, 132 (51.6%) of the parents were not aware of the recommended weight limit for carrying school backpacks and 144 (56.3%) were not aware that the size of the backpack must be proportionate to the upper back region. Significant difference was found for the mean score of awareness of a safe and standard school backpack between fathers and mothers: fathers had more knowledge about school backpack carriages in comparison with mothers (P<0.001). Children, parents and teachers should be educated about the characteristics of a standard backpack, different strategies. Parents are the best advocates for safety promotion and should represent the group most likely to help to significantly reduce backpack related injuries among school children by selecting safe school backpacks, supervising school backpack carrying and checking backpack weights.

Effects of a postural education program on school backpack habits related to low back pain in children

Population based studies have demonstrated that children and adolescents often complain of low back pain. A group-randomized controlled trial was carried out to investigate the effects of a postural education program on school backpack habits related to low back pain in children aged 10-12 year. The study sample included 137 children aged 10.7 years (SD = 0.672). Six classes from two primary schools were randomly allocated into experimental group (EG) (N = 63) or control group (CG) (N = 74). The EG received a postural education program over 6 weeks consisting of six sessions, while the CG followed the usual school curriculum. A questionnaire was fulfilled by the participants at pre-test, post-test, and 3 months after the intervention finished. The outcomes collected were: (1) try to load the minimum weight possible, (2) carry school backpack on two shoulders, (3) belief that school backpack weight does not affect to the back, and (4) the use of locker or something similar at school. A sum score was computed from the four items. Single healthy items mostly improved after the intervention and remained improved after 3-month follow-up in EG, while no substantial changes were observed in the CG. Healthy backpack use habits score was significantly increased at post-test compared to baseline in the EG (P < 0.000), and remained significantly increased after 3-month, compared to baseline (P = 0.001). No significant changes were observed in the CG (P > 0.2). The present study findings confirm that children are able to learn healthy backpack habits which might prevent future low back pain.

Evaluación de la efectividad de una intervención educativa para disminuir el peso de la mochila escolar en los alumnos de 3.° y 4.° de educación primaria

IntroductionThis work shows that classroom educational orientation provided by a physiotherapist can lead to reduction in the weight of backpacks carried by 8-10 year old schoolchildren. The purpose was to have them limit backpack weight to no more than 10-15% of the total weight of the student and avoid some of the spinal cord overload and therefore one of the risk factors of suffering back pain. Higher loads can change spinal curvature with a perception of increased effort and onset of pain. Materials and methodDesign: randomized, open labeled, controlled clinical trial. Location: public schools in Alcobendas and San Sebastian de los Reyes. Participants: a total of 357 children, aged 8 to 10 years. Main measurements: children and their school backpacks were weighed prior to the educational intervention, immediately after and at three months of the educational intervention. ResultsRegarding the study primary endpoint, average weight of the backpack, the difference between the two groups was greater than 1kg (difference considered relevant) both at the end of the intervention (difference of means (SD)=2.28kg) and at 3 months of it (SD=2.24kg) (P=<.001). Regarding the endpoint “excess weight in the backpack”, it was observed that those children who received the intervention had approximately three times more likelihood both at the end of said intervention and at 3 months (RR=2.63 and RR=2.96, respectively) of carrying backpacks without excessive weight. ConclusionsThe study shows educational intervention with review of school supplies transported by students aged 8 to 10 achieves a decrease of more than onekg in weight of their backpacks versus the control group (mean 2.28kg at the end of the first intervention). It also shows that these results are maintained over time (mean 2.24kg at 3 months).

Loading rate patterns in scoliotic children during gait: the impact of the schoolbag carriage and the importance of its position

Concerns have been raised regarding the effects of schoolbag carriage on adolescent schoolchildren and particularly those with a pre-existing spinal deformity. The purpose of this study was to determine the effect of school backpack loads in scoliotic and healthy school-age children during walking, in terms of peak vertical ground reaction forces and loading rates. We hypothesized that walking with a loaded backpack would have a greater effect on gait kinetics of scoliotic compared to healthy. Eight children with idiopathic scoliosis and eight healthy children were assessed. Kinetic data were collected using two AMTI OR6-7 force-plates, while the subjects walked freely along a 6-m walkway under three walking conditions: (1) without a schoolbag, (2) carrying a schoolbag bilaterally (over both shoulders-symmetrical load) and (3) carrying a schoolbag unilaterally (over each shoulder-asymmetrical load). Kinetic data were collected and four parameters were calculated; peak ground reaction force at the first maximum force peak (F1), time needed to reach F1 (T1), loading rate of F1 (LRF1) and total contact time (T2). We found no significant differences between the scoliotic and healthy children for any of the kinetic variables examined. In addition, the position of the bag did not seem to have any effect on loading rate. The results of this study indicate that in terms of kinetic parameters during normal gait, the schoolbag load (symmetrical or asymmetrical) does not have a different effect on children with mild adolescent idiopathic scoliosis compared to normal controls.

Asociación entre las mochilas escolares y el dolor de espalda. Revisión sistemática

Objective To identify the relationship between school backpacks and back pain in children and adolescents. Search Strategy A systematic review of observational epidemiological studies was conducted in MEDLINE, PEDro, Web of Science, LILACS and IME databases; specialized electronic journals and references of already identified relevant papers. Study and data selection Through an electronic and manual search, 102 articles were identified, including 21 research papers that met the selection criteria. Results The design of the backpack, the way it is carried and its weight were factors related to the use of school backpack and back pain. Most students carry weights that exceed recommended limits in their backpacks. Conclusions The studies are controversial regarding the relationship of the school backpack to back pain. It has been justified that the backpack weight should not exceed 10%-15% of body weight.

Effects of Visual Input on Standing Balance Control When Back-Carrying External Loads

The objective of this study was to identify how visual input affects upright balance when external loads are applied. Two independent variables were thus investigated: visual input and loading conditions. Visual input was manipulated by simply using eyes-open and eyes-closed conditions. External loads were set at 10kg and back-carried using a school backpack. During data collection, the participants were instructed to stand upright on a force platform as still as possible with feet parallel and together. The root measure square distance and mean velocity of COP were used as dependent measures to quantify balance control behaviors. Univariate ANOVA revealed that all the dependent measures significantly increased in the eyes-closed condition versus eyes-open condition when back-carrying external loads, indicating that deprived vision might lead to less postural stability and increased fall risks. In addition, the effects on balance caused by visual input were not affected by loading conditions. Findings from this study demonstrated that visual input plays an important role in the control of balance under different loading conditions. This information could be useful, especially when developing interventions for the improvement of balance in the condition where external loads are applied.

Backpack weight and postural angles in preadolescent children

It has been suggested that exposure to heavy school backpacks is a relatively recent phenomenon. Factors such as reduced use of student lockers secondary to security concerns, an increased use of laptop computers, and increased carrying of non-educational loads such as musical instruments and sports equipment have potentially increased student exposure to heavy load carriage. It is therefore pleasing to see research, as presented by Ramprasad and colleagues(1), continuing to raise awareness of this problem.

The Effect of Backpacks on the Lumbar Spine in Children

This study is a repeated measures design to measure the lumbar spine response to typical school backpack loads in healthy children. The lumbar spine in this setting was measured for the first time by an upright magnetic resonance imaging (MRI) scanner. The purpose of this study is to measure the lumbar spine response to typical school backpack loads in healthy children. We hypothesize that backpack loads significantly increase disc compression and lumbar curvature. Children commonly carry school backpacks of 10% to 22% bodyweight. Despite growing concern among parents about safety, there are no imaging studies which describe the effect of backpack loads on the spine in children. Three boys and 5 girls, age 11 +/- 2 years (mean +/- SD) underwent T2 weighted sagittal and coronal MRI scans of the lumbar spine while standing. Scans were repeated with 4, 8, and 12 kg backpack loads, which represented approximately 10%, 20%, and 30% body weight for our sample. Main outcome measures were disc compression, defined as post- minus preloading disc height, and lumbar asymmetry, defined as the coronal Cobb angle between the superior endplates of S1 and L1. Increasing backpack loads significantly compressed lumbar disc heights measured in the midline sagittal plane (P < 0.05, repeated-measures analysis of variance [ANOVA]). Lumbar asymmetry was: 2.23 degrees +/- 1.07 degrees standing, 5.46 degrees +/- 2.50 degrees with 4 kg, 9.18 degrees +/- 2.25 degrees with 8 kg, and 5.68 degrees +/- 1.76 degrees with 12 kg (mean +/- SE). Backpack loads significantly increased lumbar asymmetry (P < 0.03, one-way ANOVA). Four of the 8 subjects had Cobb angles greater than 10 degrees during 8-kg backpack loads. Using a visual-analogue scale to rate their pain (0-no pain, 10-worst pain imaginable), subjects reported significant increases in back pain associated with backpack loads of 4, 8, and 12 kg (P < 0.001, 1-way ANOVA). Backpack loads are responsible for a significant amount of back pain in children, which in part, may be due to changes in lumbar disc height or curvature. This is the first upright MRI study to document reduced disc height and greater lumbar asymmetry for common backpack loads in children.

Effects of backpack load placement on pulmonary capacities of normal schoolchildren during upright stance

Backpack carriage affects posture, physiological costs and physical performance. Limited literature concerning the effects of backpack load placement on pulmonary capacities of schoolchildren has been reported. The objective was to assess the effects of backpack load placement on pulmonary capacities of normal schoolchildren. Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1), peak expiratory flow (PEF), and forced expiratory flow (FEF 25–75%) were measured in 22 normal schoolchildren with a mean age of 12 years during free standing and when carrying a backpack of 15% bodyweight with its center of gravity positioned at T7, T12 and L3. The main effect of load was found to be significant for FVC and FEV 1. However, no significant effect of load placements on the pulmonary function of schoolchildren was found. Manipulation of load placements may not alleviate the restrictive effects exerted on the pulmonary function resulted from backpack load carriage. Relevance to industry Daily carriage of a school backpack on the musculoskeletal health of children and adolescents has become an area of concern. Restrictive effects on the pulmonary function due to backpack carriage were reported and it is useful to explore whether these effects could be alleviated by manipulating the backpack center of gravity level.

School backpacks: It's more than just a weight problem

The objectives of this study were to 1) describe the characteristics of the backpacks used by students 10-18 years of age, 2) describe self reported pain related to backpack use and 3) evaluate the relationship between self reported pain and perceived backpack weight, duration of backpack use and posture when wearing a backpack. A cross-sectional survey of 871 students assessed the features of the backpack carried; the self perceived backpack weight, duration and posture; and any backpack related pain. Results indicate that 99% of students surveyed carry backpacks, 83% carry their backpacks over both shoulders and the presence of adjustable shoulder straps were the most common feature of the backpacks. Half of the students perceive their backpack as heavy and 46% indicate they carry the backpack 10-20 minutes to and from school. Pain attributed to backpack use was reported by 33.5% of the students. Perceived backpack weight, duration of backpack carriage, posture, gender and school district were significantly associated with reported symptoms. Although other socioeconomic and demographic characteristics may contribute to backpack related pain, this study suggests that students perceive a relationship between backpack use, the duration of use, posture and pain supporting the suggestion that simple weight-based controls of backpacks may not be sufficient to eliminate pain perceived as due to backpack use.

Effect of carrying school backpacks on cardio-respiratory changes in adolescent students

Fifteen male high school students (12.5±0.5 years) voluntarily participated in this study. They carried backpacks with 0 (as a control group), 8, 10.5 and 13% of their body weights on a treadmill at 1.1 m/s for 15 min. Their systolic (SBP) and diastolic (DBP) blood pressure was measured by a digital blood pressure meter, and heart rate (HR), minute ventilation (MV) and respiratory frequency (RF) by a Gas Analyzer System, in 3 positions: rest, exercise (15 min walking) and recovery (3 min after walking). The results indicated that the SBP and MV during and 3 min after carrying backpacks 10.5 and 13% of body weight were significantly higher than under 0 and 8% body weight load conditions. The DBP increased significantly only at the 13% body weight load condition, after 15 min of walking. The weight of school backpacks for high school students can be recommended as 8% of their body weight, because carrying 8% body weight load did not significantly change cardio-respiratory parameters.

Efeitos de sessões educativas no uso das mochilas escolares em estudantes do ensino fundamental I

OBJECTIVE: To evaluate the changes in loads carried, in the model of backpack used and in the way of carrying school backpacks after the implementation of an educational program. METHODS: This study was performed on 99 children aged seven to 11 years at elementary school level in a private school in Sao Paulo, Sao Paulo, Brazil. The subjects' body mass (kg) and height (cm) and the loads carried in their backpacks (kg) were evaluated. The backpack models and the ways of carrying them were evaluated by filming before and after the intervention. The intervention program consisted of educational sessions offered to the children, parents and teachers. The sessions involved lectures about the spine and about the principles of load carrying. The children also received practical guidance relating to correct postures for load carrying. The children received monthly practical reinforcement for three months. The parents and teachers received reinforcement by means of information flyers and guidance on the school's home page. The data were analyzed by means of two-proportion equality and Wilcoxon statistical tests. The significance level was considered as α=0.05. RESULTS: The use of a two-strap backpack model increased from 46.5% to 60.6% (p=0.046) and carrying it on two shoulders increased from 41.4% to 55.6% (p=0.047). The load carried in the backpacks decreased by 2.66kg (p 15% of the subject's body mass) decreased (p<0.001). CONCLUSIONS: The educational sessions promoted changes in backpack use and it was observed a satisfactory adherence to the intervention program proposed. These results demonstrate the importance of Physical Therapy educational programs in schoolchildren's health.

How Not to Wear a School Backpack

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.

A Comparison of Two Middle School Backpacks with Varying Comfort Features under an Increasing Load

With an increase in schoolchildren reporting back pain, health officials are concerned over the long-term effects of carrying backpacks. One possible concern could be the type of backpack children are wearing. Two backpacks with varying comfort features were compared through a series of physiological and psychophysical measurements. It was found that there were no differences between the two backpacks and that choosing a backpack should possibly be a personal choice.

통학용 학생 가방 개선을 위한 구매기준과 착용 불만족 경험 조사

The purpose of this study is to investigate the satisfaction of the adolescents' school backpack bag and the important criteria when purchasing for developing comfort and functional backpack. The questionnaire was composed and surveyed with 245 middle school students and the data were analyzed through SPSS 13.0. Purchasing criteria were grouped into 5: practical, shop environment, comfort, aesthetic and maintenance. Satisfaction factors were function/comfort, fashion/aesthetic and durability/A.S. 50.2% of students recognized the inappropriate wearing backpack might cause the deformation of body shape. And the wrong habit of wearing bag was found to affect the body posture of students. Main symptoms caused by wearing it for long time are ‘sweating around shoulder and back' and ‘feeling stiff in shoulders and waist'. Needs arise to develop the bag which could prevent them and to educate students how to wear bags. According to the result from MDS of purchasing criteria, one axis is product vs. environment, and other is functional vs. psychological aspects. According to the result from MDS of bag satisfaction, one axis is function/durability vs. fashion/appearance, and other is gestalt quality vs. part quality. They wanted the improvement in the aspects of shape/design, material, maintenance, comfort and usability of the bags. Specially it is required that we research the adolescent customer-oriented way and develop the new materials or shapes pursuing both shoulder comfort and characteristics.

69. Typical School Backpack Loads Significantly Compress Lumbar Discs in Children

BACKGROUND CONTEXT: Over 92% of children in the United States carry backpacks that are typically loaded with 22% body weight (1,2). Thirty-seven percent of children age 11–14 report back pain, the majority of whom attribute their pain to wearing a school backpack (3). Our previous studies in children with 10, 20, and 30% body weight loads indicate that these loads cause very high contact pressures under backpack straps as well as significant pain (4). It is not presently known how typical school backpack loads affect the lumbar intervertebral discs in children.

Distribuição da força plantar e oscilação do centro de pressão em relação ao peso e posicionamento do material escolar

OBJETIVO: Investigou-se a influencia da carga e posicionamento do material escolar sobre a distribuicao da forca plantar (DFP) e trajetoria do centro de pressao (COP) em estudantes. METODOS: Participaram 30 voluntarios (10,7 ± 1,35 anos), ambos os generos, sem alteracao postural. Dados baropodometricos foram coletados em sistema de baropodometria computadorizada (Matscan Research, Teckscanâ, 5.72): sem carga (controle); com carga (mochila) de 5, 10 e 15% da massa corporal, posicionada nas regioes anterior e posterior do tronco, ombro direito e esquerdo. RESULTADOS: Sem carga, a DFP foi maior no calcâneo esquerdo comparado ao direito (p< 0,05). Com carga de 10% no ombro esquerdo, a DFP foi maior a direita e menor a esquerda, comparado ao controle (p< 0,05). Com 5% na regiao posterior do tronco, a DFP foi menor no medio-pe direito (mpD) e antepe esquerdo (apE); com 10%, foi menor no mpD e mpE e maior no artelho direito (atD); com 15%, foi menor no mpD e maior no atD (p< 0,05). A forca plantar foi maior no atD com carga de 10 e 15% em relacao a 5% (p< 0,05). Com carga de 15% nas regioes anterior e posterior do tronco, a trajetoria do COP foi maior (p< 0,05) comparada a carga de 5%. A DFP nao foi influenciada pelas diferentes cargas e posicoes da mochila. CONCLUSOES: Considerando o aumento da trajetoria do COP com carga de 15%, recomenda-se que a carga das mochilas escolares nao ultrapasse 10% da massa corporal. Sugere-se investigacao das adaptacoes da postura as diferentes cargas e posicoes da mochila, visando detectar possiveis alteracoes e propor acoes preventivas.