Effects of load carriage on children with scoliosis

Scoliosis is a lateral spinal deformity. Despite extensive research, the etiology of scoliosis is still unclear. However, abnormal external loading is known to be one of the possible factors that may exacerbate the deformity. As load carriage is common for schoolchildren, it has been a concern whether an 'overweight' schoolbag would impose abnormal biomechanical and physiological stress on the spine. A series of investigations were conducted to compare the effects of backpack carriage on pulmonary function, standing posture and balance as well as gait performance in children with and without scoliosis. Pulmonary function and balance control in both standing and walking were found to be adversely affected by increased backpack weight. The effects of backpack carriage on children with and without scoliosis were similar. However, pulmonary function and stability control of children with scoliosis were consistently poorer than normal. The results of these studies showed that the limit of backpack weight recommended for normal children based on the changes in biomechanical and physiological measures might not be applicable for those with scoliosis. However, there is still a lack of evidence whether carrying backpack would accelerate curve progression in children with scoliosis. Further investigation is warranted to address this question.