Forefoot pressure response to selected backpack loads and carrying durations in adolescent school-going girls

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.