The Relationship between Schoolbag Carriage with Musculoskeletal Pain and Posture in Iranian Students: A Systematic Review Study
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Abstract
Background: Students in different levels use schoolbags to carry books and other educational tools. Various studies showed that schoolbag affects musculoskeletal system and posture in children and adolescents. This systematic review study aimed to examine the relationship between schoolbag characteristics with musculoskeletal pain syndromes and posture in Iranian students.
Methods: The search strategy was run in PubMed, Scopus, Web of Science (WoS), Magiran, and SID databases. The Persian or English- written original papers that were published in peer-reviewed journals were selected without any time limit. The eligible studies were classified based on pain location and postural alignment.
Results: A total number of 2426 records were found in the databases. Thirteen studies were eligible for this study. The results showed that musculoskeletal disorders and postural abnormalities had a relatively high prevalence among Iranian students, and their prevalence was significantly higher in girls. Generally, it seems that carrying a schoolbag, carrying time, type of bag, and weight have a significant effect on the low back, wrist, shoulder, upper back, and neck pain. However, the carrying time and relative weight of the bag have a significant effect on thoracic kyphosis, lumbar lordosis, and forward head posture.
Conclusion: The factors such as weight of bag or backpack, carrying time, unilateral bag carrying, female gender, location of the schoolbag, and walking to school with a bag can affect musculoskeletal pain and posture in Iranian students.
1. Dockrell S, Blake C, Simms C. Guidelines for schoolbag carriage: An appraisal of safe load limits for schoolbag weight and duration of carriage. Work. 2015;53(3):679-88. doi: 10.3233/WOR-162260. [PubMed: 26890600].
2. Dockrell S, Simms C, Blake C. Schoolbag weight limit: Can it be defined? J Sch Health. 2013;83(5):368-77. doi: 10.1111/josh.12040. [PubMed: 23517005].
3. Kasovic M, Stefan L, Zvonar M. Normative values for relative schoolbag weight in primary school children aged 6-14 from Czech Republic: A pilot study. PLoS One. 2019;14(11):e0225741. doi: 10.1371/journal.pone.0225741. [PubMed: 31765420].
[PubMed Central: PMC6876794].
4. Brzek A, Dworrak T, Strauss M, Sanchis-Gomar F, Sabbah I, Dworrak B, et al. The weight of pupils' schoolbags in early school age and its influence on body posture. BMC Musculoskelet Disord. 2017;18(1):117. doi: 10.1186/s12891-017-1462-
z. [PubMed: 28320364]. [PubMed Central: PMC5359953].
5. Yamato TP, Maher CG, Traeger AC, Wiliams CM, Kamper SJ. Do schoolbags cause back pain in children and adolescents? A systematic review. Br J Sports Med. 2018;52(19):1241-5. doi: 10.1136/bjsports-2017-098927. [PubMed: 29720469].
6. Li SSW, Chow DHK. Effects of backpack load on critical changes of trunk muscle activation and lumbar spine loading during walking. Ergonomics. 2018;61(4):553-65. doi: 10.1080/00140139.2017.1365950. [PubMed: 28791922].
7. Orantes-Gonzalez E, Heredia-Jimenez J. Does schoolbag carriage equally affect obese/overweight and healthy-weight children? Appl Ergon. 2021;90:103236. doi: 10.1016/j.apergo.2020.103236.
8. Janakiraman B, Ravichandran H, Demeke S, Fasika S. Reported influences of backpack loads on postural deviation among school children: A systematic review. J Educ Health Promot. 2017;6:41. doi: 10.4103/jehp.jehp_26_15. [PubMed: 28584840]. [PubMed Central: PMC5441201].
9. Chow DH, Ou ZY, Wang XG, Lai A. Short-term effects of backpack load placement on spine deformation and repositioning error in schoolchildren. Ergonomics. 2010;53(1):56-64. doi: 10.1080/00140130903389050. [PubMed: 20069481].
10. Delele M, Janakiraman B, Bekele AA, Tafese A, van de Water ATM. Musculoskeletal pain and associated factors among Ethiopian elementary school children. BMC Musculoskelet Disord. 2018;19(1):276. doi: 10.1186/s12891-018-2192-6 .[ PubMed: 30064400]. [PubMed Central: PMC6069959].
11. Hernandez TL, Ferre MC, Marti SG, Salvat IS. Relationship between school backpacks and musculoskeletal pain in children 8 to 10 years of age: An observational, cross-sectional and analytical study. Int J Environ Res Public Health. 2020;17(7). doi: 10.3390/ijerph17072487. [PubMed: 32260533]. [PubMed Central: PMC7177975].
12. Keeratisiroj O, Siritaratiwat W. Prevalence of self-reported musculoskeletal pain symptoms among school-age adolescents: Age and sex differences. Scand J Pain. 2018;18(2):273-80. doi: 10.1515/sjpain-2017-0150. [PubMed: 29794297].
13. Wong AYL, Karppinen J, Samartzis D. Low back pain in older adults: risk factors, management options and future directions. Scoliosis Spinal Disord. 2017;12:14. doi: 10.1186/s13013-017-0121-3. [PubMed: 28435906]. [PubMed Central: PMC5395891].
14. Kamper SJ, Henschke N, Hestbaek L, Dunn KM, Williams CM. Musculoskeletal pain in children and adolescents. Braz J Phys Ther. 2016;20(3):275-84. doi: 10.1590/bjpt-rbf.2014.0149. [PubMed: 27437719]. [PubMed Central: PMC4946844].
15. Dianat I, Sorkhi N, Pourhossein A, Alipour A, Asghari-Jafarabadi M. Neck, shoulder and low back pain in secondary schoolchildren in relation to schoolbag carriage: should the recommended weight limits be gender-specific? Appl Ergon. 2014;45(3):437-42. doi: 10.1016/j.apergo.2013.06.003. [PubMed: 23827662].
16. Dianat I, Javadivala Z, Allahverdipour H. School bag weight and the occurrence of shoulder, hand/wrist and low back symptoms among iranian elementary schoolchildren. Health Promot Perspect. 2011;1(1):76-85. doi: 10.5681/hpp.2011.008. [PubMed: 24688903]. [PubMed Central: PMC3963609].
17. Dianat I, Javadivala Z, Asghari-Jafarabadi M, Asl HA, Haslegrave CM. The use of schoolbags and musculoskeletal symptoms among primary school children: Are the recommended weight limits adequate? Ergonomics. 2013;56(1):79-89. doi: 10.1080/00140139.2012.729612. [PubMed: 23131119].
18. Shamsoddini A, Hollisaz M, Hafezi R. Backpack weight and musculoskeletal symptoms in secondary school students, tehran, iran. Iran J Public Health. 2010;39(4):120-5. Retrieved from. [PubMed: 23113045]. [PubMed Central: PMC3481694].
19. Arghavani F, Zamanian Z, Ghanbary A, Hassanzadeh J. Investigation of the relationship between carrying school bags (handbags and backpacks) and the prevalence of musculoskeletal pains among 12-15 year old students in Shiraz. Pak J Biol Sci. 2014;17(4):550-4. doi: 10.3923/pjbs.2014.550.554. [PubMed: 25911845].
20. Ja'fari M, Faraji M, Tirgar A, Bijani A, Javanshir K. The Relationship between School Bag Characteristics and Personal Variables with Neck Pain among High School Students of Babol, Iran. J Rehab. 2014;15(2):4-11.
21. Poursadeghiyan M, Azrah K, Biglari H, Ebrahimi M, Yarmohammadi H, Baneshi mm, et al. The effects of the manner of carrying the bags on musculoskeletal symptoms in school students in the city of Ilam, Iran. Ann Trop Med Public Health. 2017;10(3):600-5. doi: 10.4103/ATMPH.ATMPH_109_17.
22. Dianat I, Alipour A, Asghari JM. Prevalence and risk factors of low back pain among school age children in Iran. Health Promot Perspect. 2017;7(4):223-9. doi: 10.15171/hpp.2017.39. [PubMed: 29085800]. [PubMed Central: PMC5647358].
23. Raeisi F, Arab AM, Adib Hesami M. the prevalence of low back pain and its relation with backpack weight among iranian students. Physical Treatments. 2018;7(4):193-6. doi: 10.32598/ptj.7.4.193. [In Persian].
24. Zakeri Y, Baraz S, Gheibizadeh M, Saidkhani V. Relationship between backpack weight and prevalence of lordosis, kyphosis, scoliosis and dropped shoulders in elementary students. Int J Pediatr. 2016;4(6):1859-66. doi: 10.22038/ijp.2016.6846.
25. Moslemi S, Mohammadi S, Hosseininejad M, Mohtasham S, kabir-Mokamelkhah E. Assessment of backpacks parameters and postural structure disturbances association among Iranian children. Int J Pediatr. 2018;6(3):7413-9. doi: 10.22038/ijp.2017.24958.2111.
26. Zahiri-Sarvari S, Daneshmandi H, Rahnama N, Akoochakiyan
M. The effect of weight and duration of carrying backpack on forward head, kyphoses and lordoses in 14-18 year-old girls. Feyz. 2018;22(1):94-102. [In Persian].
27. Naderi A, Shaabani F, Malki F, Khosravi F. Kinematic changes of body alignment resulting from backpack weight, location and carrying duration in 10 to 12 years old boy schoolchildren. Journal of Applied Exercise Physiology. 2017;13(25):25-36. doi: 10.22080/jaep.2017.1585. [In Persian].
28. Grimmer K, Dansie B, Milanese S, Pirunsan U, Trott P. Adolescent standing postural response to backpack loads: A randomised controlled experimental study. BMC Musculoskelet Disord. 2002;3:10. doi: 10.1186/1471-2474-3-10. [PubMed: 11960561]. [PubMed Central: PMC111061].
29. Piscione J, Gamet D. Effect of mechanical compression due to load carrying on shoulder muscle fatigue during sustained isometric arm abduction: An electromyographic study. Eur J Appl Physiol. 2006;97(5):573-81. doi: 10.1007/s00421-006-0221-x. [PubMed: 16767438].
2. Dockrell S, Simms C, Blake C. Schoolbag weight limit: Can it be defined? J Sch Health. 2013;83(5):368-77. doi: 10.1111/josh.12040. [PubMed: 23517005].
3. Kasovic M, Stefan L, Zvonar M. Normative values for relative schoolbag weight in primary school children aged 6-14 from Czech Republic: A pilot study. PLoS One. 2019;14(11):e0225741. doi: 10.1371/journal.pone.0225741. [PubMed: 31765420].
[PubMed Central: PMC6876794].
4. Brzek A, Dworrak T, Strauss M, Sanchis-Gomar F, Sabbah I, Dworrak B, et al. The weight of pupils' schoolbags in early school age and its influence on body posture. BMC Musculoskelet Disord. 2017;18(1):117. doi: 10.1186/s12891-017-1462-
z. [PubMed: 28320364]. [PubMed Central: PMC5359953].
5. Yamato TP, Maher CG, Traeger AC, Wiliams CM, Kamper SJ. Do schoolbags cause back pain in children and adolescents? A systematic review. Br J Sports Med. 2018;52(19):1241-5. doi: 10.1136/bjsports-2017-098927. [PubMed: 29720469].
6. Li SSW, Chow DHK. Effects of backpack load on critical changes of trunk muscle activation and lumbar spine loading during walking. Ergonomics. 2018;61(4):553-65. doi: 10.1080/00140139.2017.1365950. [PubMed: 28791922].
7. Orantes-Gonzalez E, Heredia-Jimenez J. Does schoolbag carriage equally affect obese/overweight and healthy-weight children? Appl Ergon. 2021;90:103236. doi: 10.1016/j.apergo.2020.103236.
8. Janakiraman B, Ravichandran H, Demeke S, Fasika S. Reported influences of backpack loads on postural deviation among school children: A systematic review. J Educ Health Promot. 2017;6:41. doi: 10.4103/jehp.jehp_26_15. [PubMed: 28584840]. [PubMed Central: PMC5441201].
9. Chow DH, Ou ZY, Wang XG, Lai A. Short-term effects of backpack load placement on spine deformation and repositioning error in schoolchildren. Ergonomics. 2010;53(1):56-64. doi: 10.1080/00140130903389050. [PubMed: 20069481].
10. Delele M, Janakiraman B, Bekele AA, Tafese A, van de Water ATM. Musculoskeletal pain and associated factors among Ethiopian elementary school children. BMC Musculoskelet Disord. 2018;19(1):276. doi: 10.1186/s12891-018-2192-6 .[ PubMed: 30064400]. [PubMed Central: PMC6069959].
11. Hernandez TL, Ferre MC, Marti SG, Salvat IS. Relationship between school backpacks and musculoskeletal pain in children 8 to 10 years of age: An observational, cross-sectional and analytical study. Int J Environ Res Public Health. 2020;17(7). doi: 10.3390/ijerph17072487. [PubMed: 32260533]. [PubMed Central: PMC7177975].
12. Keeratisiroj O, Siritaratiwat W. Prevalence of self-reported musculoskeletal pain symptoms among school-age adolescents: Age and sex differences. Scand J Pain. 2018;18(2):273-80. doi: 10.1515/sjpain-2017-0150. [PubMed: 29794297].
13. Wong AYL, Karppinen J, Samartzis D. Low back pain in older adults: risk factors, management options and future directions. Scoliosis Spinal Disord. 2017;12:14. doi: 10.1186/s13013-017-0121-3. [PubMed: 28435906]. [PubMed Central: PMC5395891].
14. Kamper SJ, Henschke N, Hestbaek L, Dunn KM, Williams CM. Musculoskeletal pain in children and adolescents. Braz J Phys Ther. 2016;20(3):275-84. doi: 10.1590/bjpt-rbf.2014.0149. [PubMed: 27437719]. [PubMed Central: PMC4946844].
15. Dianat I, Sorkhi N, Pourhossein A, Alipour A, Asghari-Jafarabadi M. Neck, shoulder and low back pain in secondary schoolchildren in relation to schoolbag carriage: should the recommended weight limits be gender-specific? Appl Ergon. 2014;45(3):437-42. doi: 10.1016/j.apergo.2013.06.003. [PubMed: 23827662].
16. Dianat I, Javadivala Z, Allahverdipour H. School bag weight and the occurrence of shoulder, hand/wrist and low back symptoms among iranian elementary schoolchildren. Health Promot Perspect. 2011;1(1):76-85. doi: 10.5681/hpp.2011.008. [PubMed: 24688903]. [PubMed Central: PMC3963609].
17. Dianat I, Javadivala Z, Asghari-Jafarabadi M, Asl HA, Haslegrave CM. The use of schoolbags and musculoskeletal symptoms among primary school children: Are the recommended weight limits adequate? Ergonomics. 2013;56(1):79-89. doi: 10.1080/00140139.2012.729612. [PubMed: 23131119].
18. Shamsoddini A, Hollisaz M, Hafezi R. Backpack weight and musculoskeletal symptoms in secondary school students, tehran, iran. Iran J Public Health. 2010;39(4):120-5. Retrieved from. [PubMed: 23113045]. [PubMed Central: PMC3481694].
19. Arghavani F, Zamanian Z, Ghanbary A, Hassanzadeh J. Investigation of the relationship between carrying school bags (handbags and backpacks) and the prevalence of musculoskeletal pains among 12-15 year old students in Shiraz. Pak J Biol Sci. 2014;17(4):550-4. doi: 10.3923/pjbs.2014.550.554. [PubMed: 25911845].
20. Ja'fari M, Faraji M, Tirgar A, Bijani A, Javanshir K. The Relationship between School Bag Characteristics and Personal Variables with Neck Pain among High School Students of Babol, Iran. J Rehab. 2014;15(2):4-11.
21. Poursadeghiyan M, Azrah K, Biglari H, Ebrahimi M, Yarmohammadi H, Baneshi mm, et al. The effects of the manner of carrying the bags on musculoskeletal symptoms in school students in the city of Ilam, Iran. Ann Trop Med Public Health. 2017;10(3):600-5. doi: 10.4103/ATMPH.ATMPH_109_17.
22. Dianat I, Alipour A, Asghari JM. Prevalence and risk factors of low back pain among school age children in Iran. Health Promot Perspect. 2017;7(4):223-9. doi: 10.15171/hpp.2017.39. [PubMed: 29085800]. [PubMed Central: PMC5647358].
23. Raeisi F, Arab AM, Adib Hesami M. the prevalence of low back pain and its relation with backpack weight among iranian students. Physical Treatments. 2018;7(4):193-6. doi: 10.32598/ptj.7.4.193. [In Persian].
24. Zakeri Y, Baraz S, Gheibizadeh M, Saidkhani V. Relationship between backpack weight and prevalence of lordosis, kyphosis, scoliosis and dropped shoulders in elementary students. Int J Pediatr. 2016;4(6):1859-66. doi: 10.22038/ijp.2016.6846.
25. Moslemi S, Mohammadi S, Hosseininejad M, Mohtasham S, kabir-Mokamelkhah E. Assessment of backpacks parameters and postural structure disturbances association among Iranian children. Int J Pediatr. 2018;6(3):7413-9. doi: 10.22038/ijp.2017.24958.2111.
26. Zahiri-Sarvari S, Daneshmandi H, Rahnama N, Akoochakiyan
M. The effect of weight and duration of carrying backpack on forward head, kyphoses and lordoses in 14-18 year-old girls. Feyz. 2018;22(1):94-102. [In Persian].
27. Naderi A, Shaabani F, Malki F, Khosravi F. Kinematic changes of body alignment resulting from backpack weight, location and carrying duration in 10 to 12 years old boy schoolchildren. Journal of Applied Exercise Physiology. 2017;13(25):25-36. doi: 10.22080/jaep.2017.1585. [In Persian].
28. Grimmer K, Dansie B, Milanese S, Pirunsan U, Trott P. Adolescent standing postural response to backpack loads: A randomised controlled experimental study. BMC Musculoskelet Disord. 2002;3:10. doi: 10.1186/1471-2474-3-10. [PubMed: 11960561]. [PubMed Central: PMC111061].
29. Piscione J, Gamet D. Effect of mechanical compression due to load carrying on shoulder muscle fatigue during sustained isometric arm abduction: An electromyographic study. Eur J Appl Physiol. 2006;97(5):573-81. doi: 10.1007/s00421-006-0221-x. [PubMed: 16767438].
| Files | ||
| Issue | Vol 7, No 4 (2021) | |
| Section | Review Article | |
| DOI | https://doi.org/10.18502/jost.v7i4.8857 | |
| Keywords | ||
| Schools; Musculoskeletal Pain; Posture; Students | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Sheikhhoseini R, Sayyadi P, Piri H. The Relationship between Schoolbag Carriage with Musculoskeletal Pain and Posture in Iranian Students: A Systematic Review Study. J Orthop Spine Trauma. 2022;7(4):123-6.
