The health impact of schoolbag carriage: a systematic review (2007-2016)

Abstract

Heavy schoolbag carriage precipitating musculoskeletal pain and deviant vertebral posture has become a serious concern. The objectives of the study were to: (i) identify common anatomical sites of pain due to heavy schoolbag carriage, (ii) determine the maximum mass that a scholar can carry on both shoulders, as well as one shoulder, before the onset of pain and/or deviant posture (iii) consider different methods of carrying schoolbags and their differing relations to pain and deviant posture, (iv) recognise the impact of carrying heavy schoolbags on lung capacity, (v) examine the biomechanics of pelvic alignment when carrying heavy schoolbags, (vi) understand the effectiveness of back care and strengthening intervention programmes in order to reduce pain and deviant posture, and (vii) take global research regarding schoolbag carriage on health and well-being into account. A systematic review of literature, following the 2007 to 2016 PRIMSA guidelines, identified 589 English papers related to pain and deviant posture causing schoolbag carriage. The application of the exclusion criteria allowed 55 papers to be used in the review. Literature demonstrates that a schoolbag mass exceeding 10% of boys’ and 5% of girls’ body mass (BM) produces pain and abnormal posture including kyphosis, lordosis, and scoliosis, diminishing lung capacity and cardiorespiratory function. The method of carrying schoolbags (over both shoulders versus single shoulder carriage) changes the appendicular skeleton and axial skeletal alignment producing deviant posture; further anatomical sites of pain include the cervical vertebrae, shoulders, and lower back. Educational and exercise intervention programmes have shown promise in reducing deviant posture and pain