The backpack problem is evident but the solution is less obvious

Abstract

A systematic review of the literature between 2003 and 2007 was conducted to explore the questions 1) Are school-aged children actually at risk for back pain because of carrying backpacks? How much of a load is too much? 2) Does backpack in adolescence predict back pain in adulthood? 3) Are there behaviors that lessen/increase the risk of back pain/injury? i.e. education on how to carry, pack the pack and psychosomatic behaviors? Method: Cochrane Collection, Pub-Med, OTSeeker, PEDro, FirstSearch Medline, ERIC, General Engineering, Engineering Village2 and Goggle Scholar were searched with the following keywords in various combinations: backpack, back pain, load, children, adolescents, pediatrics, and physical fitness. Sixty-three articles were considered for the study to answer the three research questions. Each study was analyzed for specific application to the three questions. Results: Ten articles were analyzed for the first, epidemiological question, two articles were analyzed for the second long term health risk question and seven articles were analyzed for the behavioral question. Conclusion: Weight recommendations and carrying behaviors are not consistently supported in the recent studies; several studies call for an examination of psychosomatic behaviors as potential predictors of back pain in childhood and adolescence.

Effects of Different Backpack Loads in Acceleration Transmission during Recreational Distance Walking

“…Previous research findings that suggest a maximum of 15% BW in a backpack are supported by this study ( American Chiropractic Association , American Occupational Therapy Association , American Academy of Orthopaedic Surgeons ; Furjuoh et al, 2004 ; Hong and Li, 2005 ; Lindstrom-Hazel, 2009 ). There was an increase in the accelerations recorded on the body, both in males and females, suggesting that individuals maybe either approaching or have reached a recommended load for carriage and any greater loads may cause injury due to the forces placed on the body as well as kinematic changes in walking in order to accommodate such heavy loads ( Goh et al, 1998 ; Harman et al, 2000 ; Holt et al, 2005 ).…”

“…Aiming to avoid carrying excessive weight and prevent aforementioned injuries, experts recommend that school backpacks should not exceed 10–15% of the individual’s body mass ( Furjuoh et al, 2004 ; Hong and Li, 2005 ; Lindstrom-Hazel, 2009 ). Regarding the adult population, the recommended lifting limit in the United States is 23 kg, whereas in Italy there is a restriction by law of 30 kg and 20 kg maximum load allowed to be lifted during work for males and females, respectively ( Negrini et al, 1999 ), although literature within adult subjects is scarce and, therefore, further investigation is necessary.…”

Domestic water carrying and its implications for health: a review and mixed methods pilot study in Limpopo Province, South Africa

“…In the United States Moore et al [53] concluded that backpack weights for children should remain below 10% of body weight and a recent review reported recommendations from several authors that back pack weights for children should be limited to 10-15% of body weight or less [54]. However conclusions drawn from studies set in high income countries may not be generalisable to poorer rural communities, where factors such as childhood health, development and general levels and types of physical activity are likely to differ in significant ways.…”

The Influence of the Schoolbag on Standing Posture of First-Year Elementary School Students

“…Likewise, almost all previous studies were based exclusively on a postural model, which was used to explain the occurrence of musculoskeletal pain in youth, which in turn served as basis for the prediction of possible chronic musculoskeletal disorders. Numerous studies have shown that there is no clear correlation between the mass of a schoolbag and poor posture, and developing chronic musculoskeletal disorders as a consequence [27,34,42,47,48]. Furthermore, an ongoing discussion is currently trying to determine the importance of the postural–structural–biomechanical model [49,50,51], and the possible consewquent appearance of chronic musculoskeletal disorders.…”