"Raise your hand if you have ever almost fallen backwards because your backpack pulled you down," an occupational therapy masters student asked a room full of about 200 kindergarten through sixth graders on Wednesday.

The students were participants in the 4th annual "Backpack Awareness Day" at St. Mary's School in Brookline.

Boston University occupational therapy students from Sargent College of Health and Rehabilitation Sciences partnered with the American Occupational Therapy Association to co-host the local event.

The goal of the day was to help educate Boston students and their parents about the potential health risks of wearing backpacks improperly, according to the AOTA pamphlet handed out to the audience members.

Professor Karen Jacobs, who teaches occupational therapy at BU, helped start the national backpack awareness initiative 10 years ago and has coordinated the annual event since.

Dr. Gloria Rudisch has attended the event since its inception.

As a Brookline Public School physician for 36 years, she said she saw kids come into her office with their backpacks every day.

"I tried to pick [the backpacks] up but I couldn't," she said. "[Backpacks] can cause serious back injuries and make backbones age faster," she said.

SAR graduate students staged a performance, which featured a character whose overly heavy backpack caused her to constantly fall down, to help raise awareness in a more student-friendly way.

"Your [backpack] is way too heavy! It was over 10 percent of my body weight, so I'm sure it is too heavy for you too," recited one SAR student who participated in the play.

SAR students also handed out key chains marked with the phrase, "I've got your back!" and coloring sheets of Rhett, the BU mascot, to St. Mary's students as they waited to weigh their backpacks to see if they were too heavy or not.

Jacobs said the kids were generally motivated for the event.

"By the third year, they are already looking forward to this day," she said, referring to the kids who have heard the talks

in the previous two years. "It is pretty unique to be able to learn about this."

Students had positive responses to the presentation.

"I think my backpack is the perfect weight and it's not too heavy any day," said first grader Naomi.

Fellow first grader Yapatt was very excited to show off his Mario Kart backpack, but said it weighed 30 lbs.

"Mine is much too heavy," he said.

St. Mary's School Principal Maureen Jutras told Jacobs and the SAR students that this year's event was the best backpack awareness presentation they'd ever had. Jutras also said Rudisch picked up a couple backpacks and noticed that they were much lighter.

"The energy today was amazing," Jacobs said. "The kids are never going to forget this experience. This is actually working."