Exploring musculoskeletal discomfort and school bag loads among Thai primary school students: a school-based cross-sectional survey

Abstract

Musculoskeletal discomfort among children carrying school bags is an increasingly significant problem. This study sought to determine the prevalence and risk factors of musculoskeletal discomfort among Thai primary school students who carry excessively heavy school bags. We conducted cross-sectional descriptive research involving 489 primary school students (ages 7-12). We utilized the standardized Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) to assess discomfort in various body regions. Measurements included student weight, school bag weight, and the angles of neck and trunk inclination. Logistic regression was used to analyze factors influencing musculoskeletal discomfort. The results showed that the majority of students had musculoskeletal discomfort (66.67%). The average relative weight of the school bags was 17.46 ± 6.02%. Significant risk factors for musculoskeletal discomfort included being female (AOR = 1.87, 95% CI = 1.12-3.10), being in grades 1-3 (AOR = 0.221, 95% CI = 0.05-0.91), carrying bags for more than 20 min per day (AOR = 28.87, 95% CI = 8.93-93.31), not storing books at school (AOR = 2.06, 95% CI = 1.07-3.95), and carrying a school bag weighing > 10% of the student's body weight (AOR = 65.46, 95% CI = 14.73-290.93). Additionally, neck and trunk inclinations > 20 degrees were associated with increased discomfort (AOR = 3.25, 95% CI = 1.89-5.57; AOR = 3.26, 95% CI = 1.58-6.70). The prevalence of musculoskeletal discomfort was higher in Thai primary school students. Female, Grades 1-3, carrying bags exceeding 20 min/day, carrying a school bag weighing > 10% of the student's body weight, and neck and trunk inclinations > 20 degrees were predictor variables for musculoskeletal discomfort. Thus, collaborative efforts from educational institutions, educators, parents, and students are essential in addressing this issue.

Keywords: Musculoskeletal discomfort; Primary school students; School bags.

Fig. 1

Illustration of neck and trunk assessment; (a) the neck angle in reference posture, (b) the neck angle in the posture while carrying a bag, (c) the trunk angle in reference posture, and (d) the trunk angle in the posture while carrying a bag.

Fig. 2

Top five musculoskeletal discomforts reported in children carrying school bags.

Fig. 3

Comparison of differences in school bag weight by grade. Data were expressed as mean ± SD. ^aCompare to Grade 1 (p < 0.001), ^bcompare to Grade 2 (p < 0.001), ^ccompare to Grade 3 (p < 0.001), ^dcompare to Grade 4 (p < 0.001).

Fig. 4

Comparison of differences in school bag weight by gender. Data were expressed as mean ± SD. *Significant difference between male and female (p < 0.05).