title: Backpack-back pain complexity and the need for multifactorial safe weight recommendation.
abstract: The study analysed backpack-related back pain in school children by investigating the possibility of multiple interactions among causative factors, which may be responsible for the non-conclusive findings on the issue. Using data from 444 prepubescent schoolchildren, a mixed method design combining survey, observation and direct measurement strategies was implemented. Using a multivariate structural equation modelling approach, the study investigated interactions among anthropometry, posture, backpack volume, rating and back pain constructs, with each construct made of 2-4 indicators. Additionally, regression analysis was used to determine the feasibility of considering the two additional factors of age and body mass index along with the globally accepted recommendation of a load of 10-15% of body weight. Our model demonstrated an acceptable model fit and revealed direct and indirect effects of the factors. Obese children were recommended to carry a one-third lighter load than other children. The application of systematic/multiple strategies provided an explanation for some of the issues associated with school children's backpack-related back pain.
authors.affiliation: Department of Materials, Manufacturing and Industrial Engineering, Faculty of Mechanical Engineering, Universiti Teknologi Malaysia, Skudai, 81310, Johor, Malaysia. Electronic address: folashademola@gmail.com.
authors.forename: Ademola James
authors.initials: AJ
authors.lastname: Adeyemi
authors.affiliation: Department of Materials, Manufacturing and Industrial Engineering, Faculty of Mechanical Engineering, Universiti Teknologi Malaysia, Skudai, 81310, Johor, Malaysia.
authors.forename: Jafri Mohd
authors.initials: JM
authors.lastname: Rohani
authors.affiliation: Department of Materials, Manufacturing and Industrial Engineering, Faculty of Mechanical Engineering, Universiti Teknologi Malaysia, Skudai, 81310, Johor, Malaysia.
authors.forename: Mat Rebi
authors.initials: MR
authors.lastname: Abdul Rani
mesh_terms: D000367:Age Factors; D000886:Anthropometry; D001416:Back Pain / Q000209:etiology* / Q000517:prevention & control*; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D011187:Posture; D016474:Weight-Bearing
keywords: Back pain; Backpack; School children