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

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

BACKGROUND: Carrying a properly weighted schoolbag is an important factor in preventing the occurrence of muscular skeletal disorder in early school age children. OBJECTIVE: 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. METHODS: 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). RESULTS: 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). CONCLUSIONS: 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.

School-based interventions to improve spinal health of children and adolescents: a systematic review

Background: The prevalence of spinal pain is high in children and adolescents attending school. There are no evidence-based guidelines to promote spinal health (spinal pain and spinal well-being) in schoolsPurpose: This study aimed to 1) determine the usefulness of school-based interventions in promoting spinal health in children and adolescents and 2) synthesize the evidence in a user-friendly infographic.Methods: A search was performed across eight databases from the inception of the databases to August 2019 for full-text English-language articles which assessed the effect of school-based interventions on spinal health. Spinal health outcomes included pain limited to the spinal area including lower back, upper back, neck, and neck-shoulder pain, and impacts of spinal pain (e.g., absenteeism from school). Studies were appraised for methodological quality (PEDro scale and Johanna Briggs Institute checklist). The usefulness of interventions was based on meta-analyses; calculated effect size; the number of spinal health outcomes; and the direction of the (summary) effect of the intervention.Results: Twenty-two studies were included. Four interventions were identified: 1) exercise; 2) education; 3) the combination of exercise and education; and 4) furniture.Conclusion: School-based exercise is most useful to promote spinal health in the short term, followed by a combination of exercise and education, and education-only interventions.

Non-specific low back pain: cross-sectional study of 11,423 children and youth and the association with the perception of heaviness in carrying of schoolbags

Background

Carrying a schoolbag is a daily activity for most children and adolescents.The perception of a schoolbag’s weight depends upon the individual and is a relevant theme in schoolchildren. Describing the association between the perception of heaviness in carrying a schoolbag and NLBP can facilitate the planning of preventive programs, quite different from those based on specific weight limits for schoolbags in children and youth.

Objective

To determine the prevalence of non-specific low back pain (NLBP) and to analyse the association between the perception of heaviness in carrying of schoolbags and NLBP in Polish children and youth aged 10–19.

Methods

This study included 11,423 children and youth (6,252 girls and 5,171 boys) from Poland. An original questionnaire was used to assess NLBP prevalence.

Results

Among 11,423 of the respondents, 41.5% of the respondents admitted that they had experienced NLBP in the period of the last 12 months. The percentage of individuals reporting NLBP increased with age of participants, p < 0.001. Girls reported NLBP more often than boys (p < 0.001). Students with NLBP declared that their school backpack was heavy more often than students without LBP. Students who thought that their backpacks weighed too much manifested a 1.44 (95% Cl [1.33–1.55]) times higher probability to experience NLBP.

Conclusion

In the examined group of schoolchildren a frequent occurrence of NLBP (41.5%) was noted. Its occurrence was related to female sex and age. Students who thought that their backpacks weighed too much manifested higher probability to develop NLBP.

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

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.

Ergonomic factors of school bags and their adaptation to the weight of students

BACKGROUND

Students use a school bag to carry their school supplies which may not have the required standards and ergonomic factors.

OBJECTIVE

This study was aimed to examine the ergonomic factors of schoolbags and their adaptation to the weight of elementary school students.

METHODS

This cross-sectional study was carried out on 721 primary schoolchildren. To collecting data a checklist, which its final version was approved by the experts, was designed by researchers. Data were analyzed by using SPSS ver. 22 and Chi-square test, One-Way ANOVA, and univariate and multivariate logistic regression models.

RESULTS

In this study, about 90.1% of students used a backpack to carry their items and most students carried backpacks with a weight up to 10% of their body weight. In 43.5% of the students, waist width was appropriate with backpack width at the bottom, and in 96.6% shoulder width was appropriate with backpack width at the top. Multivariate logistic regression showed that girls in compared to boys were more likely tolerated ratio of backpack weight to body weight, and also had more likely proportion of waist width and the backpack width at the bottom. The grades of the first, second, and fourth used more heavy backpacks. Students who their mothers were employee compared to housewives, carried heavier backpacks and had more likely proportion of waist width and the backpack width at the bottom. As the mother's age increased, the proportion of waist width and the backpack width at the bottom is diminished.

CONCLUSION

The schoolbags weight of many students was more than the standard weight, and their schoolbags did not have the required standards. Educational interventions can increase the knowledge of students and parents about the ideal weight of a schoolbag and the criteria for choosing a proper school bag.

Optimization of backpack loads using gait parameters in school boys

BACKGROUND

Backpacks are an efficient way of manual carriage used by people of all ages, and is commonly used by schoolchildren. Carrying heavy backpacks may result in cumulative trauma later in life due to biomechanical adaptations during gait. Gait parameters are known to be sensitive to force vectors, which can be altered by load carrying. This study attempts to find the most favorable backpack weight using gait changes as an indicator.

METHODS

This was an observational study conducted on twenty typically developing boys aged between 9 and 14 years. Gait analysis was done using standard recommendations, with increasing backpack loads with respect to their body weights. Gait cycles were captured using video cameras and analyzed using Kinovea0.8.25 motion analyzing software.

RESULTS

As the backpack load increased, significant kinematic changes were noted in the child's ankle, knee, and hip joints. These changes were evident when the backpack load increased beyond 15% of their body weight.

CONCLUSIONS

This study concludes that the optimum weight that can be carried without having an impact on dynamic posture will be less than 15% of the body weight.

One-shoulder carrying school backpack strongly affects gait swing phase and pelvic tilt: a case study

The use of backpacks is common to both adults and children and often leads to the onset of musculoskeletal discomforts. Although a large number of studies have focused on the optimal load for children schoolbags, there is no general consensus. Here we report a 13-yr old girl case study, showing the impact of weight and wearing the school backpack on gait parameters. The variation of gait parameters and pelvis angles in different conditions were studied: without backpack (CTRL), or with backpack at 10% Body Weight (10BW), 15% BW (15BW) and 20% BW (20BW), carried “on both shoulders” (2S), “on one shoulder” (1S), or “with one hand” (1H). Swing phase was comparably modified by 2S/20BW and 1S/10BW conditions, suggesting that a lower backpack weight was sufficient to induce gait alterations when carried in asymmetrical conditions. Pelvic tilt, which was preserved by a two-shoulders distributed 10% BW load (2S/10BW), was strongly reduced in asymmetrical condition (1S/10BW), suggesting that a low weight carried on a single shoulder generates postural modifications including reduction of pelvic tilting, which is known to be associated to low back pain.

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.

A review of the application of ergonomics in instructional design

BACKGROUND

Ergonomics can help instructional designers to develop projects compatible with students' needs, capabilities, and limitations.

OBJECTIVE

We intend to verify the application of ergonomics in instructional design methods, methodologies, techniques, and recommendations.

METHODS

We searched journal articles in the following databases: Compendex, ScienceDirect, Scopus, and Web of Science. Based on two inclusion criteria: (1) whether the article presents methods, methodologies, techniques, or recommendations for the instructional design; (2) whether the article addresses issues of ergonomics, we found 17 studies published from 1988 to 2013 in 16 journals.

RESULTS

The main ergonomic concept addressed in the reviewed studies was usability, followed by accessibility, and user-centred design. Most articles suggest guidelines for embedding ergonomics in instructional design.

CONCLUSIONS

We found that future research could explore topics, such as user experience, design thinking, service design, and organisational ergonomics to improve instructional design practice. The number of studies found in this review demonstrates that scientific research should explore the application of ergonomics in instructional design methods.

Variation of spatiotemporal parameters in school children carrying different backpack loads: a cross sectional study

The purpose of this study was to analyze spatiotemporal parameters of gait in children using varyingly loaded Backpacks(BP). This cross-sectional study examined 231 schoolchildren (118 boys, 113 girls) aged six to 12 years, carrying a traditional BP to manipulate loading (Crossing Backpack Children Arpenaz 7 Litres, Junior Red Quechua). Load was added to the BPs in increments of 5%, 10%, 15% and 20% of the child's body weight. Spatio-temporal parameters were measured with the OptoGait system. Significant differences were observed in single support (p < 0.001), and double support (p < 0.001). No statistically significant differences were observed in step length (p = 0.959) between the five loading conditions. Similarly, no statistically significant differences were found in the contact phase (p = 0.208), although significant changes were seen between baseline, 15% of body weight (p < 0.005), and 20% of body weight (p < 0.005). The effect sizes from the ANOVA in the single support was low (0.015), and double support was moderate (0.02). Increased weight in BPs reduced both children's balance and single support, increased double support, but did not change step length. The children increase double support with heavier loads to help their balance. The spatio-temporal changes were most evident with BP loads between 15-20% of body weight. Affective responses, including the perception of heaviness or difficulty in carrying the schoolbags need to be included in further and prospective investigations.

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

Back pain in children is a complex phenomenon, which has been shown to be associated with physical and psychosocial factors. None of the studies on Indian children have investigated the possible association between back pain and psychosocial factors. We decided to determine the prevalence of back pain in students and association with both physical and psychosocial factors. A cross-sectional study was conducted on 163 students from two city schools. Physical factors were evaluated using a structured questionnaire. Strengths and difficulties questionnaire was used to assess psychosocial factors. The studied sample consisted of 49.7% boys and 50.3% girls. Mean school bag weight was 6.1±2.4 kg (range: 2.2-15.6 kg). Mean weight of school bag as a percentage of body weight was 13.5±6.2%. Approximately 76% students carried more than 10% of their body weight. The prevalence of back pain (over last 1 month) was 53.9%. No associations were found between back pain and weight of school bag, weight of school bag as a percentage of body weight and physical activities. Significant associations were found between back pain and number of hours spent watching television [odds ratio (OR): 3.3, 95% confidence interval (CI): 1.5-7.5; P=0.003], history of injury to the back (OR: 4.8, 95% CI: 1.47-15.8, P=0.003), presence of a family member complaining of back pain (OR: 1.98, 95% CI: 1.25-3.14, P=0.002), conduct (P=0.042) and hyperactivity problems (P=0.045). Thus, there appears a need to consider psychosocial factors along with physical factors when evaluating a young student with back pain.

Children require less gait kinematic adaptations to pull a trolley than to carry a backpack

To transport school materials, trolleys have been proposed for children as an alternative to carrying a backpack. However, there is limited evidence comparing the adaptations associated with carrying school trolley versus backpack. This study compared the effects of carrying a backpack and pulling a trolley on gait kinematics in children. Fifty-three students were evaluated. Children walked at self-selected speeds across a walkway with no bag (control), carrying a backpack with the 15% of child́s body weight (%BW) and pulling a trolley with the same load. Spatiotemporal gait parameters and 3D kinematics of lower extremities and thorax were computed. No significant differences were obtained in spatiotemporal parameters between pulling a trolley and control. Carrying a backpack resulted in larger kinematics gait alterations than pulling the trolley compared to control. In conclusion, pulling a school trolley (15%BW) was more similar to not carrying a bag than carrying a backpack of the same load during level walking.