Backpacks, Back Pain, Sagittal Spinal Curves and Trunk Alignment in Adolescents

Korovessis, Panagiotis; Κουρέας, Γεώργιος; Zacharatos, Spyridon; Papazisis, Zisis

doi:10.1097/01.brs.0000150505.59690.1b

Cited by 111 publications

(111 citation statements)

References 36 publications

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“…The biomechanical effects of a backpack load alter the body CoM and result in forward lean 3) . This effect is similar to a forward head posture, which is the poor head posture commonly seen in neck pain patients 14,15) . In a forward head posture, the head is in front of the vertical line through the center of gravity of the body 16) .…”

Section: Discussionsupporting

confidence: 52%

“…Several studies have demonstrated that carrying a backpack results in a significant difference in the alignment of the head and spine and in sagittal shoulder posture. The stress while carrying a backpack straightens the neck, significantly decreasing the cervical curve 14) . The biomechanical effects of a backpack load alter the body CoM and result in forward lean 3) .…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Backpack Loads on FRR (Flexion-relaxation Ratio) in the Cervical Spine

Lee

Yoo

et al. 2011

J Phys Ther Sci

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Abstract. [Purpose] This study examined the effects of various backpack loads on the cervical flexion relaxation ratio as a quantitative neurological measure.[Subjects] Fourteen subjects with no neck pain participated in the study.[Methods] Surface electromyograms of the C4 paraspinal muscles were measured bilaterally, while subjects performed cervical flexion extension, and normalized in three phases. Cervical FRR data of three different backpack loads were analyzed. The FRR was calculated as the muscle activation during the cervical extension phase divided by the muscle activation during the relaxation phase.[Result] The FRR in the unloaded condition was 2.44 on the right and 2.37 on the left; for the backpack weighing 10% BM, the FRR were 1.91 and 1.89, respectively, and for the 20% BM backpack, FRR were 1.56 and 1.53, respectively. [Conclusion] A heavier backpack increased the potential for neck pain. The FRR is a functional examination that can be used to quantitatively assess the potential for developing cervical pain and the results of intervention.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

The Effect of Backpack Loads on FRR (Flexion-relaxation Ratio) in the Cervical Spine

Lee

Yoo

et al. 2011

J Phys Ther Sci

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“…Similar to previous studies [10,20,21,25,29] a cross-sectional study design was used for the weight and duration of carriage measurements. However in contrast to previous cross-sectional studies, the prevalence of schoolbagrelated musculoskeletal discomfort was established using a quasi-experimental pretest-posttest study design.…”

Section: Discussionmentioning

confidence: 99%

“…However, the relationship between schoolbag weight and musculoskeletal discomfort is not always clear as it has been found that the percent bodyweight (%BW) carried was both associated [5,19] and not associated [20,21] with musculoskeletal discomfort. Previous studies are mostly cross-sectional [10,20,21,25,29] and therefore have not been able to establish a dose-response relationship between schoolbag carriage and musculoskeletal discomfort. Additionally, they have not evaluated the discriminative ability of the proposed schoolbag weight cut-off values for identifying children with schoolbag-related discomfort.…”

Section: Introductionmentioning

confidence: 99%

Guidelines for schoolbag carriage: An appraisal of safe load limits for schoolbag weight and duration of carriage

Dockrell

Blake

Simms

2016

WOR

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Abstract. BACKGROUND:There is no global agreement on a schoolbag weight limit and little assessment of its utility. The duration of carriage is another factor yet there is no previous systematic assessment of the utility of cut-off values for it in identifying schoolbag-related discomfort. OBJECTIVES:The objectives were to establish if there was a threshold for musculoskeletal discomfort based on (i) percentage bodyweight (%BW) of the schoolbag; (ii) duration of carriage; or (iii) combined %BW and duration. METHODS: Using data from 462 primary school children, a novel experimental approach was used to explore the utility of conventional schoolbag weight limit guidelines and duration of carriage. A receiver operating characteristic (ROC) curve was constructed to examine the predictive performance of schoolbag weight and duration of carriage. RESULTS: The mean schoolbag weight (4.8 ± 1.43 kg) represented a mean 12.4 ± 4.18%BW. Only 30.7% of the sample carried schoolbags that were ≤10%BW. The majority (76%) carried schoolbags to school for ≤10 minutes. No %BW, duration of carriage or mechanical burden criterion provided a threshold cut-off point for accurately predicting schoolbag-related discomfort. CONCLUSIONS: Guidelines for safe schoolbag carriage that are based on mechanical factors alone could not be upheld. The association between duration of carriage and back discomfort warrants further investigation.

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“…Additionally, back pain is a current issue among young people with low back pain prevalence in adolescents measured between 20% to 72% [29,38]. Young people commonly use backpacks as they are an effective and most economical way of carrying weight, however, it has been proposed they can also be a significant contributing risk factor for dis-comfort, fatigue, muscle soreness and musculoskeletal pain especially low back pain [9,29,[47][48][49]57]. It has been speculated that backpacks may cause problems not only for the developing skeletal system but also for a mature spine as a developed spine is also sensitive to load [41,45].…”

Section: Introductionmentioning

confidence: 99%

Can load carriage system weight, design and placement affect pain and discomfort? A systematic review

Golriz

Walker

2011

BMR

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Abstract.Purpose: A systematic review of the literature was conducted to answer the following questions: 1. Does usage or weight of load carriage system cause pain, perceived exertion or discomfort? 2. Can load carriage system placement on the spine influence pain, perceived exertion or discomfort? 3. Can load carriage system design influence the amount of pain, perceived exertion or discomfort caused by their use? Method: Eight databases were searched. Each included study was analysed and quality appraised by two independent reviewers. Results: Forty-seven articles that addressed the research questions were included in the study. Significant variability in the study design and populations of the studies prevented data pooling and the evidence is conflicting. However, qualitative synthesis of the studies shows that carrying loads may provoke low back pain; and it may also trigger neck, thoracic and shoulder pain. Backpack weight can influence perceived pain, however other factors are involved. Discussion: There is conflicting but positive evidence on the correlation between backpack load carrying and experiencing pain during different stages of life. The research to date is lacking with the most commonly identified methodological deficiencies being poor overall design, the lack of justification of sample size, providing training sessions for examiners, and not utilising calibrated, valid and reliable instruments for measurement.

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Backpacks, Back Pain, Sagittal Spinal Curves and Trunk Alignment in Adolescents

Abstract: Backpack carrying, particularly asymmetrically, results in shift of upper trunk and shoulder and cervical lordosis, which furthermore seem to increase back pain in school period and holidays. Symmetric backpack carrying is recommended.

Cited by 111 publications

References 36 publications

The Effect of Backpack Loads on FRR (Flexion-relaxation Ratio) in the Cervical Spine

The Effect of Backpack Loads on FRR (Flexion-relaxation Ratio) in the Cervical Spine

Guidelines for schoolbag carriage: An appraisal of safe load limits for schoolbag weight and duration of carriage

Can load carriage system weight, design and placement affect pain and discomfort? A systematic review

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