The aims of this pilot study were to determine whether the weight of a backpack, its position on the spine or time carried affected adolescents cervical and shoulder posture. Standing posture measured from the sagittal and frontal planes of 13 students was recorded photographically under several load carrying conditions. Cervical and shoulder position angles were calculated and compared. Results revealed that both backpack weight and time carried influenced cervical and shoulder posture. Forward head posture increased when carrying a backpack, especially one with a heavy load. Carrying a backpack weighing 15% of body weight appeared to be too heavy to maintain standing posture for adolescents. These findings have implications for future load carrying studies in adolescents.

The Functional Rating Index seems preferable to the 18-item Roland-Morris Disability Questionnaire for use in clinical trials and clinical practice.

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Objectives: To examine responsiveness and estimate minimal clinically important difference (MCID) of the Thai version of Functional Rating Index (Thai FRI) and examine head-to-head comparisons of the Thai FRI and other questionnaires. Methods: This study related to validation of a questionnaire and head-to-head comparisons. Patients with low back pain (LBP) completed the Thai FRI, Roland-Morris (RM), modified Oswestry, and multilevel RM disability questionnaires. Patients with neck pain (NP) completed the Thai FRI and Neck Disability Index at the first visit and 2-week follow-up. Patients and therapists rated Global Perceived Effect Scales (GPES). Effect size (ES), standardized response mean (SRM), correlations between the GPES with changes in questionnaire scores, and area under receiver operating characteristic curve (AUC) were calculated. The MCID was also estimated.Results: Eighty-four patients with LBP and 52 patients with NP completed the Thai FRI. ES = 1.34 for LBP; 1.28 for NP, SRM = 1.32 for LBP; 1.20 for NP, correlation = 0.49 for LBP; 0.38 for NP, AUC = 0.83 for both groups. MCID = 11.5 for LBP; 12.5 FRI points for NP. Conclusion:The Thai FRI demonstrated responsiveness with large ES. Its MCID ranged from 11.5 to 12.5 FRI points. The Thai FRI had comparable responsiveness to other questionnaires and was appropriate for use in the patients with back and/ or neck pain. KEYWORDS back pain, functional rating index, neck pain, responsiveness