Date Presented 4/20/2018
More than 60% of college students carry book bags greater than 10% of their body weight. However, we found that book bag weight was not correlated with pain, limitations in participation, or decreased quality of life. We look to the literature for factors that may influence these outcomes.
Primary Author and Speaker: Eliza Prager
Additional Authors and Speakers: Anna Guimbarda, Torey Hentis, Allie Hill, Trisha Huxel, Kayla Massey, Katie Wecke
BACKGROUND AND PURPOSE: Students of all ages consistently rely on their book bags to transport school-related items. Evidence on the health risks associated with carrying heavy book bags indicates that the weight of the bag, distribution of the load, and total carry time predict adverse health effects such as pain and postural changes (Bauer & Freivalds, 2009; Dianat et al., 2014). Guidelines for load limits are established at 10%–15% of body weight (American Occupational Therapy Association [AOTA], n.d.; Kistner et al., 2013). The purpose of this study was to determine whether any of the factors identified in the literature affected pain, participation, or quality of life in a sample of college students.
METHOD: This descriptive study took place on the campus of a small, suburban university in the Midwest. Participants were a convenience sample of 94 students aged 18–50 with no diagnosis affecting the back, neck, or upper extremity and with no active symptoms of pain. Data were obtained using a short (15-min) self-report questionnaire in addition to an objective measure of participant weight and book bag weight. The questionnaire included two widely used assessment tools; pain intensity was reported using a visual analog scale, and the SF–12 was used to report quality of life. In addition, demographic information, book bag carriage habits, book bag carriage duration estimates, pain location, pain descriptors, and participation questions were asked in the survey.
A power analysis was completed before data collection. Data were analyzed with Spearman rho and point-biserial correlations. All statistical tests were analyzed as one-tailed tests with alpha levels of .05.
RESULTS: Results indicate that 61.4% of participants were carrying book bags over the 10% body weight guideline (M = 11.19; range = 3.01–21.5), 69% experienced pain they attributed to carrying their book bag, and 48% reported that their book bag limited the activities they chose to participate in on campus. Book bag weight was not significantly correlated with reported pain (r = .097), longest book bag carry time (r = .140), or total daily carry time (r = .121). Book bag weight also was not significantly correlated with participation scores (r = –.023) or with the physical health (r = .061) or mental health composite scores (r = –.078) on the SF–12, our quality of life measure.
CONCLUSION: Many university students are carrying book bag loads over the 10% body weight guideline and are experiencing back, neck, and upper extremity pain. However, in this study student pain was not correlated with book bag weight or estimated duration of carry. Additionally, book bag weight was not correlated with participation or quality of life. Although our results were nonsignificant, other evidence supports alternative factors that may influence student-reported pain, such as gender. Additionally, stress may affect how students experience pain, their participation, and mental health scores.
Ensuring participation and quality of life are particularly important to occupational therapy practitioners. Although book bag weight does not appear to influence these two domains, it is important that practitioners determine which factors significantly affect participation and quality of life. More than half the students sampled were carrying book bags over the AOTA-recommended guideline. It is possible that the impact on this population of repeatedly carrying heavy loads will become evident in the future and that they would benefit from an educational program aimed at prevention of injury and disability.
References
American Occupational Therapy Association. (n.d.). Backpack strategies for parents and students. Retrieved from https://www.aota.org/∼/media/Corporate/Files/AboutOT/consumers/Youth/BackpackStrategiesParentsStudents.PDF
Bauer, D. H., & Freivalds, A. (2009). Backpack load limit recommendation for middle school students based on physiological and psychophysical measurements. Work, 32, 339–350. https://doi.org/10.3233/WOR-2009-0832
Dianat, I., Sorkhi, N., Pourhossein, A., Alipour, A., & Asghari-Jafarabadi, M. (2014). Neck, shoulder and low back pain in secondary schoolchildren in relation to schoolbag carriage: Should the recommended weight limits be gender-specific? Applied Ergonomics, 45, 437–442. https://doi.org/10.1016/j.apergo.2013.06.003
Kistner, F., Fiebert, I., Roach, K., & Moore, J. (2013). Postural compensations and subjective complaints due to backpack loads and wear time in schoolchildren. Pediatric Physical Therapy, 25, 15–24. https://doi.org/10.1097/PEP.0b013e31827ab2f7
