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Backpacks, Computer Games, and Triple Burgers With Cheese Revisited

Van Sant, Ann F. PT, PhD, FAPTA

Pediatric Physical Therapy: April 2013 - Volume 25 - Issue 1 - p 1
doi: 10.1097/PEP.0b013e31827c5cc6


The Editor declares no conflicts of interest.

More than 10 years ago, I wrote an editorial titled “Backpacks, Computer Games, and Triple Burgers With Cheese.” Since that time, children in this country and other developed countries have been subjected to health risks through lifestyles that are now producing an epidemic of inactivity, obesity, and the secondary consequences of heart disease and diabetes. In that editorial I wrote:

... the concept of prevention among children who are able-bodied deserves our attention. We are uniquely positioned to translate and interpret the work directed at preventing disabling conditions in adults to the population of children and youth who are increasingly put at risk by the hazards of our contemporary lifestyles.1 (p121)

In this issue we are reminded yet again of the need for pediatric physical therapists to lend their expertise to the help with the crisis we face among children who are considered to be healthy, but due to lifestyle are increasingly at risk for lifelong disability.

Faigenbaum and colleagues2 have coined the term “exercise deficit disorder” to characterize children who do not meet recommended daily exercise guidelines but are considered to be otherwise healthy. They implore us to assume a leadership role in helping to combat this problem among youth. They suggest that having a physical therapist involved in health promotion programs would add strength to a public health initiative that is long overdue. Just a little over a year ago, Ganley and colleagues3 published a review of exercise tests and measures that provide us with a thorough review of the “components, measurement methods, and consequences of physical fitness,” and a summary of evidence-based activity recommendations for youth. Thus we have a resource that describes the necessary tools to develop effective youth fitness programs in our communities. But it takes just a bit more to make that happen. It takes time and commitment. Now is the time to accept the challenge and demonstrate our commitment to the youth that are at risk.

In that issue of the journal, written back in 2002, was what might be considered a pivotal article by Goodgold and colleagues4 that brought to our attention the detrimental effects of another lifestyle risk that affects the musculoskeletal health of children: the danger of carrying heavy backpacks. That concern comes full circle in this issue with the article by Kistner5 that clearly describes the effects of heavy backpacks on posture and resulting pain in school children. This particular problem that threatens the musculoskeletal health of our youth also deserves our attention. I would recommend that our efforts to promote wellness among children should include a strong dose of education regarding the risks of children carrying heavy loads—we have data to support this effort and we need to step forward with the message.

Many of us work in public schools. Although it is convenient to argue that the role of therapists is constrained by law, we must think outside the box and work to assure that children do not become victims of our heady lifestyles, fueled by backpacks, computer games, and triple burgers with cheese.1 (121)

It is time for us to form collaborative relationships with other health professionals and our colleagues in pediatric physical therapy who work in different practice settings. Together we can make a difference and the time to start this effort is now!

Ann F. Van Sant, PT, PhD, FAPTA


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1. VanSant AF. Backpacks, computer games and triple burgers with cheese. Pediatr Phys Ther. 2002;14(3):121.
2. Faigenbaum A, Chu D, Paterno M, Myer G. Responding to exercise-deficit disorder in youth: Integrating wellness care into pediatric physical therapy. Pediatr Phys Ther. 2013;25(1):2–6.
3. Ganley K, Paterno M, Miles C, et al. Health-related fitness in children and adolescents. Pediatr Phys Ther. 2011;23(3):208–220.
4. Goodgold S, Corcoran M, Gamache D, Gillis J, Guerin J, Coyle JQ: Backpack use in children. Pediatr Phys Ther. 2002;14(3):122–131.
5. Kistner F, Fiebert I, Roach K, Moore J. Postural compensations and subjective complaints due to backpack loads and wear time in schoolchildren. Pediatr Phys Ther. 2013;25(1):15–24.
© 2013 Lippincott Williams & Wilkins, Inc.