Abstract
Background
The objective of this study was to determine whether carrying a heavy schoolbag is associated to a higher prevalence of low back pain (LBP).
Methods
A systematic review and meta‐analysis was conducted (PROSPERO, CRD42018077839). Observational studies analyzing the relationship between schoolbag weight and LBP, were searched for in 20 electronic databases and 12 specialized journals until February 28th, 2019, without date or language restrictions. All studies which included ≥ 50 subjects aged 9 to 16, were reviewed. Methodological quality was assessed by two reviewers separately, using validated tools. A meta‐analysis and an individual patient data (IPD) meta‐analysis were conducted to examine the relationship between schoolbag weight and LBP. Certainty of evidence was assessed using an adapted GRADE methodology.
Results
5,524 citations were screened, 21 studies (18,296 subjects) were reviewed and 11 studies (9,188 subjects) were included in the meta‐analysis. The IPD meta‐analysis included 9,188 subjects from 7 studies. Among the 21 studies reviewed, the mean score for methodological quality was 78.3 out of 100. Only one study suggested an association between heavier schoolbags and LBP. Neither the meta‐analysis nor the IPD meta‐analysis found an association between carrying schoolbags weighing > 10% of bodyweight, and LBP. No differences based on age, sex or sport activity were found.
Discussion
Available evidence does not support that schoolbags weighing > 10% of bodyweight are associated with a higher prevalence of LBP among schoolchildren aged 9‐16. The certainty of evidence is low. Further research is required on the relationship between schoolbag weight and LBP.
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