Forefoot pressure response to selected backpack loads and carrying durations in adolescent school-going girls
DOI:
https://doi.org/10.47197/retos.v73.116959Keywords:
Forefoot pressure, adolescent girls, backpack load, carrying duration, maximum pressure, foot loadingAbstract
Introduction: Carrying heavy school backpacks has been recognized as a common source of biomechanical stress among children. The forefoot, serving as the primary point of propulsion during walking, frequently experiences the highest pressure. Adolescent girls may be particularly susceptible due to ongoing musculoskeletal development and lower load tolerance during growth.
Objective: To assess the effects of selected backpack loads and walking durations on maximum pressure at the forefoot in adolescent school-going girls using a repeated measures design.
Methodology: Sixty-nine girls aged 10 to 16 years participated in the study. Maximum forefoot pressure was recorded using a pressure plate system across six selected backpack loads and seven walking durations. Descriptive statistics and repeated measures analysis were performed to examine the effects of load, time, and side of the foot.
Results: Backpack load had a statistically significant effect on maximum forefoot pressure, and a significant interaction was found between load and time, indicating a cumulative effect. Walking duration alone and foot side did not show significant effects; however, side and load interaction suggested condition-specific differences.
Discussion: The findings suggested that increasing mechanical demands from heavier loads led to adaptive changes in forefoot loading patterns. The cumulative stress reflected compensatory responses to sustained external weight, highlighting the forefoot’s vulnerability during growth and its potential link to long-term musculoskeletal strain.
Conclusions: The study concludes that appropriate backpack load management and periodic gait assessments are essential to reduce excessive forefoot pressure.
References
Ahmad, H. N., & Barbosa, T. M. (2019). The effects of backpack carriage on gait kinematics and kinetics of school children. Scientific Reports, 9(1), 3364. https://doi. org/10.1038/s41598-019-40076-w
Balkó, Š., Tufano, J. J., Jelínek, M., Svoboda, Z., Błaszczyszyn, M., & Vaverka, F. (2022). Influence of school backpack load on plantar foot pressure during walking in 9–11 years old girls. Central European Journal of Public Health, 30(3), 185-189. https://doi.org/10.21101/cejph.a7109
Barbosa, J., Marques, M. C., Neiva, H. P., Santos, C., Branquinho, L., Ferraz, R., & Marinho, D. A. (2021). Impact of overloaded school backpacks: an emerging problem. The Open Sports Sciences Jour-nal, 14(1).
Bukowska, J. M., Jekiełek, M., Kruczkowski, D., Ambroży, T., Rydzik, Ł., Spieszny, M., & Jaszczur-Nowicki, J. (2021). Podiatric and Stabilographic Examinations of the Effects of School Bag Car-rying in Children Aged 11 to 15 Years. Applied Sciences, 11(19), 9357. https://doi.org/10.3390/app11199357
Castro, M., Abreu, S., Sousa, H., Machado, L., Santos, R., & Vilas-Boas, J. P. (2013). Ground reaction forc-es and plantar pressure distribution during occasional loaded gait. Applied ergonomics, 44(3), 503-509. https://doi.org/10.1016/j.apergo.2012.10.016
Cavanagh, P. R., & Lafortune, M. A. (1980). Ground reaction forces in distance running. Journal of bio-mechanics, 13(5), 397-406.
Chansirinukor, W., Wilson, D., Grimmer, K., & Dansie, B. (2001). Effects of backpacks on students: measurement of cervical and shoulder posture. Australian Journal of physiotherapy, 47(2), 110-116.
Chow, D. H., Kwok, M. L., Au-Yang, A. C., Holmes, A. D., Cheng, J. C., Yao, F. Y., & Wong, M. S. (2005). The effect of backpack load on the gait of normal adolescent girls. Ergonomics, 48(6), 642-656. https://doi.org/10.1080/00140130500070921
De Paula, A. J. F., Silva, J. C. P., & Silva, J. C. R. P. (2015). The influence of load imposed by the backpack school in children and teens in Brazil. Procedia Manufacturing, 3, 5350-5357. https://doi.org/10.1016/j.promfg.2015.07.645
Fang, Q. (2018). Comparisons of foot pressure between teenager girls and young female adults. Physical Activity and Health, 2(1). https://doi.org/10.5334/paah.9
Grimmer, K., Dansie, B., Milanese, S., Pirunsan, U., & Trott, P. (2002). Adolescent standing postural re-sponse to backpack loads: a randomised controlled experimental study. BMC musculoskeletal disorders, 3, 1-10. https://doi.org/10.1186/1471-2474-3-10
Guo, P., Zhang, X., Xu, H., Wang, R., Li, Y., Xu, C., Yang, Y., Zhang, L., Adams, R., Han, J., & Lyu, J. (2024). Evaluating plantar biomechanics while descending a single step with different heights. Frontiers in Bioengineering and Biotechnology, 12. https://doi.org/10.3389/fbioe.2024.1431988
Hasbiah, H., Hendrik, H., Tandi, M. S., Hakim, S., Halimah, A., & Arpandjam’an, A. (2025). Carrying ba-ckpacks causes postural problems in primary school students. Retos, 67, 1067-1074. https://doi.org/10.47197/retos.v67.111737
Hennig, E. M., Staats, A., & Rosenbaum, D. (1994). Plantar pressure distribution patterns of young school children in comparison to adults. Foot & ankle international, 15(1), 35-40. https://doi.org/10.1177/107110079401500107
Husain, R., Mola, D. W., & Shaw, D. (2024a). Effect of selected backpack loads carried for selected du-rations on temporal pattern of peak forces of walking gait of school-going boys. International Journal of Kinesiology and Sports Science, 12(4), 48-56. http://dx.doi.org/10.7575/aiac.ijkss.v.12n.4p.48
Husain, R., Mola, D. W., & Shaw, D. (2024b). Understanding the Effects of Selected Backpack Loads Carried for Certain Durations on Peak Forces of Walking Gait in School-Going Boys. Journal of Learning Theory and Methodology, 5(3), 144-152. https://doi.org/10.17309/jltm.2024.5.3.08
Hutton, W. C., & Dhanendran, M. (1979). A study of the distribution of load under the normal foot dur-ing walking. International orthopaedics, 3, 153-157. https://doi.org/10.1007/BF00266887
Jenčíková, K., Kasović, M., & Zvonař, M. (2024). The effects of a school bag load carriage on gait kine-matics in children: a school-based study. Kinesiology, 56(2), 189-197.
Kasović, M., Zvonar, M., Gomaz, L., Bolčević, F., & Anton, V. (2018). The influence of a school bag car-riage on the pattern changes in plantar pressure during walking among schoolchildren in the first grade. Kinesiology, 50(2), 188-193. https://doi.org/10.26582/k.50.2.14
Koenraadt, K. L., Stolwijk, N. M., van den Wildenberg, D., Duysens, J., & Keijsers, N. L. (2012). Effect of a metatarsal pad on the forefoot during gait. Journal of the American Podiatric Medical Associ-ation, 102(1), 18-24.
Laštro, D., Muftić, M., Ponorac, N., Talic, G., & Janković, S. (2021). Short-term effects of carrying a school bag on the distribution of force and plantar pressure during walking of children of dif-ferent levels of physical activity. Journal of Health Sciences, 11(2), 122-129. https://doi.org/10.17532/jhsci.2021.1329
Lehnen, G. C., Magnani, R. M., Sá e Souza, G. S. D., Rodrigues, F. B., Andrade, A. D. O., & Vieira, M. F. (2017). Effects of backpack loads and positions on the variability of gait spatiotemporal pa-rameters in young adults. Research on Biomedical Engineering, 33, 277-284.
Liew, B., Morris, S., & Netto, K. (2016). The effect of backpack carriage on the biomechanics of walk-ing: A systematic review and preliminary meta-analysis. Journal of applied biomechan-ics, 32(6), 614-629. https://doi.org/10.1123/jab.2015-0339
Paez-Moguer, J., Montes-Alguacil, J., Garcia-Paya, I., Medina-Alcantara, M., Evans, A. M., & Gijon-Nogueron, G. (2019). Variation of spatiotemporal parameters in school children carrying dif-ferent backpack loads: a cross sectional study. Scientific reports, 9(1), 12192.
Palumbo, N., George, B., Johnson, A., & Cade, D. (2001). The effects of backpack load carrying on dy-namic balance as measured by limits of stability. Work, 16(2), 123-129.
Pau, M., Corona, F., Leban, B., & Pau, M. (2011a). Effects of backpack carriage on foot–ground relation-ship in children during upright stance. Gait & posture, 33(2), 195-199. https://doi.org/10.1016/j.gaitpost.2010.10.096
Pau, M., Leban, B., & Pau, M. (2013). Alterations in the plantar pressure patterns of overweight and obese schoolchildren due to backpack carriage. Journal of the American Podiatric Medical As-sociation, 103(4), 306-313. https://doi.org/10.7547/1030306
Pau, M., Leban, B., Corona, F., Gioi, S., & Nussbaum, M. A. (2015b). School-based screening of plantar pressures during level walking with a backpack among overweight and obese schoolchil-dren. Ergonomics, 59(5), 697-703.
Pau, M., Mandaresu, S., Leban, B., & Nussbaum, M. A. (2015a). Short-term effects of backpack carriage on plantar pressure and gait in schoolchildren. Journal of Electromyography and Kinesiolo-gy, 25(2), 406-412. https://doi.org/10.1016/j.jelekin.2014.11.006
Perrone, M., Orr, R., Hing, W., Milne, N., & Pope, R. (2018). The impact of backpack loads on school children: A critical narrative review. International journal of environmental research and pub-lic health, 15(11), 2529.
Sokhi, S. S., Shaw, D., Singh, D., Murtaza, S., & Andrabi, H. (2022). Effect of back pack loads carried for extended time durations on mean pressure on the plantar aspect of the foot of school going children’s gait (a descriptive approach). Int J Phys Educ Sports Health, 9(2), 365-9.
Van Alsenoy, K., Thomson, A., & Burnett, A. (2019). Reliability and validity of the Zebris FDM-THQ in-strumented treadmill during running trials. Sports biomechanics, 18(5), 501–514. https://doi.org/10.1080/14763141. 2018.1452966
Wafai, L., Zayegh, A., Woulfe, J., Aziz, S. M., & Begg, R. (2015). Identification of Foot Pathologies Based on Plantar Pressure Asymmetry. Sensors, 15(8), 20392-20408. https://doi.org/10.3390/s150820392
Wang, Y. “Tai,” Pascoe, D. D., & Weimar, W. (2001). Evaluation of book backpack load during walk-ing. Ergonomics, 44(9), 858–869. https://doi.org/10.1080/00140130118572
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Rabiya Husain, Pawan Kumar, Virender Singh Jaggi, Dhananjoy Shaw

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
- Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).
This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.