The aim of this study is to identify the appropriate variables related to the profile of schoolchildren, to the characteristics of the backpacks (weight, carrying method, and design), and to the short- and long-term impact of backpacks on musculoskeletal health. It seeks to highlight gaps in the current knowledge for the prevention and management of these disorders related to the backpack usage in the pediatric and adolescent populations.
A scoping review was conducted. Inclusion criteria were: (i) studies with at least 50 healthy schoolchildren; (ii) intervention: school backpacks; (iii) study design: experimental and observational studies in English, Portuguese, and Spanish from the past 10 years. The search was conducted in PubMed, Scopus, Web of Science, and Pedro in February 2024.
Nine observational studies were selected. The population ranged from 5 to 18 years old, with age brackets stratified every 2 years. Regarding backpack characteristics, 7 studies considered backpack weight (kg, estimated weight, weight perception, load distribution, number of bags), 6 studies the backpack type, 3 the use of lockers, 4 the straps (length, quantity) and 7 the carrying method (way, time, transportation method).The effect/impact of backpacks was mostly evaluated using ad hoc questionnaires. The studied effects were pain (intensity, prevalence, location, impact, chronicity, and pain threshold), posture (in spine and lower limb), gait, and muscle endurance.
The variables used in most of the analyzed studies are heterogenous and incomplete, which hinders making consistent comparisons. Additionally, there is considerable variability in the measurement of these variables, which adds an extra level of uncertainty to the results obtained.
This study identifies significant research gaps concerning the relationship between backpacks and musculoskeletal disorders in schoolchildren. By consolidating the variables explored by other researchers, the findings can direct future investigations and facilitate the establishment of standardized methodologies in this area. This, in turn, will enhance the understanding and management of backpack-related issues among schoolchildren. Additionally, the results can support physiotherapists in recognizing the key factors associated with backpack use, potentially informing educational programs on ergonomics within schools.
Child
Musculoskeletal disorders
