Schoolbags and back pain in children between 8 and 13 years: a national study

Spiteri, Karl; Busuttil, Maria-Louisa; Aquilina, Susan; Gauci, Dorothy; Camilleri, Erin; Grech, Victor

doi:10.1177/2049463717695144

Cited by 52 publications

(64 citation statements)

References 13 publications

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“…We observed no significant difference between the fifth-and sixth-grade students in relation to the schoolbag weight (≤10% or >10% of child body mass), and in both groups, about half of the students (48.5% in the fifth and 50% in the sixth grade) carried schoolbags weighing more than 10% of the body mass. Two other studies on the association between schoolbag weight and back pain in children showed that majority of students carried heavier schoolbags (>10% of the body mass) (27,28). Overall, these results indicate that schoolchildren are often required to carry schoolbags that are heavier than recommended.…”

Section: Discussionmentioning

confidence: 70%

School bags and associated back pain

Hadžiomerović

Jaganjac

Avdić

et al. 2018

JHSCI

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Introduction: The most common health problem associated with the negative effect of heavy school bags is back pain, and non-specific back pain is frequently observed in childhood. The prevalence of back pain in schoolchildren varies from 12% to 92%, depending on the age and affected region of the back. To prevent the occurrence of back pain in schoolchildren, the weight of school bag should not exceed 10% of the child’s body mass.Methods: This was a descriptive, cross-sectional study conducted in April 2017. We included 79 students of the fifth and sixth grade from the elementary school in Sarajevo. Information on the weight and type of school bag, method of carrying a school bag, and feelings of pain and tiredness due to school bag were obtained by questionnaire.Results: In the total sample, the majority of the students (64.6%) reported occasional back pain while carrying the bag, 20.3% of students reported no back pain, and 11.4% of students experienced frequent back pain. The mean school bag weight in the fifth grade was 4.01 ± 0.57 kg, and it was significantly higher (4.61 ± 0.86 kg) in the sixth grade. About 48.5% of the students in the fifth and 50% in the sixth grade carried school bags weighing more than 10% of the body mass. A higher mean weight of school bag was significantly more frequent in students who reported always feeling tired (11.03 ± 2.74%) compared to those who did not feel tired while carrying the school bag (8.41 ± 2%).Conclusions: Overall, more frequent occurrence of back pain and tiredness in schoolchildren was associated with heavier school bags (>10% of the body mass), and the occurrence of back pain due to school bag was related to gender (i.e., back pain was more common in girls compared to boys).

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Section: Discussionmentioning

confidence: 70%

School bags and associated back pain

Hadžiomerović

Jaganjac

Avdić

et al. 2018

JHSCI

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“…The notion that the excessive weight of schoolbags carried by school students can trigger LBP, makes clinical sense. Moreover, the cut-off point of > 10% of bodyweight defining an "excessive" weight to be carried, is indirectly supported by some evidence and has elicited consensus among clinicians, researchers and some professional associations American Chiropractic Association, 2018;American Occupational Therapy Association, 2017;American Physical Therapy Association, 2017;Devroey et al, 2007;Erne & Elfering, 2011;Grimmer & Williams, 2000;Mackie & Legg, 2008;Negrini et al, 1999;Sahli et al, 2013;Spiteri et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…Establishing 10% of the bodyweight as the cut‐off point to consider the weight of the schoolbag as "excessive" may appear reasonable; it has some data supporting it and is equivalent to the threshold most commonly used for adults in the work‐related environment. This has led to most recommendations establishing that the "acceptable" weight for the schoolbag should be below this threshold (Alghadir et al, ; American Chiropractic Association, ; American Occupational Therapy Association, ; American Physical Therapy Association, ; Devroey et al, ; Erne & Elfering, ; Grimmer & Williams, ; Mackie & Legg, ; Negrini et al, ; Sahli et al, ; Spiteri et al, ). However, other cut‐off points have been proposed, as low as 5% or as high as 20% (Dockrell et al, ; Rateau, ).…”

Section: Discussionmentioning

confidence: 99%

The association between the weight of schoolbags and low back pain among schoolchildren: A systematic review, meta‐analysis and individual patient data meta‐analysis

Calvo-Muñoz

Kovacs

Figuls

et al. 2019

European Journal of Pain

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Background The objective of this study was to determine whether carrying a heavy schoolbag is associated to a higher prevalence of low back pain (LBP). Methods A systematic review and meta‐analysis was conducted (PROSPERO, CRD42018077839). Observational studies analysing the relationship between schoolbag weight and LBP, were searched for in 20 electronic databases and 12 specialized journals until February 28th, 2019, without date or language restrictions. All studies which included ≥ 50 subjects aged 9 to 16, were reviewed. Methodological quality was assessed by two reviewers separately, using validated tools. A meta‐analysis and an individual patient data (IPD) meta‐analysis were conducted to examine the relationship between schoolbag weight and LBP. Certainty of evidence was assessed using an adapted GRADE methodology. Results 5,524 citations were screened, 21 studies (18,296 subjects) were reviewed and 11 studies (9,188 subjects) were included in the meta‐analysis. The IPD meta‐analysis included 9,188 subjects from seven studies. Among the 21 studies reviewed, the mean score for methodological quality was 78.3 of 100. Only one study suggested an association between heavier schoolbags and LBP. Neither the meta‐analysis nor the IPD meta‐analysis found an association between carrying schoolbags weighing > 10% of bodyweight, and LBP. No differences based on age, gender or sport activity were found. Discussion Available evidence does not support that schoolbags weighing > 10% of bodyweight are associated with a higher prevalence of LBP among schoolchildren aged 9–16. The certainty of evidence is low. Further research is required on the relationship between schoolbag weight and LBP. Significance This systematic review, with a meta‐analysis and an IPD meta‐analysis, failed to find a link between schoolbags weighing ≥ 10% of body weight and LBP among schoolchildren aged 9 to 16. Further longitudinal studies, with large samples, long follow‐up periods, and rigorous methods taking into account duration of carry and the physical capacity of each subject, are required in this field.

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“…Heavy school bags are one of the common factors that influence the incidence of musculoskeletal back pain and alteration of students' body posture. [20] The musculoskeletal system react properly to compensate for this stress and alteration. A limit weight of school bags not excess 15% of the body weight is one of the methods that decrease and prevent students' back pain.…”

Section: Discussionmentioning

confidence: 99%

A study of school bag weight and back pain among intermediate female students in Dammam City, Kingdom of Saudi Arabia

Alghamdi

Nafee²,

El-Sayed³

et al. 2018

JNEP

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Background: The most common cause of low back pain in children is muscle sprain and strain which can occur from carrying a heavy backpack or from activities. This study aimed to assess the relationship between school bag weight and back pain among female students in Dammam city.Methods: A total of 300 female students were included in this study both from east and west sectors of Dammam city, Saudi Arabia. Tools: Data were collected using (1) A structured questionnaire sheet including, socio-demographic data of the students, and close-ended questions about the school-bags as methods of carrying, (2) A weight scale that measured student’s body weight and weight of the school bags, (3) A self-report (Numeric pain rating scale) that assessed pain intensity. Univariate and Multivariate Statistical analysis was performed to test the relationship between the study variables.Results: A total of 288 school children (96.2% out of 300) were carrying bags of weight more than 15% of their body weight. Shoulder and neck pain were reported by 40% of the female students. Statistically there is a significant relationship was found between school bags weight and severity of shoulder pain (p = .042).Conclusion and recommendation: The weights of schoolbags of Dammam city intermediate female students were higher than the internationally acceptable standards. Ministry of Education should set standards to prevent and mange problems of carrying heavy school bags in the intermediate school.

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Schoolbags and back pain in children between 8 and 13 years: a national study

Cited by 52 publications

References 13 publications

School bags and associated back pain

School bags and associated back pain

The association between the weight of schoolbags and low back pain among schoolchildren: A systematic review, meta‐analysis and individual patient data meta‐analysis

A study of school bag weight and back pain among intermediate female students in Dammam City, Kingdom of Saudi Arabia

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