Original Research

Altered cervical posture kinematics imposed by heavy school backpack loading: A literature synopsis (2009–2019)

Terry J. Ellapen, Yvonne Paul, Henriëtte V. Hammill, Mariëtte Swanepoel
African Journal of Disability | Vol 10 | a687 | DOI: https://doi.org/10.4102/ajod.v10i0.687 | © 2021 Terry J. Ellapen, Yvonne Paul, Henriëtte V. Hammill, Mariëtte Swanepoel | This work is licensed under CC Attribution 4.0
Submitted: 12 November 2019 | Published: 22 January 2021

About the author(s)

Terry J. Ellapen, Department of Sport and Dental Therapy, Tshwane University of Technology, Tshwane, South Africa
Yvonne Paul, Department of Sport, Rehabilitation and Dental Therapy, Health Science, Tshwane University of Technology, Tshwane, South Africa
Henriëtte V. Hammill, School of Human Movement Science, Faculty of Health Science, North-West University, Potchefstroom, South Africa
Mariëtte Swanepoel, School of Human Movement Science, Faculty of Health Science, North-West University, Potchefstroom, South Africa


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Abstract

Background: Habitual school backpack carriage causes neuro-musculoskeletal vertebral, shoulder and hand pain; deviated posture compromised cardiopulmonary function and proprioception.

Objective: Present a novel literature summary of the influence of backpack carriage associated with deviated cervical posture and compromised pulmonary function.

Method: An electronic literature appraisal adopting the Preferred Reporting Items for Systematic Reviews, using Google Scholar, Science Direct, EMBASE, AMED, OVID, PubMed and Sabinet search engines, was instituted during 2009–2019. Key search words: schoolbag, backpack, carriage, cervical posture and children. The quality of the studies was assessed using the Downs and Black Appraisal Scale.

Results: 583 records were initially identified which was reduced to 14 experimental and observational studies. A total of 1061 participants were included across the 14 studies, with an average age of 11.5 ± 1.3 years, body mass of 37.8 ± 6.6 kilograms (kg), height of 1.41 ± 0.05 meters (m), backpack mass of 5.2 ± 0.9 kg and percentage backpack mass to child’s body mass of 13.75%. The studies mean rating according to the Downs and Black Appraisal Scale was 76.3%. The average craniovertebral angle (CVA) was 53.9° ± 14.6° whilst standing without carrying a backpack was reduced to 50.4° ± 16.4° when loaded (p < 0.05). Backpack loads carried varied from 5% – 30% of the participant’s body mass that produced a mean CVA decline of 3.5°.

Conclusion: Backpack carriage alters cervical posture, resulting in smaller CVA and compromised pulmonary function. There is no consensus of the precise backpack mass that initiates postural changes. Girls’ posture begin changes when carrying lighter backpacks as compared to boys of the same age strata.


Keywords

cervical posture; compromised cardiopulmonary function; neuro-musculoskeletal; vertebral; proprioception; school backpack carriage

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