The backpack problem is evident but the solution is less obvious.
OBJECTIVE
A systematic review of the literature between 2003 and 2007 was conducted to explore the questions 1) Are school-aged children actually at risk for back pain because of carrying backpacks? How much of a load is too much? 2) Does backpack in adolescence predict back pain in adulthood? 3) Are there behaviors that lessen/increase the risk of back pain/injury? i.e. education on how to carry, pack the pack and psychosomatic behaviors?


METHODS
Cochrane Collection, Pub-Med, OTSeeker, PEDro, FirstSearch Medline, ERIC, General Engineering, Engineering Village2 and Goggle Scholar were searched with the following keywords in various combinations: backpack, back pain, load, children, adolescents, pediatrics, and physical fitness. Sixty-three articles were considered for the study to answer the three research questions. Each study was analyzed for specific application to the three questions.


RESULTS
Ten articles were analyzed for the first, epidemiological question, two articles were analyzed for the second long term health risk question and seven articles were analyzed for the behavioral question.


CONCLUSIONS
Weight recommendations and carrying behaviors are not consistently supported in the recent studies; several studies call for an examination of psychosomatic behaviors as potential predictors of back pain in childhood and adolescence.
Department of Occupational Therapy, Western Michigan University, Kalamazoo, MI 49009, USA. dhazel@wmich.edu
Debra
D
Lindstrom-Hazel
D000293:Adolescent; D001416:Back Pain / Q000209:etiology* / Q000517:prevention & control; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010372:Pediatrics; D016138:Walking; D016474:Weight-Bearing / Q000502:physiology*