Type of Article:  Original Research

Volume 5; Issue 1 (February 2017)

Page No.: 1824-1828

DOI: https://dx.doi.org/10.16965/ijpr.2016.199


Siddhartha Sen *1, Ajita D Singh 2.

*1 Research Scholar PhD, Punjabi University, Patiala, Punjab, India.

2 Associate Professor, Punjabi University, Patiala, Punjab, India.

Address for the correspondence: Dr. Siddhartha Sen. PT.,  Research Scholar PhD, Punjabi University, Patiala, Punjab, India. E-Mail: siddhartha.pt@gmail.com


Introduction: Backpack carriage is common among adults, schoolchildren and adolescents for daily transferring of personal belongings, laptops, books and stationeries to and from offices, colleges or schools. As the load of backpack is directly applied to the spine via the shoulder straps and external loading has been demonstrated to be associated with spinal disorders.

Purpose of the study is to find out the changes in head posture & shoulder by 2D method in collegiate student with backpack and side pack.

Materials and Methods: 105 subjects collegiate student were recruited to measure the head posture. Photograph of the cervicothoracic region were taken from side to measure craniovertebral angle and sagittal shoulder posture with loaded right side pack and left side pack.

Results: Comparison between individuals with side pack and without any pack in craniovertebral angle and sagittal shoulder posture was done using pared sample t test and the result showed significant differences. When comparison was done between different pack the results showed significant between back pack & right side pack and back pack & left side pack.

Conclusions: The subjects who were carrying load in side pack for prolonged past duration and presently 2 hours per day have decreased craniovertebral angle and produces forward head posture when compared with no pack and sagittal shoulder angle increases which produces rounded shoulder posture.

Key words: Side pack, craniovertebral angle, sagittal shoulder posture, musculoskeletal disorders.


  1. Korovessis P, Koureas G, Zacharatos S, Papazisis Z. Backpacks, back pain, sagittal spinal curves and trunk alignment in adolescents: a logistic and multinomial logistic analysis. spine. 2005;30:247-55.
  2. De Paula AJF, Silva JCP, Paschoarelli LC, Fujii JB. Backpacks and school children’s obesity: challenges for public health and ergonomics. work. 2012;41(Suppl 1):900-6.
  3. Mackie HW, Legg SJ, Beadle J, Hedderley D. Comparison of four different backpacks intended for school use. Applied Ergonomics. 2003;34:257-64.
  4. Grimmer K, Williams MT, Gill TK. The Associations between Adolescent Head-on-Neck Posture, Backpack Weight, and Anthropometric Features. Spine. 1999;24(21):2261-7.
  5. Javadivala Z, Allahverdipour H, Dianat I, Bazargan M. Awareness of parents about characteristics of a healthy school backpack. Health Promotion Perspectives. 2012;2:166-72.
  6. McIntosh SE, Leemon D, Visitacion J, Schimelpfenig T, Fosnocht D. Medical incidents and evacuations on wilderness expeditions. Wilderness & Environmental Medicine. 2007;18(4):298-304.
  7. Haisman MF. Determinants of load carrying ability. Applied Ergonomics. 1988;19(2):111-21.
  8. Mohamed Z. Ramadan, Al-Shayea AM. A modified backpack design for male school children. International Journal of Industrial Ergonomics. 2013;43:462-71.
  9. Swinkels A, Dolan P. Regional assessment of joint position sense in the spine. spine. 1998;23:590-7.
  10. Matthews PB. Proprioceptors and their contribution to somatosensory mapping: complex messages require complex processing. Canadian journal of physiology and pharmacology. 1988;66:430-8.
  11. Bygrave S, Legg SJ, Myers S, Llewellyn M. Effect of backpack fit on lung function. Ergonomics. 2004;47:324-9.
  12. Hong Y, Li JX, Fong DT. Effect of prolonged walking with backpack loads on trunk muscle activity and fatigue in children. J Electromyogr Kinesiol. 2007.
  13. Sally Raine, lance Twomey. Posture of the head, shoulders and thoracic spine in comfortable erect standing. Australian Journal of Physiotherapy. 1994;40:25-32.
  14. Lewis J, Green A, Reichard Z, Wright C. Scapular position: the validity of skin surface palpation. Manual Therapy. 2002;7(1):26-30.
  15. Raine S, Twomey LT. Head and shoulder posture variations in 160 asymptomatic women and men. Arch Phys Med Rehabil. 1997;78:1215-23.
  16. Braun BL, Amundson LR. Quantitative assessment of head and shoulder posture. Arch Phys Med Rehabil. 1989;70(4):322-9.
  17. Pascoe DD, Pascoe DE, Wang YT, Shim D-M, and Kim CK. Influence of carrying book bags on gait cycle and posture of youths. . Ergonomics. 1997;40:631-41.
  18. Pheasant S. Bodyspace: Anthropometry, Ergonomics and Design. london: Taylor & Francis; 1986.
  19. Kolehmainen A, Harms-Ringdahl K, and Lanshammart H. Cervical spine positions and load moments during bicycling with different handlebar positions. Clinical Biomechanics. 1989;4:105-10.
  20. Fiolkowski P, Horodyski M, Bishop M, Williams M, Stylianou L. Changes in gait kinematics and posture with the use of a front pack. Ergonomics. 2006;49(9):885-94.
  21. Wilson VJ, Boyle R, Fukushima K, Rose PK, Shinoda Y, Sugiuchi Y. The vestibulocollic reflex. . Journal of Vestibular Research. 1995;5:147-70.
  22. Peterson BW, Goldberg J, Bilotto G, Fuller JH. Cervicocollic reflex: its dynamic properties and interaction with vestibular reflexes. Journal of Neurophysiology. 1985;54:90-109.
  23. Morningstar M, Strauchman M, Gilmour G. Idiopathic scoliosis treatment using the pettibon corrective procedures: A case report. Journal of Chiropractic Medicine. 2004;3:96-103.
  24. Grimmer K, Dansie B, Milanese S, Pirunsan U, Trott P. Adolescent standing postural response to backpack loads: a randomised controlled experimental study. BMC Musculoskeletal Disorders. 2002;3:10.
  25. Hong Y, Cheung C. Gait and posture responses to backpack load during level walking in children. Gait and Posture. 2003;17:28-33.
  26. Bendix T. Seated trunk posture at various seat inclinations, seat heights and table heights’ Human Factors. 1986;26:695-703.
  27. Chansirinukor W, Grimmer WK, Dansie B. Effects of Backpacks on Students: Measurement of Cervical and Shoulder Posture. The Australia Journal of Physiotherapy. 2001;47(2):110-6.
  28. Williams GR, Shakil M, Klimkiewicz J. anatomy of the scapulothoracic articulation. Clin Orthop. 1999;359:237-46.

Cite this article: Siddhartha Sen, Ajita D Singh. CHANGES IN HEAD & SHOULDER POSTURE OF COLLEGIATE STUDENTS CARRYING LAPTOP BAG AS SIDE PACK. Int J Physiother Res 2017;5(1):1824-1828. DOI: 10.16965/ijpr.2016.199