The consequence of head-loading on the neuro-musculoskeletal health of the ILembe District youth of KwaZulu-Natal

ABSTRACT

Background: Head-loading, as a mode of transporting food, water and firewood, is a longstanding tradition assigned to female South African youth and has been associated with adverse health consequences. Objectives: This study determined the impact of head-loading on the neuromusculoskeletal health and proprioception of female South African youth. Method: This study comprised a counterbalanced, within-subject, single-factor experimental design which compared the changes that occurred when the same independent variable (head-loading) within two homogenous groups was measured in terms of the dependent variables (outcomes: neuromusculoskeletal pain and proprioception) at two time periods, before and after the introduction of the independent variable. A cohort of South African female youth (n = 100), aged 9­17 years, voluntarily partook in the study. The participants were randomly distributed into an experimental (n = 50) and a control (n = 50) group. The experimental group stood in a head-loaded state with their respective habitual head-load mass. Their proprioception measurements were compared during their unloaded versus loaded states, with the proprioceptive measurements including the total proprioception index, the anterior­posterior (front­back) index and the medial­lateral (side-to-side) index. Participants furthermore completed a head-loading health-related questionnaire. Results: Participants had a mean age of 12.3 ± 2.5 years, body mass of 44.4 ± 13.7 kg, stature of 145 ± 10 cm and a head-load mass of 8.0 ± 2.5 kg. Participants had poorer medial­lateral proprioception during head-loading as compared to their unloaded state (1.4 ± 0.8 as compared to 1.6 ± 0.9) (p < 0.05). Most youth (96%) experienced neuromusculoskeletal pain in their cervical vertebrae (40.9%), shoulders (27.3%), lumbar vertebrae (10.7%), arms (8.3%), legs (8.3%), knees (1.9%), fingers (1.5%), toes (0.5%) and thoracic vertebrae (0.5%) (χ2 p < 0.05). Conclusion: Head-loading adversely affects the medial­lateral proprioception and neuromusculoskeletal health of participants.