The effects of weight of school bag on gait for subjects with and without adolescent idiopathic scoliosis

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The effects of weight of school bag on gait for subjects with and without adolescent idiopathic scoliosis


Author: Au-Yang, Choi-kam Alexander
Title: The effects of weight of school bag on gait for subjects with and without adolescent idiopathic scoliosis
Degree: M.Sc.
Year: 2002
Subject: Hong Kong Polytechnic University -- Dissertations
Spine -- Wounds and injuries
Scoliosis in children
Weight (Physics) -- Measurement
Department: Jockey Club Rehabilitation Engineering Centre
Pages: 97 leaves : ill. ; 30 cm.
Abstract: Scoliosis is a serious musculoskeletal deformity that can affect all parts of the spine. Among the various causes, the most common group is Adolescent Idiopathic Scoliosis (AIS) that typically affects growing adolescent girls between the age of 10 to 16. If scoliosis deformity is not treated or improperly treated, it may deteriorate progressively leading to significant cosmetic problems and functional disabilities. Surveys show that the prevalence of AIS in Hong Kong is growing and higher than other countries. Despite extensive research, the etiology of AIS is still unclear. However, abnormal external loading is known to be one of the possible factors that may exacerbate the deformity. It is a common phenomenon in Hong Kong that the school bag carried by primary school students is quite heavy and disproportionate to their body sizes, and previous survey showed that the average school bag weight was well over the 'recommended' level of 10% of the Body Weight (BW). As an 'overweight' school bag can impose abnormal biomechanical and physiological stress on the spine and affect its growth, it is important to know whether this is associated with the growing prevalence of the AIS in Hong Kong.
Study showed scoliosis patients exhibit balance problem during the stance phase, but the effect of additional external load for AIS was still unknown. In this study, the effects of carrying weight in form of schoolbag on gait in children with AIS were examined and compared with normal age-matched controls. Five different weight schoolbags (0%, 7.5%, 10%, 12.5% and 15% BW) were used for examination in this study. This study was not aimed at the design of schoolbag, and the dummy schoolbag used was a two-strap backpack style, which was suggested to have minimum adverse effect on school children. The result shown that the effect of school bag loading was well demonstrated, but the gait pattern of the two groups was very similar. However if absolute value was taken into consideration, the AIS is always lower or inferior to the normal. That is, the effect of 7.5% BW or 10% BW on AIS was already comparable to the maximum loading effect on normal. It was also found that the latter walked slower with less extend movement in the pelvic and hip region. They tended to walk timidly without drastic change in the walking pattern even with the increasing load. From a clinician's viewpoint, this may due to the spinal deformity or psychological constraint of the AIS patients, thinking that vigorous movement may exacerbate the deformed spine. As load carrying when walk is a multidimensional paradigm, studies on static balance, cardiopulmonary function and muscle EMG are crucial in order to get a more comprehensive picture.

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