A holistic backpack back pain model for prepubescent primary school children

Abstract

The present recommendation of the maximum bag weight to be 10-15% of body weight for schoolchildren has not been adequate as it is mainly based on biomechanical and physiological factors, without considering interaction with other risk factors associated with the subjective nature of back pain believed to be affected by psychosocial and individual characteristics of people. This serves as the basis to believe that the recommendation may not be sufficient for prepubescent primary schoolchildren, who constitute little or no part in the research leading to the initial recommendation. This research therefore aimed at developing a holistic multifactorial backpack back pain model that will provide explanation for the complex and multiple interactions associated with the back pain problem among the children. The research used mixed methodological design that employed survey, observation and objective measuring tools to investigate and understand the backpack back pain problem. A total of 662 primary schoolchildren aged 7-12 years (primary year 1-6) took part in the study. Descriptive and correlation statistical techniques were used to identify significant association among the factors. Reliability analysis and exploratory factor analysis were used for validating and reducing the variables into fitted constructs. Structural equation modelling was used for building and validating the model fit. Electromyography was used to establish the effect of age and body mass index on the trunk muscles of the children when carrying various weights corresponding to 5%, 10% and 15% of the body weight. The research established the insufficient nature of the 10-15% body weight for pain among primary schoolchildren. Most of the pain, load, anthropometric and physiological variables vary across age and racial groups. A multifactorial backpack back pain model consisting of anthropometry, pain, posture, backpack volume and rating ability was developed for better understanding of the relationship. A new safe weight recommendation based on percentage body weight and body mass index was made for the primary schoolchildren to reduce their chances of exposure to back pain. More longitudinal and control studies need to be conducted to identify appropriate percentage body weight suitable for different age groups.