Back pain and school bag weight - a study on Indian children and review of literature

Exploring musculoskeletal discomfort and school bag loads among Thai primary school students: a school-based cross-sectional survey

Musculoskeletal discomfort among children carrying school bags is an increasingly significant problem. This study sought to determine the prevalence and risk factors of musculoskeletal discomfort among Thai primary school students who carry excessively heavy school bags. We conducted cross-sectional descriptive research involving 489 primary school students (ages 7-12). We utilized the standardized Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) to assess discomfort in various body regions. Measurements included student weight, school bag weight, and the angles of neck and trunk inclination. Logistic regression was used to analyze factors influencing musculoskeletal discomfort. The results showed that the majority of students had musculoskeletal discomfort (66.67%). The average relative weight of the school bags was 17.46 ± 6.02%. Significant risk factors for musculoskeletal discomfort included being female (AOR = 1.87, 95% CI = 1.12-3.10), being in grades 1-3 (AOR = 0.221, 95% CI = 0.05-0.91), carrying bags for more than 20 min per day (AOR = 28.87, 95% CI = 8.93-93.31), not storing books at school (AOR = 2.06, 95% CI = 1.07-3.95), and carrying a school bag weighing > 10% of the student's body weight (AOR = 65.46, 95% CI = 14.73-290.93). Additionally, neck and trunk inclinations > 20 degrees were associated with increased discomfort (AOR = 3.25, 95% CI = 1.89-5.57; AOR = 3.26, 95% CI = 1.58-6.70). The prevalence of musculoskeletal discomfort was higher in Thai primary school students. Female, Grades 1-3, carrying bags exceeding 20 min/day, carrying a school bag weighing > 10% of the student's body weight, and neck and trunk inclinations > 20 degrees were predictor variables for musculoskeletal discomfort. Thus, collaborative efforts from educational institutions, educators, parents, and students are essential in addressing this issue.

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

BACKGROUND: 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. OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

Prevalence of Musculoskeletal Pain and Its Relation With Weight of Backpacks in School-Going Children in Eastern India

Background: Recently, heavy school backpacks have become a significant concern among parents and health professionals, as well as the media, but evidence for the same is limited in the Indian context.

Aim: To find the prevalence of musculoskeletal pain among school-going children and its relationship with backpack weight.

Design: Cross-sectional study.

Method: This study was carried out among school-going children from grade 6 to 10 with age of 10 to 16 years from an urban and rural location. Schools were selected randomly from all enlisted schools in the district of Khurdha, Odisha state of India. A structured questionnaire was administered to assess symptoms of musculoskeletal pain. Anthropometric measurements along with backpack weight were taken.

Statistical Analysis: Chi-square test was performed for categorical variables and Student's t-test for continuous variables. Multivariate regression analysis was performed to identify factors with maximum effect on musculoskeletal pain.

Results: The prevalence of musculoskeletal pain was 18.8% in the preceding year. Backpacks weights were higher among children of urban schools as compared with rural areas. Children from urban schools were more likely to have pain than those from rural schools (OR 1.88, 95% CI 1.41–2.49). Those children with a backpack weight more than 10% of body weight had almost twice the risk of musculoskeletal pain compared to backpack weight less than 10% (OR 1.91, 95% CI 1.4–2.6) in univariate analysis where as no significant association was found on multivariate analysis.

Conclusion: The prevalence of musculoskeletal pain was high in school-going children. In children, carrying higher backpack weight, and a higher percentage of the backpack to bodyweight had a significant association with musculoskeletal pain. Gender, height, body mass index, and backpack weight to body weight > 10% had no association with musculoskeletal pain.

Development and Experimental Verification of an Ergonomic Backpack

Carrying a heavy school backpack has extensively been reported as a prime cause of children's body strain. It is suggested that the load should not exceed 10 percent of the child's body weight; however, ensuring this requires continuous monitoring. The study explores how ergonomically designed school backpack based on the user anthropometric data (n = 280) and ergonomic parameters help reduce force concentration on shoulders and back. It provides a validation process of the developed prototype by experimental verification. The developed design was assessed in a comparison experiment with a commercially available local school backpack. An experimental study was used which recruited thirty healthy college students (aged 19 to 23 years). Two independent variables evaluated were school backpack type (developed backpack versus commercial one) and load levels as a percentage of body weight. Three load levels were employed 10%, 15%, and 20%. These variables were measured on the responses: bag comfort scale and the percent of maximum voluntary contraction (%MVC) of six muscles (right and left of erector spine, right and left of external abdominal oblique muscle, and right and left of trapezius). The developed backpack provided astonishing performance at levels of 15% and 20% of body weight in terms of subjective measure and electromyography (EMG) responses. It also showed that increasing the carried weight more than 10% result in reducing activity on the erector spinal muscles, while it increases on abdominal oblique muscles. The developed backpack design confirmed the efficiency of its bases by distributing the carried weight among the trunk through side pockets, attached to the body through two upper and lower straps. It helped the body to distribute the carried weight and avoid concentrating pressure on specific areas.

Back Pain and Schoolbags among Adolescents in Abha City, Southwestern Saudi Arabia

The incorrect carriage of schoolbags and heavy bags may result in back pain (BP) in adolescents. Our objective was to assess the problem of BP and associated factors among adolescents. This was a cross-sectional study targeting intermediate and secondary school adolescents in Abha City, Saudi Arabia. An anonymous questionnaire for BP was used. Student body weight and the weight of their full schoolbag were measured. The study included 876 adolescents. An overall prevalence of BP of 39.4% (95% CI: 35.3-43.7) was found. Upper BP (UBP), middle BP (MBP), and lower BP (LBP) amounted to 14.5%, 13.4%, and 11.5%, respectively. Associated significant factors with MBP were carrying the bag on one side compared to on the back (adjusted odds ratio (aOR) = 2.13, 95% CI: 1.20-3.73) and being at intermediate level compared to secondary (aOR = 1.56, 95% CI: 1.04-2.40). On the other hand, gender and schoolbag weight/body weight percent were not found to be significantly associated with MBP. None of the studied factors were significantly associated with overall BP, UBP, or LBP. BP is a prevalent among adolescents in southwest Saudi Arabia. One-sided schoolbag carriage is a significant associated factor for middle back pain. Parents and teachers should encourage students to consider the correct way to carry schoolbag.

Effects of carrying school bags on cervical and shoulder posture in static and dynamic conditions in adolescent students

Background Neck and Back Pain in Students is closely related to the school bags that they carry. There is a dearth of literature in terms of postural changes due to school bags in adolescents, especially those discussing postural changes in static and dynamic loading conditions. Objective To assess the effects of weight, position, and time of school bag carriage in static and dynamic conditions on cervical and shoulder posture in adolescent students. Subjects Seventy adolescents (35 Females, 35 Males) between 10 and 15 years of age. Methods: Craniohorizontal Angle, Craniovertebral Angle, Sagittal Shoulder Posture, Anterior Head Alignment were assessed in 7 different conditions using Photographic Method and MB Ruler. Results and Conclusion Significant changes in Sagittal Shoulder Posture and Craniohorizontal Angle were found with unilateral school bag carriage as compared to minimal significant postural changes with bilateral carriage. Maximal significant postural changes, in terms of all outcome measures were noted during loaded dynamic activity. Craniovertebral Angle kept significantly reducing with time. Immediate assessments taken with a school bag weighing 13.5% of the body weight showed a significant decrement in the Craniohorizontal Angle. Even a bag weighing less than 10% of the body weight proved to bring about biomechanical changes, when assessments were taken during the activities that a child has to perform with a school bag (Post Standing, Post Walking, and During Walking).