Clinical Bottom Line
“How could I apply this information?”
This study encourages us to minimize the weight and time that school-aged children spend carrying backpacks. To minimize body pain and postural strain, children are recommended to carry backpacks weighing no more than 10% of their body weight. Elementary school children who were healthy and who carried backpacks weighing 10% of their body weight reported neck, shoulder, and mid back pain and also exhibited postural compensations linked to increased spinal forces, tension, and fatigue. Such postural strain and body pain increased as children carried heavier backpacks, especially after walking 6 minutes (a time frame considered comparable with the minimal time children need to access classrooms). This study's findings and recommendations may be aptly integrated when screening and promoting the health, fitness, and wellness of school-aged children.
If children of school age and healthy presented with increased body pain and postural strain, we might expect that children with special needs might face greater challenges. Although children with special needs were excluded from this study, the increased physical demands these children face may lead to increased reports of pain and postural compensations. For example, while children who are healthy did not report increased low back pain despite carrying heavier backpacks, increased pain may surface in children who require greater walking time to access classrooms. If it is not possible for children who are healthy to avoid carrying backpacks or to use adaptive strategies, backpacks should be loaded to maximum of 10% of a child's body weight, to minimize postural strain and body pain. Participants in this study weighed on average 39 kg with a range of 23 to 65 kg. This indicates that a range of 5 to 14 pounds should be the maximum backpack weight children in this weight range should carry.
“What should I be mindful about in applying this information?”
Generalizing from this sample of children who are healthy to children with movement problems should be done with caution. Compensation for loads may take very different forms for different children with movement problems. Backpacks may not be a good choice for many children with special needs, even if loads are 10% or less of body weight.
Dorothy Ho, PT, DPT
California Children's Service
Los Angeles, CA
Linda Fetters, PT, PhD, FAPTA
University of Southern California
Los Angeles, CA