The backpack load in schoolchildren: clinical and social importance, and efficacy of a community-based educational intervention. A prospective controlled cohort study.

The aims of this paper were: to establish the efficacy of an educational intervention in reducing school backpack weight and, possibly, back pain; to verify the content of backpacks and the social importance of the problem; to confirm existing data in the literature.Design: controlled prospective educational intervention. Setting: community. Participants: the entire Year 6 population (402 pupils) of 2 randomly chosen rural school districts of the province of Mantua (Italy); of these, we took 108 (selected according to position in the class register): 82.4\% completed the study; 402 parents and 124 teachers entered the study, 77.1\% and 37.1\% respectively completed it. Intervention: instructive meeting and written material for teachers, and a leaflet for parents on backpack management. Main outcome measures: backpack weight and content; back pain; subjective perceptions of backpack load; packing and carrying methods; backpack load: importance, management and education; backpack characteristics.We obtained a statistically significant reduction in the backpack weight in each of the groups (study 11.2\%; control 7.9\% - not a statistically significant difference); 90.1\% of the material carried is necessary. Backpacks are considered a problem by 95.1\% of parents, 73\% of teachers, and 60.3\% of pupils. Backpack weight: 8.75+/-1.26 kg (19.9+/-5.3\% of body weight); fatigue during backpack carrying: 72.7\%; back pain life prevalence: 58.4\%; fatigue during backpack carrying and considering backpacks a problem were associated with back pain (odds ratios 4.4 and 5).Educational intervention is not the answer to the problem and solutions, like the clear legal limits established for adults, need to be found.