Haltungsveränderungen bei SchülerInnen der 5. Klasse durch das Tragen von unterschiedlich schweren Schulranzen

The aim of this work was to answer the question if there are differences in the incidence of back pain and postural changes in students of 5th grade after the reduction of the weight of their school bags. The prospective study included a total of 87 students (45 girls and 42 boys) from the 5th grade of Grotefend-Gymnasium in Hannoversch-Munden (Niedersachsen). This purpose has been achieved by the provision of two sets of books (home and school) and by reducing the weight of schoolbags for an experimental group of students (n=31) in this way. The control group (n=57) took as usual one set of books, so they had to carry the books to school and back home. In a period of one year there were altogether three investigations at different times (April/May 2009, October/November 2009, May/June 2010). We handed out a survey among the students with questions about wearing habits of the schoolbag and the presence of back pain. In addition, all participants were examined clinically and measured on the LASAR Posture equipment (Otto Bock HealthCare GmbH). This equipment enables the use of a pressure measurement plate, the line of gravity is optically projected onto the body of the respective participants in a plurality of planes through a laser beam. All measurements were carried out with and without schoolbags. The survey of students showed that 48 of the 87 participating students have ever had back pain (55.2%), 66.7% saw a direct relationship with the wearing of a schoolbag. There was no significant difference (p=0.59) in body size and age in both groups. On physical examination, 12.64 % (n=11) showed pathologies (rib hump n=7, lumbar bulge n=5), but there was a need of treatment in only one case (1.15%). The measuring on the LASAR Posture equipment showed that children with a heavier schoolbag (n=56) took a significantly (p<0.0001) different attitude than children with the lightweight schoolbag (n=31). With heavy schoolbag loaded children (n =31) showed the following patterns of posture. There was an increased forward inclination of children with reduced lordosis in the lumbar spine and increased kyphosis in the thoracic spine. Measuring the sagittal profile of the right side without schoolbag showed a significant difference (p<0.001) only in the course of time of studies between study 1 and 2 and between study 1 and 3, but not between the two different groups of students. This means that after discontinuation of the schoolbag no effect was detectable on the attitude any longer. Point 2, the measurements of the sagittal profile of the right side with schoolbag showed a significant difference with p<0.0001 over time and p=0.0011 with the group between study 1 and 2 (p=0.0002), and between study 1 and 3 (p<0.0001), but not between study 2 and 3 (p=0.6082). Therefore heavy schoolbags influence the attitude of the child in a different way than lighter schoolbags. The results from the present study show that the schoolbag weight in the study population (n=87) is still above the 10% of body weight. With increasing of the schoolbag weight all children showed a postural change, but this was reversible in the present study after discontinuation of the schoolbags. On this basis of data it can be assumed that the attitude pathology is completely reversible within a short period of time (one year) during this age group.