The complex and limited understanding of the interactions among multiple factors associated with back pain occurrence among schoolchildren might explain the current inconclusive and contradictory findings on the issue. The global increase in the prevalence of childhood overweight and obesity, which reportedly affects children’s physical abilities, calls for concern among school/children ergonomists and other stakeholders.
OBJECTIVE:
The study investigated the interaction of body mass index (BMI) and age on the muscular activities, backpack height and perceived level of pain arising from carrying different weight of backpacks.
METHODS:
Surface electromyography analysis of erector spinae and trapezius muscular activities was conducted on 47 primary schoolchildren aged between 8 and 11 years. Repeated measure ANOVA were carried out on the data.
RESULTS:
There was significant difference in all the measures of muscular activities, backpack height and pain rating at different levels of backpack weight. However, the children were only significantly fatigable in the erector spinae muscles of the lower back and not in the trapezius of the upper back. The interactive effect of BMI was more pronounced than the children’s age.
CONCLUSIONS:
The study shows that it is not appropriate for all schoolchildren to have the same backpack weight limit and obese schoolchildren should carry a lower bag-to-body ratio of backpack weight. The younger children also need an appropriate bag surface-to-trunk ratio size of backpack as they were more affected by the position of the backpack.
Lindstrom-HazelD2009The backpack problem is evident but the solution is less obviousWork32329338
2.
DockrellSSimmsCBlakeC2013Schoolbag weight limit: Can it be defined?J Sch Health83368377
3.
DianatIJavadivalaZAsghari-JafarabadiMAsl HashemiAHaslegraveCM2013The use of schoolbags and musculoskeletal symptoms among primary school children: Are the recommended weight limits adequate?Ergonomics567989
4.
Rodríguez-OviedoPRuano-RavinaAPérez-RíosMGarcíaFBGómez-FernándezDFernández-AlonsoA2012School children’s backpacks, back pain and back pathologiesArch Dis Child97730732
5.
Al-hazzaaHM2006How much load do Saudi School Boys Carry on their ShoulderSaudi Med J2715671571
6.
AmiriMDezfooliMSMortezaeiSR2012Designing an ergonomics backpack for student aged 7-9 with user centred design approachWork41Suppl 111931201
7.
CardonGBalaguéF2004Backpacks and spinal disorders in school childrenEura Medicophys401521
8.
KurtzSEdidinA2006The Basic Tools and Terminology of Spine TreatmentKurtzSEdidinASpine Technol. Handb.Academic Press19
9.
YangGMarrasWSBestTM2011The biochemical response to biomechanical tissue loading on the low back during physical work exposureClin Biomech (Bristol, Avon)26431437
10.
GolrizSWalkerB2011Can load carriage system weight, design and placement affect pain and discomfort? A systematic reviewJ Back Musculoskelet Rehabil24116
11.
BauerDHFreivaldsA2009Backpack load limit recommendation for middle school students based on physiological and psychophysical measurementsWork32339350
12.
HongYLiJ-XFongDT-P2008Effect of prolonged walking with backpack loads on trunk muscle activity and fatigue in childrenJ Electromyogr Kinesiol18990996
13.
SpielholzPSilversteinBMorganMCheckowayHKaufmanJ2001Comparison of self-report, video observation and direct measurement methods for upper extremity musculoskeletal disorder physical risk factorsErgonomics44588613
14.
PiscioneJGametD2006Effect of mechanical compression due to load carrying on shoulder muscle fatigue during sustained isometric arm abduction: An electromyographic studyEur J Appl Physiol97573581
15.
FarinaDGazzoniMMerlettiR2003Assessment of low back muscle fatigue by surface EMG signal analysis: Methodological aspectsJ Electromyogr Kinesiol13319332
16.
KamenGGabrielDA2010Essentials of electromyographyChampaignHuman Kinetics Publishers
17.
MotmansRREETomlowSVissersD2006Trunk muscle activity in different modes of carrying schoolbagsErgonomics49127138
18.
De LucaCJ1993Use of the surface EMG signal for performance evaluation of back musclesMuscle and Nerve16210216
19.
De NooijRKallenbergLACHermensHJ2009Evaluating the effect of electrode location on surface EMG amplitude of the m.erector spinae longissimus dorsiJ Electromyogr Kinesiole19257266
20.
KimMHYiCHKwonOYChoSHYooWG2008Changes in neck muscle electromyography and forward head posture of children when carrying schoolbagsErgonomics51890901
21.
DevroeyCJonkersIde BeckerALenaertsGSpaepenA2007Evaluation of the effect of backpack load and position during standing and walking using biomechanical, physiological and subjective measuresErgonomics50728742
22.
KuoCYLinWHSubjectsA2010The Effects of Schoolbag Style on Muscle Activation in Lower Extremities during Level Walking and Hill Walking in Primary School StudentsIFMBE Proc. 31, springerlink317319
23.
DianatISorkhiNPourhosseinAAlipourAAsghari-JafarabadiM2014Neck, shoulder and low back pain in secondary schoolchildren in relation to schoolbag carriage: Should the recommended weight limits be gender-specific? Appl Ergon45437442
24.
PauMKimSNussbaumMA2012Does load carriage differentially alter postural sway in overweight vs. normal-weight schoolchildren?Gait Posture35378382
25.
AdeyemiAJJafriMRAbdulRaniMR2014Back pain arising from schoolbag usage among primary schoolchildrenInt J Ind Ergon44590600
26.
KellisEEmmanouilidouM2010The effects of age and gender on the weight and use of schoolbagsPediatr Phys Ther221725
27.
ColeTJBellizziMCFlegalKMDietzWH2000Establishing a standard defination for child overweight and obesity worldwide: International surveyBMJ3201240
28.
ChowDHKOuDZYLaiA2010Effects of load carriage on spinal motor control in schoolchildrenIFMBE Proc316063
29.
CaelC2010Functional anatomy: Musculoskeletal anatomy, kinesiology, and palpation for manual therapistsBaltimoreWolters Kluwer Health
30.
Megawin.MegaWin 3.0 Software User Manual.Kuopio:Mega Electronics Ltd; 2010
31.
DolanPMannionAFAdamsMA1995Fatigue of the erector spinae muscles. A quantitative assessment using “frequency banding” of the surface electromyography signalJ Biomech20149159
32.
CardozoACGonçalvesM2012Assessment of Low Back Muscle by Surface EMGSteeleCAppl EMG Clin Sport Med396RijekaInTech Publishing
33.
GranataKPWilsonSE2001Trunk posture and spinal stabilityClin Biomech (Bristol, Avon)16650659
34.
NegriniSNegriniA2007Postural effects of symmetrical and asymmetrical loads on the spines of schoolchildrenScoliosis28
SouthardSAMirkaGA2007An evaluation of backpack harness systems in non-neutral torso posturesAppl Ergon38541547
37.
PiiraTHayesBGoodenoughBvon BaeyerCL2006Effects of attentional direction, age, and coping style on cold-pressor pain in childrenBehav Res Ther44835848
38.
LuQTsaoJCIMyersCDKimSCZeltzerLK2007Coping predictors of children’s laboratory-induced pain tolerance, intensity, and unpleasantnessJ Pain8708717
39.
ZhangY-XWangS-R2012Distribution of body composition index and the relationship with blood pressure among children aged 7 to 12 years in Shandong, ChinaAsia Pac J Public Health24981988
40.
MüllerAMKhooSLambertR2013Review of physical activity prevalence of Asian school-age children and adolescentsAsia Pac J Public Health25227238
41.
GreigAMStrakerLMBriggsAM2005Cervical erector spinae and upper trapezius muscle activity in children using different information technologiesPhysiotherapy91119126
42.
EsteveRMarquina-AponteV2012Children’s pain perspectivesChild Care Health Dev38441452
43.
PoussaMHeliövaaraMMSeitsamoJTKönönenMHHurmerintaKANissinenMJ2005Anthropometric measurements and growth as predictors of low-back pain: A cohort study of children followed up from the age of 11 to 22 yearsEur Spine J14595598
44.
GrimesPLeggS2004Musculoskeletal Disorders (MSD) in school students as a risk factor for adult MSD: A review of the multiple factors affecting posture, comfort and health in classroom environmentsJ Human-Environmental Syst719
45.
KistnerFFiebertIRoachK2012Effect of backpack load carriage on cervical posture in primary schoolchildrenWork A J Prev Assess Rehabil4199108
46.
GonçalvesMAArezesPM2012Postural assessment of school children: An input for the design of furnitureWork41Suppl 1876880
47.
MackieHWLeggSJBeadleJHedderleyD2003Comparison of four different backpacks intended for school useAppl Ergon34257264
48.
DePaulaAJFSilvaJCPPaschoarelliLCFujiiJB2012Backpacks and school children’s obesity: Challenges for public health and ergonomicsWork A J Prev Assess Rehabil41900906
49.
MaslenBStrakerL2009A comparison of posture and muscle activity means and variation amongst young children, older children and young adults whilst working with computersWork32311320
50.
ErneCElferingA2011Low back pain at school: Unique risk deriving from unsatisfactory grade in maths and school-type recommendationEur Spine J2021262133
51.
TrigueiroMJMassadaLGargantaRBack pain in Portuguese schoolchildrenEur J Public Health23499503
