Effect of Backpack Load Carriage on Cervical Posture in Primary Schoolchildren

The Chiro.Org Blog


SOURCE:   Work. 2012 (Jan 1);   41 (1):   99—108

By Fran Kistner, Ira Fiebert, Kathryn Roach

School of Physical Therapy, Massachusetts College of Pharmacy and Health Sciences, Worcester, MA, USA.


Objective:   This study examined the effects of various backpack loads on elementary schoolchildren’s posture and postural compensations as demonstrated by a change in forward head position.

Subjects:   A convenience sample of 11 schoolchildren, aged 8-11 years participated.

Methods:   Sagittal digital photographs were taken of each subject standing without a backpack, and then with the loaded backpack before and after walking 6 minutes (6MWT) at free walking speed. This was repeated over three consecutive weeks using backpacks containing randomly assigned weights of 10%, 15%, or 20% body weight of each respective subject. The craniovertebral angle (CVA) was measured using digitizing software, recorded and analyzed.

Results:   Subjects demonstrated immediate and statistically significant changes in CVA, indicating increased forward head positions upon donning the backpacks containing 15% and 20% body weight. Following the 6MWT, the CVA demonstrated further statistically significant changes for all backpack loads indicating increased forward head postures. For the 15 & 20% BW conditions, more than 50% of the subjects reported discomfort after walking, with the neck as the primary location of reported pain.

Conclusions:   Backpack loads carried by schoolchildren should be limited to 10% body weight due to increased forward head positions and subjective complaints at 15% and 20% body weight loads.

There is more material like this at:

Forward Head Posture Page and the

Backpacks and Children Page