Relationship between School Backpacks and Musculoskeletal Pain in Children 8 to 10 Years of Age: An Observational, Cross-Sectional and Analytical Study
Round 1
Reviewer 1 Report
The study is well designed and presents important information related to school backpacks in 8-10-year group children.
I have some comments.
Materials and methods. The prelavence of pain is missing a reference (line 84).
Results. Include TV and video games (line 198). How was the cardiovascular demand assess?
Discussion. The limitations should be more accurately presented. The indications for the future research may be described as recommendations.
Conclusions. The conclusions must be rephrased pointing out the main findings of the study.
Author Response
Please see the attachment.
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Thank you for submitting this interesting and very relevant article. The abstract would benefit from a summary and/or recommendations statement at the end and also reference to the recommended maximum in the body of the text of the abstract.
Line 27 'and it seems' would be better
Line 43 with cervical and shoulder pain
Avoid excessive use of ; as this makes the text disjointed.
Line 45 clarify it is the weight of the back pack
Line 61 clarify what the other group did i.e. was it carried on their back ?
Line 72 method is the correct work not methodologies
Line 80 you use the word collaborate do you mean co-operate?
Line 82 this is the first mention or pressure pain threshold I suggest you refer to it on the background
Line 88/89 you refer to activity level in the abstract but not here.
You need to refer to reliability and validity of all the measures you are taking
Line 96 Re word the information was collected by Researcher (supply initials)
Provide justification of choice or areas for measuring the pressure pain threshold
Line 120-122 you need to name the questionnaires
Line 124-26 I would expect reference to to an information sheet
Line 135 Detail what anthropometric data was collected
Line 138 is this correct that the student did not complete the questionnaires -that the student was interviewed and then the researcher completed the questionnaires ? This poses issue regrading bias ensure this is in the limitations if my interpretation is correct
Where there any attempts at standardisation of the placement of the algometer ?
Line 188 justify why the majority of back packs were too large --does this mean too heavy ? needs clarification
The Discussion covers all the main areas
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
All my comments were answered.
Author Response
Thank you for the corrections.
Reviewer 2 Report
Abstract :
Line 10 Should be in present not past tense. Back pain in children is a reality and various factors are involved
Line 14 should say and their physical activity
Line 15 would be better saying The results indicated that all backpacks .....
Line 18 19 you need to indicate where the Pressure pain thresholds were collected from -just give general details
Line 22 It's not clear what the term biopsychsocial refers to in this context as the study does not really gather data on this in totality.
Main paper
Line 48/49 this is an odd place to reference to Pressure pain thresholds. I suggest you need to find a paper that does use Algometry to measure PPT and refer to it. It may not be in the same context i.e. backpacks and children but that is not a problem it just needs to be in a study related back pain.
Line 51 Starts with For this reason --however the text following does't necessarily link to the last sentence of previous paragraph. If you place the section on algometry somewhere else it may link better.
Line 54 55 say muscles chosen for examination but doesn't say in what way-
I suggest delete these 4 words and add tot eh section on algometry
Line 68-71 This is a repetitive and longwinded collection of phrases- re write into a more succinct clear hypotheses
Line 111 Sentence start with Has. please clarify what has and reword.
Line 130 suggest remove brackets and say lifestyle habits including mode of travel to School....
Line 162 Reference needed for the use of the muscle belly as the point to measure PPT.
Line 206 Reference needed to support statement about the size of back pack
Line 398 399 Point 3 referring algometery doesn't make sense please rephrase
Lin3 399 I suggest deleting point 4 ore rephrase to say if the study/topic needs doing again it needs to be conducted with larger sample size
Line 409. You say very few children carry their back packs with handles but you need to clarify how they do carry them
Author Response
Please see the attachment.
Author Response File: Author Response.pdf
