Effect of Backpack Load Carriage on Cervical Posture in Primary Schoolchildren

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Effect of Backpack Load Carriage on Cervical Posture in Primary Schoolchildren

Kistner F, Fiebert I, Roach K.

School of Physical Therapy,
Massachusetts College of Pharmacy and Health Sciences,
Worcester, MA, USA.


Objective:   This study examined the effects of various backpack loads on elementary schoolchildren’s posture and postural compensations as demonstrated by a change in forward head position.

Subjects:   A convenience sample of 11 schoolchildren, aged 8-11 years participated.

Methods:   Sagittal digital photographs were taken of each subject standing without a backpack, and then with the loaded backpack before and after walking 6 minutes (6MWT) at free walking speed. This was repeated over three consecutive weeks using backpacks containing randomly assigned weights of 10%, 15%, or 20% body weight (BW) of each respective subject. The craniovertebral angle (CVA) was measured using digitizing software, recorded and analyzed.

Results:   Subjects demonstrated immediate and statistically significant changes in craniovertebral angle (CVA), indicating increased forward head positions upon donning the backpacks containing 15% and 20% body weight. Following the walking of 6 minutes, the CVA demonstrated further statistically significant changes for all backpack loads indicating increased forward head postures. For the 15 & 20% of body weight conditions, more than 50% of the subjects reported discomfort after walking, with the neck as the primary location of reported pain.

Conclusions:   Backpack loads carried by schoolchildren should be limited to 10% body weight due to increased forward head positions and subjective complaints at 15% and 20% body weight loads.