The school backpack and physical parameters relationship with spinal alignment in the sagittal plane. Are changes in the design of school backpacks for younger school-age children necessary?

• Autorzy: Brzęk Anna , Wysocka-Bochenek Regina , Sołtys Jacek , Chmielarz Agata

Identyfikatory

DOI

10.2478/pjmpe-2025-0023

• Języki publikacji: EN

Abstrakty

EN

Introduction. A school backpack, as an off-axis external load, induces changes in the spinal alignment within the compensatory mechanism. Objective. Considering the above, the aim of this study was to examine how the angular parameters of the sagittal plane, the thoracic kyphosis angle, and the lumbar lordosis angle change under normative school backpack load. Additionally, the study aimed to assess how carrying a backpack affects the symmetry of foot load distribution in children. Materials and Methods. The study included 75 children (45 girls and 30 boys) aged 7-9 years (Mean = 8.48; SD = 0.89). A backpack model closely resembling those currently available on the Polish market was developed. The backpack’s weight was standardized, and sagittal plane measurements were taken using a digital inclinometer. The symmetry of load distribution was assessed using a stabilometric platform, and the endurance of postural muscles was evaluated with the Matthias test. The study only included backpacks that met the standard weight range of 10–15% of the child’s body weight. Results. Three previously undescribed types of compensation were identified: flexion type, extension type, and balanced type. Only in the balanced type did the endurance of postural muscles not significantly decrease after wearing the school backpack. Conclusions. It is necessary to modify the design of school backpacks to prevent spinal alignment changes in the sagittal plane, even within normative or excessive load values. Proper spinal curvatures are crucial for maintaining an upright body posture. Non-invasive, modern technologies based on thermal imaging should be considered as potential solutions.

Słowa kluczowe

EN

school backpack; physical parameters; sagittal plane; body weight distribution

• Wydawca: Polskie Towarzystwo Fizyki Medycznej
• Czasopismo: Polish Journal of Medical Physics and Engineering
• Rocznik: 2025
• Tom: Vol. 31, Iss. 3
• Strony: 202--210
• Opis fizyczny: Bibliogr. 43 poz., rys., tab.

Twórcy

autor

Brzęk Anna

• Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia, Medyków 12 Street; 40-754 Katowice, Poland

autor

Wysocka-Bochenek Regina

• Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia, Medyków 12 Street; 40-754 Katowice, Poland

autor

Sołtys Jacek

• Department of Physiotherapy, Faculty of Health Sciences in Katowice, Medical University of Silesia, Medyków 12 Street; 40-754 Katowice, Poland

autor

Chmielarz Agata

• Chair of Industrial Design Faculty of Design, the Academy of Fine Arts and Design in Katowice, Raciborska 37 Street, 40-074 Katowice

Bibliografia

• 1. Burton AK, Balagué F, Cardon G, et al. Chapter 2 European guidelines for prevention in low back pain. Eur Spine J. 2006;15(S2):s136-s168. doi:10.1007/s00586-006-1070-3
• 2. Alvi Z, Alvi A, Mascarenhas MA, Alvi M, Zakzanis KK. Musculoskeletal symptomatology in skeletally immature students carrying heavy backpacks: a cross-sectional study. J Can Chiropr Assoc. 2024;68(2):131-141.
• 3. Brzęk A, Dworrak T, Strauss M, et al. The weight of pupils’ schoolbags in early school age and its influence on body posture. BMC Musculoskelet Disord. 2017;18(1). doi:10.1186/s12891-017-1462-z
• 4. Brzek A, Plinta R. Exemplification of Movement Patterns and Their Influence on Body Posture in Younger School-Age Children on the Basis of an Authorial Program “I Take Care of My Spine.” Medicine. 2016;95(12):e2855. doi:10.1097/md.0000000000002855
• 5. Dockrell S, Simms C, Blake C. Schoolbag Weight Limit: Can It Be Defined? Journal of School Health. 2013;83(5):368-377. doi:10.1111/josh.12040
• 6. American Academy of Pediatrics Section on Orthopaedics and Pediatric Orthopaedic Society of North America. [Accessed 1 May 2023]. Available from: https://www.healthychildren.org/English/safety-prevention/at-play/Pages/Backpack-Safety.aspx
• 7. Recommendations for school bags - Chief Sanitary Inspectorate - Gov.pl portal [Accessed 10 September 2024]. Available from: https://www.gov.pl/web/gis/zalecenia-dotyczace-tornistrow-szkolnych
• 8. Negrini S, Negrini A. Postural effects of symmetrical and asymmetrical loads on the spines of schoolchildren. Scoliosis. 2007;2(1). doi:10.1186/1748-7161-2-8
• 9. Claus AP, Hides JA, Moseley GL, Hodges PW. Is ‘ideal’ sitting posture real?: Measurement of spinal curves in four sitting postures. Manual Therapy. 2009;14(4):404-408. doi:10.1016/j.math.2008.06.001
• 10. Wysocka R, Sołtys J, Mikuś-Nowak M, Grabska-Klein E, Jaunich A, Brzęk A. A quality of body posture in early school-aged children after a pandemic and selected lifestyle components – preliminary report. Ann Acad Med Siles. 2024;1(nr specj.)(1):27-34. doi:10.18794/aams/190425
• 11. Koprowski R. Automatic analysis of the trunk thermal images from healthy subjects and patients with faulty posture. Computers in Biology and Medicine. 2015;62:110-118. doi:10.1016/j.compbiomed.2015.04.017
• 12. Lubkowska A, Gajewska E. Temperature Distribution of Selected Body Surfaces in Scoliosis Based on Static Infrared Thermography. IJERPH. 2020;17(23):8913. doi:10.3390/ijerph17238913
• 13. Skolimowski T, Anwajler J, Dragan Sz, Konik H, Koprowski R, Wróbel Z. Wykorzystanie termografii do doboru ćwiczeń w bocznych idiopatycznych skrzywieniach kręgosłupa. Kwartalnik Polskiego Towarzystwa Fizjoterapii. 2001;9(3):123-127.
• 14. Vutan AM, Lovasz EC, Gruescu CM, et al. Evaluation of Symmetrical Exercises in Scoliosis by Using Thermal Scanning. Applied Sciences. 2022;12(2):721. doi:10.3390/app12020721
• 15. Cholewka A, Drzazga Z, Sieroń A, Stanek A. Thermovision diagnostics in chosen spine diseases treated by whole body cryotherapy. J Therm Anal Calorim. 2010;102(1):113-119. doi:10.1007/s10973-010-0873-y
• 16. Kułaga Z, Świąder-Leśniak A, Kotowska A, Litwin M. Population-based references for waist and hip circumferences, waist-to-hip and waist-to-height ratios for children and adolescents, and evaluation of their predictive ability. Eur J Pediatr. 2023;182(7):3217-3229. doi:10.1007/s00431-023-05001-4
• 17. Muscolino J. E. The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns and Stretching. St. Louis, Mo, USA: Mosby Elsevier; 2008.
• 18. Cyfrowy Pochyłomierz Saundersa. Instrukcja obsługi. Technomex, Sp.z O.O. Gliwice.
• 19. Andersson GBJ, Cocchiarella L. American Medical Association. Guides to the Evaluation of Permanent Impairments. 5th ed. Chicago: American Medical Association; 2004.
• 20. Czaprowski D, Pawłowska P, Gębicka A, Sitarski D, Kotwicki T. Intra- and interobserver repeatability and reliability of the assessment of the anterio-posterior curvatures of the spine. Ortopedia, traumatologia, rehabilitacja. 2012;14(2):145-154. doi:10.5604/15093492.992283
• 21. Durmala J, Detko E, Krawczyk K. Values of thoracic kyphosis and lumbar lordosis in adolescents from Czestochowa. Scoliosis. 2009;4(S1). doi:10.1186/1748-7161-4-s1-o53
• 22. Brzęk A, Kozinoga M, Stoliński Ł. Fizjoprofilaktyki skolioz niskostopniowych. In: Monika Grygorowicz, Marta Podhorecka, eds. Kompendium fizjoprofilaktyki. Wyd. UM im. K. Marcinkowskiego w Poznaniu. 2020:149-158.
• 23. https://schodyzdrowia.sum.edu.pl/uploads/images/Zdrowa_postawa_uczniow.pdf
• 24. Hey HWD, Teo AQA, Tan KA, et al. How the spine differs in standing and in sitting – important considerations for correction of spinal deformity. The Spine Journal. 2017;17(6):799-806. doi:10.1016/j.spinee.2016.03.056
• 25. Wang CXG, Chow DHK, Pope MH. Biomechancal effect of loaud carriage on spine curvature and responsitioning ability in adoloscents. ACTA Press, Anaheim, CA; 2007:161-166.
• 26. Claus AP, Hides JA, Moseley GL, Hodges PW. Is ‘ideal’ sitting posture real?: Measurement of spinal curves in four sitting postures. Manual Therapy. 2009;14(4):404-408. doi:10.1016/j.math.2008.06.001
• 27. Czaprowski D, Pawłowska P, Kolwicz-Gańko A, Sitarski D, Kędra A. The Influence of the „Straighten Your Back” Command on the Sagittal Spinal Curvatures in Children with Generalized Joint Hypermobility. BioMed Research International. 2017;2017:1-7. doi:10.1155/2017/9724021
• 28. Baranowska A, Sierakowska M, Owczarczuk A, Olejnik BJ, Lankau A, Baranowski P. An Analysis of the Risk Factors for Postural Defects among Early School-Aged Children. JCM. 2023;12(14):4621. doi:10.3390/jcm12144621
• 29. Brackley HM, Stevenson JM. Are Children’s Backpack Weight Limits Enough? A critical review of the relevant literature. Spine. 2004;29(19):2184-2190. doi:10.1097/01.brs.0000141183.20124.a9
• 30. Negrini S, Negrini A. Postural effects of symmetrical and asymmetrical loads on the spines of schoolchildren. Scoliosis. 2007;2(1). doi:10.1186/1748-7161-2-8
• 31. Pau M, Pau M. Postural sway modifications induced by backpack carriage in primary school children: acase study in Italy. Ergonomics. 2010;53(7):872-881. doi:10.1080/00140139.2010.489965
• 32. Chow DHK, Leung KTY, Holmes AD. Changes in spinal curvature and proprioception of schoolboys carrying different weights of backpack. Ergonomics. 2007;50(12):2148-2156. doi:10.1080/00140130701459832
• 33. Chow DHK, Leung DSS, Holmes AD. The effects of load carriage and bracing on the balance of schoolgirls with adolescent idiopathic scoliosis. Eur Spine J. 2007;16(9):1351-1358. doi:10.1007/s00586-007-0333-y
• 34. Chow DHK, Kwok MLY, Cheng JCY, et al. The effect of backpack weight on the standing posture and balance of schoolgirls with adolescent idiopathic scoliosis and normal controls. Gait & Posture. 2006;24(2):173-181. doi:10.1016/j.gaitpost.2005.08.007
• 35. Mongkonkansai J, Narkkul U, Rungruangbaiyok C, Punsawad C. Exploring musculoskeletal discomfort and school bag loads among Thai primary school students: a school-based cross-sectional survey. Sci Rep. 2024;14(1). doi:10.1038/s41598-024-81545-1
• 36. Polyong CP, Sarapimpha N, Deekla C, Phukkarawek S, Thepthong B, Poldongnok P. Effects of Upper Musculoskeletal disorder from School Bag usage among primary School Grade 4-6 students for a school in Bangkok Metropolis. J Dep Med Serv. 2019;44(4):48-53.
• 37. Mrozkowiak M, Stępień-Słodkowska M. The impact of a school backpack’s weight, which is carried on the back of a 7-year-old students of both sexes, on the features of body posture in the frontal plane. BMC Sports Sci Med Rehabil. 2022;14(1). doi:10.1186/s13102-022-00448-8
• 38. Drzał-Grabiec J, Truszczyńska A, Rykała J, Rachwał M, Snela S, Podgórska J. Effect of asymmetrical backpack load on spinal curvature in school children. WOR. 2015;51(2):383-388. doi:10.3233/wor-141981
• 39. Drzał-Grabiec J, Snela S, Rachwał M, Podgórska J, Rykała J. Effects of Carrying a Backpack in an Asymmetrical Manner on the Asymmetries of the Trunk and Parameters Defining Lateral Flexion of the Spine. Hum Factors. 2014;57(2):218-226. doi:10.1177/0018720814546531
• 40. Mosaad DM, Abdel-Aziem AA. Backpack carriage effect on head posture and ground reaction forces in school children. WOR. 2015;52(1):203-209. doi:10.3233/wor-152043
• 41. Dahl KD, Wang H, Popp JK, Dickin DC. Load distribution and postural changes in young adults when wearing a traditional backpack versus the BackTpack. Gait & Posture. 2016;45:90-96. doi:10.1016/j.gaitpost.2016.01.012
• 42. Negrini S, Carabalona R. Backpacks on! Schoolchildren’s Perceptions of Load, Associations With Back Pain and Factors Determining the Load. Spine. 2002;27(2):187-195. doi:10.1097/00007632-200201150-00014
• 43. Woynarowska B., Oblacińska A. Stan zdrowia dzieci i młodzieży w Polsce. Najważniejsze problemy zdrowotne. Stud BAS. 2014;2:41-64.