Subjective perceptions of load carriage on the head and back in Xhosa women

The purpose of this study was to compare the subjective perceptual responses to both head-loading and back-loading in a group of Xhosa women. Thirty two women were divided into three groups based on their experience of head-loading and walked on a treadmill on two occasions, head-loading and back-loading, at a self selected walking speed for 4 min with a variety of loads until pain or discomfort caused the test to be terminated or a load of 70% body mass was successfully carried. After each workload there was a 1 min rest period during which the women indicated feelings of pain or discomfort in particular areas of the body via visual analogue scales. At the end of each test the women were asked to complete further questionnaires relating to pain and discomfort and on completion of the second test were also asked to compare the two loading conditions. Finally the women were interviewed to establish their history of load carriage and associated pain and discomfort. The data indicate that whilst back-loading was generally associated with more areas of discomfort than head-loading, the pain and discomfort in the neck associated with head-loading was the predominant factor in the termination of tests and that this was independent of head-loading experience. This early termination meant that, on average, the women could carry greater loads on their backs than on their heads. The study suggests that further work needs to be carried out to establish viable alternatives to head-loading for rural dwellers in Africa.