INTRODUCTION

The evidence of the existence of degenerative changes in the spine, namely scoliosis, hyperkyphosis and hyperlordosis at various stages of growth, alerts to the importance and urgency of early intervention^2-3, through "School Health" with actions aimed at the school community towards the implementation of health promotion proposals¹¹.

Thus, it is considered that the school period is essential to work on health from the perspective of its promotion, where the discipline of Nursing, namely the specialist nurse in Rehabilitation, can develop actions for the prevention of diseases and for the strengthening of protective factors.

The National School Health Program (2015-2020) states that musculoskeletal injuries in students result from physical overload associated with excess weight in backpacks, the adoption of incorrect postures and due to inadequate sports activity⁴.

The regular use of school backpacks, often heavy and/or unfit, which hold manuals and materials for the entire school day, presents a multiplicity of risks, including postural changes and back pain¹, especially during the period of growth of the child^12-13.

Since 1977, there has been scientific reference regarding the percentage of weight that a child must carry in the school bag, which should not exceed 10% of their body weight, ie, the maximum acceptable limit will be 1/8 of their body weight⁵.

Since then, this value has been accepted by the scientific community^12-13, although there are studies that contrast this percentage, suggesting other values, such as 7.4%⁶ or even a non-specific interval between 5 and the 15% depending on the child's gender⁷, or even mentioning that it is not appropriate to suggest the same backpack weight limit for all children, that is, a single weight limit may not be suitable for all students⁸.

Currently, in Portugal it is suggested by the General Directorate for Health that the weight of backpacks, briefcases and similar items and their contents should not exceed 10% of the child's body weight⁴.

As seen, the percentage of weight of the recommended school backpack is not unanimous, and this problem involves a multifactorial complexity, transversal to several areas where knowledge about anatomy, biomechanics and pathophysiology of the spine provide ergonomic and postural guidance for the activities of the daily life⁴, which should deserve the full attention of the school community and a more in-depth literature review, since after conducting preliminary research at the Joanna Briggs Institute (JBI) Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews, in the Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCO, and in the Medical Literature Analysis and Retrieval System Online (MEDLINE), via PubMed, no literature reviews were found published in this thematic area.

In this sense, it is proposed to carry out this scoping review with the general objective of mapping the evidence in relation to the maximum backpack weight recommended for children aged 6 to 12 years in a school context, seeking to answer the question: what is the maximum backpack weight recommended for children (6-12 years-old) in a school setting?

MÉTHODS

In order to deepen the knowledge on this subject, this scoping review protocol will adopt the methodology suggested by (JBI), described by The JBI Reviewers’ Manual⁹. This method is intended to provide a map of the scope of available evidence, when a specific issue is not clear.

Data Mapping

The extracted data will be presented in the form of a PRISMA diagram (figure 1).

Figure 1 PRISMA diagram of the study selection process. Porto, Portugal, 2018 

PRESENTATION AND DISCUSSION OF RESULTS

A narrative summary will accompany the tabulated and/or diagram results and describe how they relate to the objectives and the starting question.

A data presentation table will be developed specifically for this mapping. However, it can be refined during the review process.

The mapping of the maximum recommended backpack weight for children aged 6 to 12 in a school context will contribute to the dissemination of available evidence on the subject.

CONCLUSION

The School, in addition to having a specific pedagogical function, has a social and political nature aimed at transforming society, related to the exercise of citizenship and access to development and learning opportunities, reasons that justify actions aimed at the school community, responding to health promotion needs¹⁰.

Health promotion by specialist nurses in Rehabilitation Nursing in School Health should take as a starting point the real needs of the school population, developing teaching and learning processes that improve academic results, in order to contribute to raising the level of literacy in health and improving the lifestyle of the educational community⁴.

With the synthesis of research results, through the scoping review methodology, it will be possible to see the percentage of maximum backpack weight recommended for children (6-12 years-old) in the school context, in order to promote the incorporation of scientific evidence in professional practice of Nursing, more specifically in the Rehabilitation specialty.

With this literature review, it will allow the future transfer of knowledge by highlighting aspects inherent to the maximum backpack weight recommended for children aged 6 to 12 years-old in a school context, according to the scientific literature on the subject.

As a strategy of differentiation in the promotion of School Health, it is essential to link knowledge from research in clinical practice, so it is expected that this scoping review will constitute a preliminary exercise that justifies the development of systematic reviews on effectiveness of some practices in the promotion of healthy postural habits in the school context.