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Postural Compensations and Subjective Complaints Due to Backpack Loads and Wear Time in Schoolchildren

Kistner, Frances PT, PhD, CEAS; Fiebert, Ira PT, PhD; Roach, Kathryn PT, PhD; Moore, James PT, PhD

doi: 10.1097/PEP.0b013e31827ab2f7
Research Article

Purpose: This study investigated the effects of carrying weighted backpacks of up to 20% of body weight on the posture and pain complaints of elementary-school children.

Methods: Craniovertebral, forward trunk lean and pelvic tilt angles were measured from sagittal photographs of 62 children (8-11 years old) before and after walking while carrying backpacks containing 10%, 15%, or 20% of body weight. Pain severity after a 6-minute walk with the loaded backpack was recorded. Subjective complaints of pain were assessed using a visual analog scale after walking.

Results: Repeated-measures ANOVA revealed statistically significant differences in postural angles and increased complaints of pain after walking with increased backpack loads.

Conclusion: These results indicate that typical backpack loads create worsening postural changes due to backpack loads and time spent carrying those loads, putting children at increased risk for injury and pain, the latter of which is a strong predictor for back pain in adulthood.

The authors report the effects of backpack loads of 10%, 15%, and 20% of body weight on posture and pain in children 8–11 years old. Their findings suggest detrimental effects even at the lowest load, suggesting that backpacks are putting children at risk for headache, neck pain, and back pain.

School of Physical Therapy (Dr Kistner), Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts; Department of Physical Therapy (Drs Fiebert, Roach, and Moore), Miller School of Medicine, University of Miami, Coral Gables, Florida.

Frances Kistner, PT, PhD, CEAS, 10 Lincoln Square, Worcester, MA 01608 (

At the time this work was completed, Frances Kistner was a doctoral student in the Department of Physical Therapy, University of Miami, Miller School of Medicine, Coral Gables, Florida.

Grant support: This study was supported by a grant from the iTrace Foundation, Inc, Plantation, Florida.

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.