The effect of school backpacks on rates of back and shoulder problems in children and adolescents is a cause for concern among parents and school officials.1 This study from the Moore Chiropractic Wellness Centre and National University in Redding, CA, sought to determine whether a recommendation that school backpacks should not exceed 10% of the student’s body weight is better than a recommendation of 15% of body weight, to determine whether the recommendation of relative weight should vary by age, and to identify evidence that backpack weight predicts use of medical services or interference with school activities and attendance. Investigators enrolled 531 students from three high schools (grades 9–12) and two middle schools (grades 5–8) in Northern California (54% female, 92% non-Hispanic white). Students were weighed with and without a backpack to determine relative backpack weight (RBW=backpack weight as percentage of body weight). Each student was individually interviewed about pain, its frequency, and site. All students who reported pain were also surveyed about use of a chiropractor or other practitioner and time lost from school, physical education, and/or school sports as a function of backpack pain.
Almost half (49%) of the respondents reported pain, with pain reporters having significantly higher RBWs than nonpain reporters (mean RBW 11.4% vs 9.9%; P<.001). A significantly higher percentage of females reported pain than males (57.8% vs 38.9%; P<.001). Females had higher RBW than males, attributed to both having a lower body weight and carrying heavier backpacks than males. The RBW was also greater for children in lower grades where the body weight was lower but the backpack weight was similar to that in higher grades. Once gender and RBW were accounted for, grade level did not predict pain reporting. RBW was associated with upper and mid-back but not neck or low back pain. Nearly a quarter of the pain reporters (21%) had sought chiropractic care and 2.3% had received other medical care. Of those reporting pain, 4.2% reported lost time at school, 9.2% reported lost sports time, and 6.9% reported lost physical education time due to backpack-related pain. Based on a mean RBW of 11.4% among those reporting pain, the investigators support a recommendation that backpack weight not exceed 10% of a student’s body weight for all grades and ages. They caution that younger students may be at higher risk since they weigh less and their packs weigh the same as older students’. Likewise, females are more likely to carry heavier bags despite weighing less than males.
Dr. Grant has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of a commercial product/device. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
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