Altered cervical posture kinematics imposed by heavy school backpack loading: A literature synopsis (2009–2019)

Abstract

15% relative to the child's body mass, whilst the American Academy of Pediatrics supports Voll and Klimt's (1977) 10% load guideline prescription (Dockrell et al. 2016). Another factor Background: Habitual school backpack carriage causes neuro-musculoskeletal vertebral, shoulder and hand pain; deviated posture compromised cardiopulmonary function and proprioception.Objective: Present a novel literature summary of the influence of backpack carriage associated with deviated cervical posture and compromised pulmonary function.Method: An electronic literature appraisal adopting the Preferred Reporting Items for Systematic Reviews, using Google Scholar, Science Direct, EMBASE, AMED, OVID, PubMed and Sabinet search engines, was instituted during 2009-2019. Key search words: schoolbag, backpack, carriage, cervical posture and children. The quality of the studies was assessed using the Downs and Black Appraisal Scale.Results: 583 records were initially identified which was reduced to 14 experimental and observational studies. A total of 1061 participants were included across the 14 studies, with an average age of 11.5 ± 1.3 years, body mass of 37.8 ± 6.6 kilograms (kg), height of 1.41 ± 0.05 meters (m), backpack mass of 5.2 ± 0.9 kg and percentage backpack mass to child's body mass of 13.75%. The studies mean rating according to the Downs and Black Appraisal Scale was 76.3%. The average craniovertebral angle (CVA) was 53.9° ± 14.6° whilst standing without carrying a backpack was reduced to 50.4° ± 16.4° when loaded (p < 0.05). Backpack loads carried varied from 5% -30% of the participant's body mass that produced a mean CVA decline of 3.5°. Conclusion:Backpack carriage alters cervical posture, resulting in smaller CVA and compromised pulmonary function. There is no consensus of the precise backpack mass that initiates postural changes. Girls' posture begin changes when carrying lighter backpacks as compared to boys of the same age strata.

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

“…The average weight of their bag with teaching content was 5248 g. On average, the bag was 118 g lighter for girls than for boys. The results of our study were consistent with a literature review by Ellapen et al (2021) that included 14 studies and 1061 participants, mean age 11.5 ± 1.3 years, body weight 37.8 ± 6.6 kg, height 1.41 ± 0.05 meters (m), and backpack weight 5.2 ± 0.9 kg. The percentage of backpack weight in relation to the body weight of the respondents in our study was lower in relation to the authors' statement of 13.75%.…”

“…Differences in maximal heel pressures were significant between inactive and moderately active children. The maximum force time of % of the standing time on the left foot in the middle part lasted 48.83% in inactive children changes (33). The average weight of an empty school bag without books for the whole sample (n = 124) was 624.72 g, for girls, the empty bag was on average lighter by 123.41 g than for the boys.…”

The Acute Effects of Schoolbag Loading on Posture and Gait Mechanics in 10- to 13-Year-Old Children: A Cohort from the North West Province

“…Participants could experience increases or decreases in postural angles of more than 10–20° in some instances, but the direction of the change was arbitrary and independent of the load, as shown by the regression analysis. Although CHA, CVA, and SSP have been mentioned numerous times in the literature [ 1 , 8 , 24 ], it is likely that these angles lack the sensitivity and/or specificity to reliably measure changes in posture as a function of load or over time.…”

“…Although substantial changes of 4–9° have been recorded in key upper body postural angles with acute schoolbag loading of ~18% BM, there appears to be substantial variability in both magnitude and direction of these changes as a function of loading [ 10 , 12 , 13 , 21 , 22 , 23 ]. Whether or not these changes were associated with increased perceptions of pain or longer-term postural alterations remains an under-studied component of load-related research, especially within the African context [ 24 ].…”

“…Although research on the effects of schoolbag mass on posture and gait has been conducted internationally, to date only one study has been conducted within the South African context [ 24 , 25 ]. Importantly, the latter study only recorded body mass and bag mass and used a questionnaire to infer aspects related to bag carriage and pain.…”