Schoolbag Weight Research Articles

IJCM_218A: Association between school bag weight and trunk strength among children in Mangalore

Background: School bags serve as a practical means for students to transport essential academic materials and personal items, including food. The significance of school bag weight has garnered increased attention in recent years due to its potential impact on the musculoskeletal health of school children. Excessive school bag weight has been identified as a significant contributor to various health issues, ranging from neck pain and shoulder discomfort to headaches, general fatigue, decreased muscle strength, and, notably, back injuries among children. Methods: The study involved 178 school children in Mangalore, ranging from 10-15 years, for a period of 23 days. School bag weights were measured using calibrated scales, and trunk strength was assessed using a hand held dynamometer. Statistical analysis, including Chi-square test, student’s ‘t’ test and Karl Pearson correlation test were employed to identify any significant relationships between these variables. Results: Preliminary findings revealed a positive correlation between school bag weight and trunk strength among the participants. Results indicated that a considerable proportion (83.1%) of students were burdened with an excessive load of bags. The evaluated muscular strength was discovered to be diminished in these individuals, and they experienced symptoms that were interconnected, highlighting the potential impact of school bag weight on the musculoskeletal health of children in Mangalore. Conclusion: These findings advocate measures to alleviate the burden on children’s musculoskeletal health. Further research and interventions are warranted to promote a balanced and healthy school environment for the well-being of the younger generation.

Schoolbag weight and its relationship to the occurrence of pain among schoolchildren in the western region of Libya

This study investigated the relationship between the schoolbag weight, and factors related to schoolbag carriage and occurrence of pain among primary school children in western part of Libya. 2371 students (1212 male and 1159 female) in grades 1 - 4 (6-9 years) were selected. Weight, tall and schoolbag weight were measured and questionnaire was used to collection the data. During the interviewing period children were classified as having pain or non. ANOVA, T-test and Logistic regression were used for analysis the data. Among participants, (96.25%) of students were used two-strap backpack with general mean weight was 3.85 kg. (91.40%) of students carried more than 10% of their body weight. Of 2371 children, neck 1137 (47.90%), Shoulder 1481 (62.60%), back 1179 (49.70%) were classified as having pain while, neck 1234 (52.10%), Shoulder 890 (37.40%), back 1192 (50.30%) were classified as having no pain respectively. The bag weight was significantly associated with occurrence of pain in primary school children.

School-Related Risk Factors for Posture Disorders and Spinal Deformities in Children and Adolescents in Kazan

Introduction: Deterioration of health of children and adolescents during school years is of particular concern to domestic experts. Myopia and diseases of the musculoskeletal system traditionally rank high in the structure of pediatric diseases. Objective: To study the prevalence of school-related risk factors for postural disorders and spinal deformities in schoolchildren of different age groups. Materials and methods: The study was conducted in December 2022 involving 278 students aged 9–15 years. We evaluated the lesson timetable, functional parameters of school furniture, weights of schoolbags and supplies, and the compliance of indoor shoes with hygienic requirements. The data were then analyzed to obtain the mean, minimum and maximum values, the share of the trait, and the significance of differences was assessed using Fisher’s exact test. Results: We found violations in organization of the educational process, such as double lessons and the absence of in-class physical activity breaks, in all grades. Evaluation of classroom furniture showed that the proportion of table and chair mismatch with the height of students in elementary school was 32.09 % and 40.30 %, decreasing by the ninth grade to 13.16 % and 21.05 %, respectively. The mean weight of the schoolbag was above the permitted level in 97.14 % of elementary school girls and in 20.68 % of girls in grades 7–8 (φemp = 8.395; p ≤ 0.001); as for boys, the recommended schoolbag weight was exceeded in 93.75 % of third to fourth graders and 28 % of seventh to eighth graders (φemp = 6.46; р ≤ 0.001). Assessment of the compliance of indoor shoes with hygienic requirements revealed a significant (φemp = 1.85; p ≤ 0.05) excess in the number of elementary school boys (71.32 %) who prefer sneakers; more than a third of girls of all age groups have ballet flats or sneakers as their indoor footwear. Conclusion: The prevalence of school-related risk factors for posture disorders is higher in elementary school, which makes it possible to predict an increase in the number of students with dorsopathy in high school. To maintain health of students, a set of measures has been proposed to minimize the adverse impact of school-related risk factors.

THE EFFECT OF SCHOOL BAG WEIGHT ON CHILDREN’S HEALTH: AN URGENT CALL FOR ACTION

In recent years, the issue of school bag weight and its impact on the health of children has gained significant attention from health experts, educators, and concerned parents alike. The consensus among experts is clear: a heavy backpack can have detrimental effects on a child’s physical well-being. The repercussions of lugging around an overloaded bag are far-reaching, with potential consequences ranging from headaches and shoulder pain to lower back pain, neck discomfort, and even arm pain. It is an issue that demands immediate attention and action, as it directly affects the health and well-being of our future generations.
 One might wonder why this issue persists when governments, like that of Khyber Pakhtunkhwa in Pakistan, have taken steps to address it. In 2020, the Khyber Pakhtunkhwa government introduced the School Bags Limitation of Weight Act, aiming to regulate the weight of school bags and protect the health of young students. Under this act, specific weight limits were established for school bags based on grade levels, with the intention of preventing excessive loads. For instance, nursery class children were advised not to carry bags weighing more than 1.5kg, while class one students were recommended to limit their bags to 2.4kg. The weight limits increased incrementally as students advanced in grade, with students in class 11 and 12 advised to carry bags not exceeding 7kg. The introduction of such legislation was a significant step toward ensuring the well-being of young students.
 However, despite these commendable efforts by the government, the implementation of these regulations remains a challenge. Reports from parents, educators, and students suggest that many schools have yet to adhere to these guidelines effectively. This raises the question of whether the regulations are being enforced rigorously and whether the well-being of children is truly being prioritized. It is crucial for both government and private schools to take this issue seriously and implement the weight limits as stipulated by the law.

E61 Prevalence and related factors of spinal pain in Tunisian children and adolescents

Abstract Introduction The prevalence of back and neck pain is common in children and adolescents, and in some series the numbers are alarming. Various risk factors have been identified, although some are controversial. Objective To determine the prevalence of neck and back pain in children and adolescents and to investigate the potential association with various risk factors identified in the literature. Methods We established a questionnaire targeting parents of children and adolescents aged between 6–18 years old in Tunisia. The recruitment of participants was done online using the Google Forms application. The questionnaire was divided into 2 parts: Part one collected the sociodemographics characteristics of the participants: age, gender, body mass index (BMI), exposure to passive smoking, the practice of a physical activity, puberty status and age at puberty if applicable, type and weight of the schoolbag, mean daily time spent on electronic devices, type of school the child attends (private/public), mode of transport from home to school, parental history of neck and/or back pain, posture of the sitting position of the child, and finally whether the child reports neck/back pain. The second part was aimed at parents whose child reported neck and/or back pain. We asked about the weekly frequency of neck/back pain, school absenteeism due to neck/back pain, whether it prevented the child from practicing physical activity and, finally, whether the child had ever seen a doctor/chiropractor/physiotherapist for their neck/back pain. For all statistical tests, the significance threshold was fixed at 0,05. Results Eighty-two participants (sex-ratio = 1) answered the questionnaire. Mean age was 11.4 ± 3.8[6–18]. Thirty (36.6%) were pubescent. Fifty-three children practiced regularly an extracurricular physical activity (swimming n = 11, basketball n = 9, football = 9, tennis = 9, gymnastics= 6, ballet = 5, horseback riding n = 3, krav maga = 2, running n = 1, volley ball n = 1). Mean schoolbag weight according to the participants was 7.6 ± 1.6 kg [1–9]. Fifty-seven children (69.5%) attended private school. Mode of transport was walking, taking public transport and driving the family car respectively in 10 and 1 and 71 children. Parental history of neck and/or back pain was positive in 47 participants (57.3%). Forty-four participants (53.7%) reported bad sitting position of their child. Neck pain, dorsal pain and low back pain (LBP) were reported respectively in 21 (25.6%), 15 (18.3%), 25 (30.5%) participants. Four children (4.9%) had neck, dorsal and low back pain. Among participants who reported neck or back pain, the average weekly frequency was 1.6 [0–7] and 3.7% had a history of missing school due to neck/back pain with a mean truancy per trimester of 3.6 times [1–12]. Spinal pain prevented 9 participants from engaging in physical activity. Twelve participants (14.6%) revealed that their spinal pain made them see a doctor and three (3.7%) a chiropractor/physiotherapist. The analytical study didn’t show an association between neck/back pain and gender, physical activity, type of school and mode of transport to school. A positive parental history of neck or back pain was significantly associated with the presence of neck, dorsal and LBP (P = 0.043, P = 0.011 and P < 0.0001 respectively). The presence of neck pain and LBP were both associated with a bad sitting position (P = 0.05 and P = 0.02 respectively). Presence of LBP was associated with a positive puberty status (P = 0.016), use of a backpack (P = 0.05), and exposure to passive smoking (P = 0.001). No significant correlations were found between neck/back pain and age at puberty, time spent daily on electronic devices, weekly duration of physical activity, schoolbag weight and absenteeism rate. LBP was significantly associated with higher BMI (P = 0.001) and higher age (P = 0.003). Similarly, dorsal pain was associated with higher age (P = 0.03). Conclusion The prevalence of spinal pain was frequent in our series. A positive parental history of spinal pain, a bad posture while sitting, passive smoking, use of backpack, higher age and higher BMI were potential associated factors.

Impact of Educational Intervention in Reducing the Weight of School Bags in Selected School Children.

To assess the effectiveness of educational intervention to reduce the weight of school bags. The study design was one group pre- and posttest experimental Research design. Government Senior Secondary School Dhanas, Chandigarh, and Shri Guru Harkrishan Model Senior Secondary School Sector-38D, Chandigarh (A private school) between July and November 2018. Names of the schools can be avoided. Total 760 students from selected sections nursery to 10th class of school were enrolled in the study. At baseline and end line weight of children, school bags and its content were weighed using weighing scale. Length of bag strap, breath of bag, torso of children, and their shoulders size were measured by measuring tape. Bag carrying style, posture, etc., were observed by observation checklist. Interviewed children (5th to 10th class) were using Nordic musculoskeletal questionnaire for musculoskeletal system assessment. Educational intervention was provided to the children for one month to reduce weight of school bag by teaching in assembly and displaying the charts in school. (Use of softbound thin textbooks, breaking thin books in 2-3 thin softbound books, use lightweight bag, pencil box, lunch box, and water bottles. Pack bag as per timetable.). The result revealed that heavy school bags were carrying 69.7% children from government school and 80.2% from private school. Children carrying heavy bags reported musculoskeletal problems 5 times higher than their counterparts. After intervention, there was significant reduction in the weight of school bags (P < 0.001 as per paired t-test). Provide the weight of the bags before and after intervention in addition to the P value. Children carrying heavy bags were suffering from musculoskeletal problems. Intervention helped in reducing the weight of school bag.

Assessment of the elementary school students' schoolbag weight in the urban environment in Poland: A cross-sectional study carried out as a part of the 'Lightweight Schoolbag' and 'Let's Get the Kids Moving' projects.

Carrying a properly weighted schoolbag is an important factor in preventing the occurrence of muscular skeletal disorder in early school age children. The purpose of this cross- sectional observational study was to examine the schoolbag weight and to determine the percentage of children were carrying overloaded schoolbag. The study group included pupils from five primary public schools in Wrocław, Poland. Anthropometrical measurements such body weight (BW) and height were conducted on 650 children (51.1% of boys). Children's age, gender, Cole's Index was juxtaposed with schoolbag weight. The mean age of the examined students was 8.7±0.8 years (range 7 to 10 years). The mean schoolbags weight was 3.7±0.92 kg, which represented 13.0±3.8% of pupils' BW. The percentage of pupils carry the schoolbags weighing more than 10% of their BW was 77.9%. More than a quarter of Polish children carry school backpack above 15% of their BW. The majority (96.8%) had schoolbags which may be carried on both shoulders. A significant negative correlation was observed between relative schoolbag weight and Cole's Index (rho = -0.44, p < 0.05). The problem of overloaded schoolbags among elementary school children was frequent. Pupils ought to be educated in the proper packing of their school backpacks. Additionally, parents and teachers should pay attention regarding the contents carried by children in their respective schoolbags.

Evaluation of an ergonomically designed schoolbag: Heart rate variability and body discomfort rating.

Unsuitable schoolbags may stress the spine and promote poor body posture, particularly for school students. Global recommendations have suggested that schoolbag weight must not exceed 10% of a healthy student's body mass, which would need continuous monitoring and enforcement. The present study presents a comparison between an ergonomically designed schoolbag, which helps reduce the potential effects of carrying a load, and a commercial one. A total of 30 healthy male students were recruited for this experiment. Independent variables determined were schoolbag type (ergonomically designed and commercial schoolbags) and three load levels based on body mass percentage (i.e., 10%, 15%, and 20% of body mass). Heart rate variability (HRV) and body discomfort rating were then measured. Our results showed that the developed schoolbag promoted enhanced subjective measures and HRV response at 15% and 20% of body mass. Participants who wore the developed schoolbags experienced significantly lesser neck, shoulder, upper and lower trunk discomfort than those who wore the traditional ones. Changing the load percentage from 10% to 15% caused an increase in heart rate among participants carrying a commercial schoolbag but a decrease in heart rate among those carrying the developed schoolbag. The findings presented herein suggest introducing strategies for reducing the potential impact of load carrying through the combined effect of new educational inventions and policy changes.

Evaluation of musculoskeletal pain and related factors in school-age children (8-12 years).

The aim of this study was to evaluate the frequency of pain and related factors in musculoskeletal system in children. A total of 313 primary school students were analyzed in this cross-sectional study conducted in the Famagusta city center and surrounding villages. The physical activity musculoskeletal pain (MSP) level, health-related quality of life weight, height, and school bag weights of the students were measured by a blinded researcher. The study group consisted of 164 (52.40%) boys and 149 (47.6%) girls with a mean age of 9.53±0.82 years. In the present study, MSP frequency was found to be 39.0%. There was no relationship between MSP and the following parameters: Age, sex, body mass index, hours of weekly gym lesson, regular participation in sports, weekly time spent with sports, school bag type, and school bag weight. There was also no relationship between these parameters and region of pain. Excessive walking and sitting were associated with increased MSP. Contrary to popular opinion, it was found that school bag weight and school bag type were not effective on MSP. Our results show that the quality of life of children can be improved by reducing MSP.

Assessment of Postural Changes Among School-Going Children Due to Heavy Backpacks in Lahore

Posture is a matter a big concern. Because of increased workload the weight of school bags is also increasing day by day. The weight of bags with heavy books can develop many spinal deformities in young children. Objective: To assess the postural changes happening in school going kids because of heavy backpacks. Method: It is a cross sectional study and was conducted on different schools in Lahore, within the time period of three months from 1st November 2019 to 1st February 2020. The sample size was 145 and the survey followed convenient sampling technique. Children per inclusion criteria were selected from different government schools to collect data and informed consent was taken before data collection. REEDCO scale was used to examine the postural disturbance. Results: Results showed head posture as 3.4% poor &amp; 13.1% fair, neck posture as 6.2% poor &amp; 16.6% fair, shoulder posture as 5.5% poor &amp; 15.2% fair, upper back posture as 3.4% poor &amp; 38.6% fair, trunk posture as 10.3% poor &amp; 46.2% fair, abdominal posture as 5.5% poor &amp; 14.5% fair, hip posture as 0.7% poor &amp; 5.5% fair and the ankle posture as 1.4% poor &amp; 26.9% fair. Conclusion: This study concluded a significantly frequent postural problems in trunk region because of carrying heavy loaded school backpacks which is neither good in present time nor in future, as with the passage of time, postural changes become irreversible. Along with that, hip region prominently perceived least postural changes according to current study.

School Bag-Related Factors and Their Implications for Walking and Cycling to School among New Zealand Adolescents.

Excessive school bag weight may be a modifiable barrier to active transport to school. This study examined correlates of school bag weight and adolescents’ perceptions of excessive school bag weight for walking and cycling to school among New Zealand adolescents living in diverse settlement types. Adolescents (n = 1512; 15.0 ± 1.3 years) completed a questionnaire and had their bag weight (n = 1190) and body weight (n = 1038) measured. Adolescents using active transport and rural adolescents had lighter school bags compared to their counterparts. One-third of adolescents reported excessive school bag weight for walking (31.2%) and cycling (37.2%) to school. Positive correlates of relative school bag weight were female gender (regression coefficient (95% CI): 0.53 (0.13, 0.93)), and underweight (2.21 (1.39, 3.02)), whereas negative correlates were Māori ethnicity (−0.87 (−1.41, −0.32)), overweight (−1.84 (−2.35, −1.34)) and obesity (−3.57 (−4.26, −2.87)), and school location in small urban areas (−2.10 (−4.19, −0.01)), and rural settlements (−3.58 (−5.66, −1.49)). Older adolescents, females, those with greater relative school bag weight, and those experiencing school bag-related pain symptoms and/or fatigue were more likely to report excessive school bag weight for both walking and cycling to school. Future initiatives should target reducing excessive school bag weight, particularly in female and urban adolescents.

Prevalence of lower limb deformities among primary school students

BackgroundLower limb deformities could affect child's quality of life and may worsen with time. This work aims to study the prevalence of lower limb deformities among primary school students in our governorate.MethodsThis cross-sectional descriptive study was carried out on 4689 students attending 12 public primary schools during the academic year 2019–2020.Complete clinical examination was done for picking of cases of genu varum, genu valgum, genu recurvatum, flat foot, pes cavus, hallux valgus, in-toeing, and lower limb discrepancy, and x-ray on both feet, pelvis, and full-length lower limb was requested.ResultsThis cross-sectional descriptive study included 4689 students. The prevalence of lower limb (LL) deformities was 16.61%. One hundred twenty-three (2.62%) children had a positive history of musculoskeletal pain, 0.09% had genu varum, 0.11% had genu valgum, 0.75% had Genu recurvatum, 0.03% had LL discrepancy, 13.86% had flexible flat foot, 1.22% had rigid flat foot, 0.23% had pes cavus, 1.04 % had in-toeing, 0.06% had hallux varus, and 0.11% had hallux valgus.ConclusionsLower limb deformities are a considerable problem in primary school students that need early diagnosis because it could affect child’s future, health, and career. Further studies are needed to investigate spinal deformity, vit D level, calcium level, foot wear, and school bag weight as hidden factors.

Short-term effects of carrying a school bag on the distribution of force and plantar pressure during walking of children of different levels of physical activity

Introduction: Carrying a school bag is a dominant activity that a child performs during daily productive activities. The aim of the research is to examine how carrying a school bag of different weights affects the distribution of force and plantar pressure during normal walking on the flat terrain of children of varying levels of physical activity.Methods: The pilot study included 124 students aged 11-12 from Banja Luka. According to the protocol, each group of respondents was treated with an intervention-customized school bag and a comparator-school bag that the child only opted for. For the research, the Physical Activity Questionnaire for Older Children, measurement of anthropometric parameters, school bag weight, and Zebris tape (Zebris Medical GmbH, Germany) were used for gait analysis.Results: Inactive children achieved the lowest and active children’s highest walking speed during normal walking without a bag, with their customized school bag. When carrying a custom school bag: The highest maximum force is projected on the left heel 330.72 N in inactive children, and the lowest 265.93 N in moderately active children, the highest maximum pressure on the left heel is registered in inactive children, 27.60 N/cm2, and the lowest 21.85 N/cm2 in moderately active children. The maximum force-time of % of standing time on the left foot in the middle part lasted the longest in inactive children, and the shortest active children carried their school bag 40.31% and a custom school bag 39.76%.Conclusion: High physical activity and individual adjustment to distribute the burden well allow the child to adequately respond to the loads carried by the weight of the school bag.

Factors affecting the prevalence of idiopathic scoliosis among children aged 8\u201315\xa0years in Prishtina, Kosovo

Prospective study, Level of evidence II. The aim of the study was to assess the prevalence of scoliosis among children aged 8–15 years old and to identify the impact of schoolbag weight in developing adolescent idiopathic scoliosis (AIS). AIS is a common disease whose prevalence varies between countries and gender, with an increased rate among females compared to males. Screening children in primary school settings for idiopathic scoliosis (IS) is an important public health issue and is crucial for early detection, prevention of further deformity, and healthy child growth. Our sample was composed of 1619 pupils from the municipality of Prishtina, surveyed from March to April 2019. Measurements were made with a scoliometer on the basis of the Adams test process. Three measurements were taken for each of the participants. Additionally, all the pupils were subjected to bare-foot height and weight measurements with and without school bags. The mean ± standard deviation age of pupils was 11.67 ± 2.00 years old and 49% were females. The prevalence of the angle of trunk rotation (ATR) ≥ 5 ° was 26.1%, females had 1.49 higher odds (95%CI 1.19–1.86) to develop an ATR of ≥ 5° compared to males. The highest rate of ATR of ≥ 5° was seen among the ninth-grade students (31.3%). 56.5% of 4th grade students carry a schoolbag weighing over 12.5% of body weight. Relatively high prevalence of idiopathic scoliosis was found in primary schools in Prishtina. The highest prevalence was found in students attending the ninth grade, while females gender dominated.

Prevalence and factors associated with low back pain in schoolchildren in Cameroon, sub-Saharan Africa.

Data on the prevalence and factors associated with low back pain (LBP) in schoolchildren are scarce in Africa, particularly in sub-Saharan Africa. To assess the prevalence and factors associated with LBP in schoolchildren in Cameroon. We performed a cross-sectional study in 10 randomly selected schools (public and private) in Douala, Cameroon. Using a self-administrated questionnaire, sociodemographic, usual physical activity, and clinical data were collected and all the schoolbags were weighted. Informed consent was obtained from the parents. Statistical significance was established at P<.05. Logistic regression was performed to identify factors associated with LBP. We included 1075 schoolchildren (543 boys, 50.5%). The prevalence of LBP was 12.3% (132 children: 81 girls and 51 boys). The mean age was 11±1years (range, 8-14years). Body mass index was normal in 110 schoolchildren (83.4%). Sixteen schoolchildren had already met a physician for LBP. Among the factors evaluated, those associated with LBP were female gender, doing competitive sport, sitting position, and LBP in at least 1 parent. The mean weight of the schoolbags was 4.9±1.9kg. We had 99 children with LBP and a schoolbag weight ≥10% of their body weight. No association was found between the weight of schoolbag and LBP. LBP is common in Cameroonian schoolchildren, where 12.3% suffer from it. The weight of schoolbags was not associated with LBP. However, female gender, competitive sport, sitting position, and parental history of LBP were significantly associated with its occurrence.

Prevalence and Factors Associated with Musculoskeletal Pain among Secondary School Students

The purpose of this paper is to examine the factors associated with the occurrence of shoulder pain, neck pain, upper back pain and lower back pain with particular focus on carrying schoolbags. A questionnaire containing a range of musculoskeletal pain related information was designed specifically for a group of schoolchildren aged 11 to 20 years and distributed to Grade 7 to Grade 13 students attending three main secondary education schools in Mauritius over the period July 2017 to February 2018. A total of 1048 questionnaires were circulated out of which 849 were useable. The study analyzed the impact of socio-economic characteristics, student perception of use of tablets, type of schoolbag, private tuition, performance, duration of bag carriage and anthropometric characteristics. Logistic regressions models were applied to inspect how those recorded factors contribute to the occurrence of musculoskeletal pain. The main findings in this paper indicate that students from single-sexed girl and mixed schools relative to boys’ schools, student perception of tablet use, backpack schoolbag relative to handbag and shoulder-bag, performance, total weight and excess weight of schoolbags have significant positive impact on musculoskeletal pain. The results point towards the importance of raising awareness among students to achieve a positive musculoskeletal health. Information obtained is deemed to affect schoolbook and equipment-carrying behaviour and future choice of schoolbag type.

Need of Postural Awareness in School-going Children

Posture refers to the position a person assumes while sitting, standing, or lying down. Our skeleton is formulated to support our body without spending much energy even with the pull of gravity. If we adopt poor posture, our muscles have to carry out the job of skeleton. When this overload remains for hours or days, we habitually develop some movement-related problems which hamper us at both, workplace and home.Postural problems in children are more concerning because heavy backpacks are badly affecting school-going children. Growth rate of appendicular skeletal system halts around 16 years of age for females and 18 years for males. Secondary ossification of vertebrae stops in mid-twenties. Therefore, spine is vulnerable to injury for longer time period. Various risk factors like inadequate ergonomic conditions, improper school bags, classroom's furniture, prolonged poor sitting posture, repetitive tasks, sedentary lifestyle, and absence of exercise are hampering children on daily basis in terms of developing musculoskeletal disorders including shoulder, upper &amp; lower back and knee pain.In rural areas of Pakistan, children are used to sit on floor for prolonged period in schools due to unavailability of furniture, prolong sitting period which leads to many musculoskeletal disorders and eventually may cause spinal curvature to be poorly affected. American Occupational Therapy Association (AOTA )recommends that students should carry backpacks no more than 15% of their body w e i g h t . A b i l l h a s p a s s e d b y K h y b e r Pakhtunkhwa government that bag weights shouldn't be more than 7kg. Other provinces should also enact similar laws to protect children from postural problems. An international study found that carrying10-kg backpack on one shoulder brought about asymmetric gait which meant selecting bags with two-straps andhanging it on both shoulders can prevent the gait kinetics to be disturbed1. A study conducted in Pakistan onschool going children, analyzed 54.61%children with low back paindue to poor posture2. According to educational statistics 2016-17, in Pakistan, there are around 28.68 million school-going children which portrays that a significant number of population, due to unawareness, no ergonomic measures in classrooms, no postural adaptations, is at a greater riskfor developing posture-related musculoskeletal disorders and in near future, disability. It is the need of hour to promote postural education in Pakistan as a strategy to mitigate high prevalence of musculoskeletal problems in school-going children. There is low awareness among parents and teachers about school bag weight limit, accurate carrying method, and proper posture. Many school administrations are acquainted with problems related to carrying heavy backpacks, but they pay no heed, so conducting seminars only isn't enough, the implementation and adaptation of correct posture in school is pivotal. There should be exercise session for 30 minutes per day to train bodies to preventpain onset and to improve body stance. Take into consideration that consuming proper diet alone is not enough to stay healthy, good posture equally matters for staying physically stable in long run.

BURDEN OF THE SCHOOL BAG: IS ANYBODY LISTENING?

In recent years, the weight of students' school bag has become an increasing concern to people with an interest or involvement in education at primary and secondary level. Parents, in particular, have given voice to this concern both as individuals and through their representative organisations. In addition, school authorities and teachers, health professionals and, indeed students themselves have increasingly voiced their unease regarding the heavy loads, which must be carried to and from school on a daily basis. Heavy school bags can be a burden, which tire students unnecessarily. There are also many researches, which have revealed strong correlation between school bag weight and physical problems among all students that can result in serious consequences in the future. So what are the factors, which contribute to the increased burden and weight on school children? Is it the number of textbooks, workbooks and copies , the size and weight of individual textbooks, the additional content and weight of the school bags or some other factors which have an indirect influence on the weight of school bags? These could be the provision of storage facilities, the lack of coordination of homework by teachers, students' lack of organisational skills and awareness in the school authorities of the possible health problems posed by excessively heavy school bags. This paper seeks to address these issues.

Do School Bag Weights of Primary School Children Affect Back Pain?

Purpose:The aim of our study was to investigate whether the school bag properties used by children had an effect on their back pain. Patients and Methods:Eighty-two volunteer students were included in the study. The characteristics of the school bag used by the children who were participating in the study, the data of the variables such as perceived bag weights, bag carrying patterns and pain and fatigue levels were questioned with the form prepared by the researchers. SPSS 22.0 analysis program was used to analyze the data. Results:The average age of the participants was 9.82 ± 0.65 years. Of the 82 volunteer students who included in the study were 39 (47.6%) female and 43 (52.4%) were male. It was determined that the type of bag that children used when coming to school was a backpack. 29.26% (n = 23) of the students carry their backpacks with one shoulder strap and 70.74% (n = 59) with two shoulder straps. There was a statistically significant correlation between the severity of back pain and the type of carrying bag (p<0.05). There was no statistically significant difference between the level of back pain and gender (p> 0.05). Conclusion:It was recommended that the weight of school bag should not exceed 10% of the child\'s body weight in Europe but we found approximately 13% and exceeded the recommended limit. The results of our study suggest that the bag weight perceived by children is related to back pain and fatigue.

Musculoskeletal Pain and its Association with School Bag Weight and Diet Intake: A Cross-Sectional Study among School-Going Adolescents in Delhi

Background: Prevalence of musculoskeletal pain is increasing in adolescent school students. This studyconducted to assess the role of heavy bag packs and faulty dietary habits in the causation of musculoskeletalpain.Methods: The study was conducted in school going 1600 adolescent school students of Delhi, India fromApril 2018 to March 2019. The demographic profile, symptoms of pain in neck, shoulder and back wasrecorded through a validated questionnaire and the simplified dietary gap assessment tool was applied toassess the dietary habits. The weight of the school bag was measured. The prevalence of musculoskeletalpain was 56.8% among adolescent school students. The musculoskeletal pain was significantly higher inthose students who were carrying bag weight 10-15% of their body weight and was two times higher thanthose students who were carrying bag weight less than 10% of their body weight. Students having dietarygap score of less than 5 out of 10 were more prevalent to get musculoskeletal pain than those having dietaryscore more than 8.Conclusions: Carrying of heavy school bag weight and gap in the diet among the school going adolescentscan lead to musculoskeletal pain