The influence of smartphone use on spinal posture - A laboratory study

Does Texting While Walking Affect Gait's Plantar Pressure Parameters?

BACKGROUND

This study aims to examine the possible effects of mobile phone use on plantar pressure and spatiotemporal parameters during walking.

MATERIALS AND METHODS

Thirty volunteers (18 males and 12 females) participated in the study. A 10-m walking path was prepared, and a messaging connection was established. They were asked to write three posts without word or character mistakes and participants walked on the path walk as much as they wanted on the trail to make sure they were walking at their own pace. The gait's spatiotemporal parameters and plantar pressure parameters were recorded while walking. A paired samples t-test was used to determine whether there was a difference between normal walking and walking while texting.

RESULTS

While walking and writing a message, cadence, speed, and step length decreased significantly (P < 0.05). In the plantar pressure parameters, the fore- and midfoot load and pressure were significantly increased (P < 0.05).

CONCLUSIONS

Compared to normal walking, the forces on the forefoot and midfoot and the pressure per unit area increased in walking while texting. It is thought that the pace of walking slows down, and focus and attention shift to the front of the body.

A Preliminary Diagnostic Model for Forward Head Posture among Adolescents Using Forward Neck Tilt Angle and Radiographic Sagittal Alignment Parameters

Despite numerous attempts to correct forward head posture (FHP), definitive evidence-based screening and diagnostic methods remain elusive. This study proposes a preliminary diagnostic methodology for FHP, utilizing a noninvasive body angle measurement system as a screening test for FHP and incorporating radiological parameters for sagittal alignment. We enrolled 145 adolescents for FHP screening. The forward neck tilt angle (FNTA), defined as the angle between the vertical line and the line connecting the participant's acromion and tragus, was measured using the POM-Checker (a noninvasive depth sensor-based body angle measurement system). A whole-spine standing lateral radiograph was obtained, and eight sagittal alignment parameters were measured. Statistical analyses of the association between the FNTA and eight sagittal alignment parameters were conducted. We used 70% of the participant data to establish a preliminary diagnostic model for FHP based on FNTA and each sagittal alignment parameter. The accuracy of the model was evaluated using the remaining 30% of the participant data. All radiological parameters of sagittal alignment showed weak statistical significance with respect to FNTA (best case: r = 0.16, p = 0.0500; cranial tilt). The proposed preliminary diagnostic model for FHP demonstrated 95.35% agreement. Notably, the model using FNTA without radiological parameters accurately identified (100%) participants who required radiographic scanning for FHP diagnosis. Owing to the weak statistical significance of the association between radiological parameters and external body angle, both factors must be considered for accurate FHP diagnosis. When a clear and severe angle variation is observed in an external body angle check, medical professionals should perform radiographic scanning for an accurate FHP diagnosis. In conclusion, FNTA assessment of FNTA through the proposed preliminary diagnostic model is a significant screening factor for selecting participants who must undergo radiographic scanning so that a diagnosis of FHP can be obtained.

Smartphone Use-Influence on Posture and Gait during Standing and Walking

Prolonged gaze at a smartphone is characterized by pronounced flexion of the cervical spine and is associated with health risks. In addition, it is suspected that smartphone distraction could lead to gait changes. Therefore, the aim of this study was to detect smartphone-associated postural changes at thoracic and lumbar levels as well as gait changes. Spinal analysis was performed prospectively in 21 healthy men using the DIERS 4Dmotion®Lab in a controlled crossover design to evaluate posture-associated parameters while standing and walking. The examination sequence provided three randomized gaze directions: GN = Gaze Neutral; S1H = Smartphone one-handed; S2H = Smartphone two-handed. Results reveal a higher vertebra prominens (VP)-flexion in S1H (23.8° ± 6.9°; p ≤ 0.001) and S2H (22.4° ± 4.7°; p ≤ 0.001) compared to GN (17.6° ± 3.8°). Kyphosis angles were also different with higher values observed in S1H (58.8° ± 5.8°; p ≤ 0.001) and S2H (61.6° ± 4.9°; p ≤ 0.001) compared to GN (49.1° ± 4.6°). During walking, similar results were observed in kyphosis angles. No differences were observed in gait during smartphone use (p = 0.180-0.883). The study revealed a significantly increased inclination of the lower cervical and thoracic spine during smartphone use. However, the inclination was larger during S2H. Standing or walking conditions did not affect the measurement outcomes. Long-term smartphone use associated with a larger inclination of the cervical and thoracic spine might result in increased pressure and shear forces acting on vertebral bodies, intervertebral discs, and muscles, which potentially increases the risk of spinal pain and disease.

Severity of slouched posture during smartphone use is associated with the musculoskeletal discomfort, daily usage, and school year among adolescents

Real-time measurement of the craniovertebral, thoracic kyphosis, and lumbar lordosis angles during natural and smartphone usage postures in sitting were analysed in a cohort of 560 adolescents using independent t-tests and Spearman's correlations between their reported musculoskeletal symptoms, daily device use and school year. Students with musculoskeletal symptoms (mean difference: 4.1-9.4°, p < .001) and in secondary schools (mean difference: 13.6-29.4°, p < .001) had a greater forward-head posture quantified by craniovertebral angle in both postures. Loss of lumbar lordosis was found in students spending ≥2 h/day on electronic devices (mean difference: 3.2°, p = .029) and those with musculoskeletal symptoms (mean difference: 5.4°, p = .001). Secondary school students exhibited a greater thoracic kyphosis when using smartphones (mean difference: 3.3°, p = .003). Findings suggest the urgent need for early and proactive intervention targeted to minimise the risk of developing musculoskeletal disorders related to intense device use for young adolescents.Practitioner Summary: Adolescents: (1) in higher school year had increased forward-head posture (FHP) and thoracic kyphosis; (2) with musculoskeletal symptoms had increased FHP and loss of lumbar lordosis, and; (3) with extended device use had a loss of lumbar lordosis. Early intervention targeting young adolescents promoting optimal posture and habit of device use is warranted.

Risk factors associated with the prevalence of neck and shoulder pain among high school students: a cross-sectional survey in China

BACKGROUND

After the COVID-19 outbreak, many Chinese high school students have increased their dependence on electronic devices for studying and life, which may affect the incidence of neck and shoulder pain (NSP) in Chinese adolescents.

METHODS

To evaluate the prevalence of NSP in high school students and its associated risk factors during COVID-19, a survey was conducted among 5,046 high school students in Shanghai, Qinghai, Henan and Macao during the second semester and summer vacation of the 2019-2020 academic year. The questionnaire included questions regarding demographic characteristics, the prevalence of NSP and lifestyle factors such as sedentary behavior, poor posture and electronic device usage. Univariable and multivariable logistic regression was used to analyze the possible influencing factors for neck and shoulder pain.

RESULTS

A total of 4793 valid questionnaires (95.0%) were collected. The results indicated that the prevalence of NSP was 23.7% among high school students. Binary logistic regression analysis revealed that female gender (P < 0.05, OR = 1.82), grade (P < 0.05, range OR 1.40-1.51) and subject selection (P < 0.05, range OR 0.49-0.68) were risk factors for NSP in high school students. Sedentary behavior (P < 0.05, range OR 1.74-2.36), poor posture (P < 0.05, range OR 1.19-2.56), backpack weight (P < 0.05, range OR 1.17-1.88), exercise style and frequency (P < 0.05, range OR 1.18-1.31; P < 0.05, range OR 0.76-0.79, respectively), and the time spent using electronic devices (P < 0.05, range OR 1.23-1.38)had a significant correlation with NSP in high school students.

CONCLUSIONS

NSP is currently very common among high school students during the outbreak of COVID-19. Sedentary behavior, poor posture and other factors have a great impact on the occurrence of NSP in high school students. Education regarding healthy lifestyle choices should be advocated for to decrease NSP among high school students, such as more physical activity, changing poor postures and reducing the amount of time spent using electronic devices.

Smartphones and Learning: Evaluating the Focus of Recent Research

The smartphone has become integral to most aspects of students' lives and is the primary conduit for accessing the internet. Objective research into the promise and dangers of this device is critical. While educational uses of the smartphone with young adults hold promise, the potential for harm is also present. While objectivity is valued, the focus of researchers can subjectively skew towards optimistic or pessimistic views of technology. The topics addressed in smartphone and learning research illuminate trends and potential biases in the field. This study investigates the issues addressed in smartphone and learning research in the past two years. These topics are compared with smartphone research in a similar field: psychology. The study, using a bibliometric approach, identified an overall negative arc of the literature towards topics such as addiction, depression, and anxiety in the psychology literature. The educational literature topics were comparatively more positive than psychology. Highly cited papers in both fields reflected explorations of adverse outcomes.

Does Smartphone Use Really Impact Cervical Rotation and Cervical Proprioception in Asymptomatic Individuals?

Background and objective Smartphone use has increased exponentially over the last two years worldwide. The outbreak of the coronavirus disease 2019 (COVID-19) pandemic led to significantly higher dependence on the smartphone for information exchange and communication among the general public. Currently, India has hundreds of millions of smartphone users, and their numbers are on the rise. This has raised concerns regarding the adverse effects of smartphone use on mental and musculoskeletal health. In light of this, this study aimed to determine and evaluate the musculoskeletal consequences of smartphone use. Method A total of 102 participants (50 adolescents and 52 adults) who were smartphone users and are asymptomatic for cervical spine-related disorders were included based on convenience sampling. The components assessed were cervical rotation using tape measurement and cervical proprioception using the head repositioning accuracy test. Frequency distribution tables and text were used to report the results. Results The results of this research indicated reduced cervical rotation range and cervical proprioception deficits in both adolescent and adult smartphone users. Furthermore, no correlation was found between cervical rotation (right and left) and cervical proprioception (right and left rotation). Conclusion Though the results showed that both the individual components - cervical rotation and cervical proprioception - were significantly affected, there was no correlation between the components, which indicates that these asymptomatic individuals who are marginally excessive smartphone users are at increased risk for reduced cervical mobility and deficits in cervical proprioception.

The association between problematic smartphone use and the severity of temporomandibular disorders: A cross-sectional study

Objective

To evaluate the prevalence of different types of temporomandibular disorders (TMD) symptoms in young adults and determine their associations with problematic smartphone use (PSU).

Methods

The data of the study were collected from local university students through an online questionnaire survey. Demographic information, Fonseca Anamnestic Index (FAI), Smartphone Addiction Scale-Short Version (SAS-SV), and Patient Health Questionnaire-4 (PHQ-4) responses were gathered electronically and analyzed using multiple logistic regression analysis.

Results

There were 163 male and 307 female respondents were participated in this study. The prevalence of PSU and TMD were 83.6% and 66.4%, respectively. There was a moderate statistical correlation between PSU and TMD among young adults (r = 0.31, p < 0.01). The logistic regression model revealed that the risk of TMD was 1.77 times higher in people with PSU than in those without PSU (OR = 1.77; 95% CI 1.04-3.06). PSU is a risk factor for pain-related TMD (OR = 1.81; 95% CI 1.08-3.04) but not intra-articular TMD.

Conclusion

Subjects showed high prevalence of both TMD and PSU. People with PSU experienced more severe and frequent pain-related rather than intra-articular TMD symptoms than those without PSU. By reducing the problematic smartphone use, the risk factor of TMD might be avoided.

The Italian version of the mobile phone problematic use scale for adults (MPPUS): A validation study

The Mobile Phone Problematic Use Scale (MPPUS) is a self-report measure developed to identify the problematic use of mobile phones (PSU) among adults. The purpose of this study was to create an Italian version of this scale. A sample of 568 Italian adults completed the MPPUS, presented in association with another validated scale for the assessment of smartphone addiction. We carried out exploratory factor analyses on the MPPUS. Findings emphasised that the Italian version of the MPPUS fits a bi-factor model, in which the general factor 'PSU' was found, including two additional specific factors (i.e., 'Withdrawal and social aspects' and 'Craving and escape from other problems'). The MPPUS was correlated with the Smartphone Addiction Scale short version. With respect to criterion-oriented validity, the MMPUS was also evaluated in relation to socio-demographic variables (i.e., age and gender). The internal consistency and temporal stability of the scales (test-retest assessment after three months) were confirmed.

Health Risks and Musculoskeletal Problems of Elite Mobile Esports Players: a Cross-Sectional Descriptive Study

BACKGROUND

Mobile-gaming athletes sit in the same posture for prolonged periods, contributing to significant health risks. This study investigated the health profiles, fatigue, pain and complaints, and musculoskeletal problems of full-time mobile-gaming athletes.

METHODS

A total of 50 elite mobile-gaming athletes were involved in this study. They were the starting lineup players from all ten professional teams competing in a top-tier multiplayer online battle arena tournament. A survey was conducted to evaluate their fatigue patterns, pain levels, and complaints. A descriptive analysis was conducted to evaluate the athletes' health profiles [body mass index (BMI), fat ratio], fatigue, number of complaints, and musculoskeletal problems. The associations of career duration with BMI, fat ratio, and the total number of confirmed injuries were then determined using Spearman's rank correlation test.

RESULTS

A total of 46% and 44% of the participants felt tired frequently and occasionally, while 34% and 58% experienced eyestrain frequently and occasionally, respectively. More than 30% of the participants reported headache and rhinitis. A longer esports career duration was associated with a reduction in BMI (r = -0.272, p = 0.056). Career duration had no significant association with smoking habits (p = 0.666), alcohol habits (p = 0.655), coffee habits (p = 0.946), rounds of games for which the player could maintain concentration (p = 0.253), ease of eyestrain (p = 0.569), tiredness (p = 0.510), dizziness (p = 0.071), or leg numbness (p = 0.318).

CONCLUSION

The findings of this study stress the significance of esports injuries and indicate preventive measures for both athletes and recreational players.

Distraction From Smartphones Changed Pedestrians’ Walking Behaviors in Open Areas

The prevalence of phone use has become a major concern for pedestrian safety. Using smartphones while walking reduces pedestrians’ ability to perceive the environment by increasing their cognitive, manual, and visual demands. The purpose of this study was to investigate the effect of common phone tasks (i.e., reading, tapping, gaming) on walking behaviors during outdoor walking. Nineteen young adults were instructed to complete four walking conditions (walking only, walking–reading, walking–tapping, and walking–gaming) along an open corridor. Results showed that all three phone tasks increased participants’ neck flexion (i.e., neck kyphosis) during walking. Meanwhile, the reading task showed a greater influence on the temporal aspect during the early phases of a gait cycle. The tapping task lowered the flexion angles of the middle and lower back (i.e., torso lordosis) and induced a longer terminal double support. And the gaming task resulted in a decrease in middle back flexion, a shorter stride length, and a longer terminal double support while walking. Findings from the study confirmed our hypothesis that phone tasks changed pedestrians’ physical responses to smartphone distraction while walking. To avoid potential risks caused by the observed posture and gait adaptations, safety precautions (e.g., roadside/electronic warning signals) might be imposed depending on the workload expected by different phone tasks.

Spinal and Pelvic Alignment of Sitting Posture Associated with Smartphone Use in Adolescents with Low Back Pain

This study aimed to assess the association between smartphone use in the sitting posture and changes in thoracolumbar kyphosis, lumbar lordosis, and pelvic asymmetry in adolescents with low back pain (LBP). Twenty-five adolescents with LBP and 25 healthy adolescents participated in this study. They were instructed to sit on a height-adjustable chair with their hips and knees bent at 90° for 30 min in their usual sitting postures. Thoracolumbar kyphosis, lumbar lordosis, and pelvic asymmetry were measured using a three-dimensional motion capture system. Thoracolumbar kyphosis and lumbar lordosis increased after 30 min of sitting compared to the baseline. In both groups, thoracic kyphosis and lumbar lordosis angle increased with increasing sitting time. Compared to healthy adolescents, adolescents with LBP presented greater thoracolumbar kyphosis and lumbar lordosis after prolonged sitting. Pelvic asymmetry showed no significant difference between the sitting time and groups. Using a smartphone during prolonged sitting may lead to a slumped posture; these associations were more pronounced in adolescents with LBP.

The effect of the use of smartphone while walking on the electromyography activity of the lower extremity in young students

The study aims to determine the effects of smartphone use on the muscle activity of the lower extremity when walking. Twenty-three healthy young students were asked to perform a 10-m walk test between normal walking without using a smartphone and walking while two-handed texting on a smartphone. The electromyography activities of the lower extremity were quantified. To quantitatively assess the cervical flexion range of smartphone users, the cervical flexion angle was measured using a digital goniometer. The study results indicated that the use of a smartphone while walking could lessen muscle activity on the tibialis anterior, gastrocnemius, rectus femoris, gluteus maximus, and gluteus medius than that of normal walking without using a smartphone. The walking speeds were reduced in walking while using a smartphone compared with normal walking without using a smartphone. The cervical flexion angle was greater when walking while using a smartphone compared to that of normal walking without using a smartphone. These results suggest that frequently using a smartphone while walking could be a potential risk for musculoskeletal problems.