Prevalence and Associated Factors of Clinical Myelopathy Signs in Smartphone-Using University Students with Neck Pain

Risk factors for neck pain in college students: a systematic review and meta-analysis

BACKGROUND

During the COVID-19 epidemic, the prevalence of neck pain among college students has increased due to the shift from offline to online learning and increasing academic and employment pressures. Therefore, this systematic review aimed to identify the personal, occupational, and psychological factors associated with the development of neck pain to promote the development of preventive strategies and early intervention treatment.

METHODS

Seven electronic databases were searched from inception to December 2022 for cross-sectional studies, cohort studies, case----control studies, and randomized controlled trials (RCTs) on neck pain. The quality of the selected studies were assessed by American Agency for Healthcare Research and Quality (AHRQ) or the Newcastle-Ottawa Scale (NOS). Pooled odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated to evaluate the effects of the included risk factors on neck pain.

RESULTS

Thirty studies were included, including 18,395 participants. And a total of 33 potentially associated risk factors were identified. Ultimately, 11 risk factors were included in the meta-analysis after assessing, and all results were statistically significant (P < 0.05). The factors supported by strong evidence mainly include the improper use of the pillow (OR = 2.20, 95% CI: 1.39 to 3.48), lack of exercise (OR = 1.88, 95% CI: 1.53 to 2.30), improper sitting posture (OR = 1.97, 95% CI: 1.39 to 2.78), history of neck and shoulder trauma (OR = 2.32, 95% CI: 1.79 to 3.01), senior grade (OR = 2.86, 95% CI: 2.07 to 3.95), staying up late (OR = 1.80, 95% CI: 1.35 to 2.41), long-time electronic product usage daily (OR = 1.53, 95% CI: 1.33 to 1.76), long-time to bow head (OR = 2.04, 95% CI: 1.58 to 2.64), and emotional problems (OR = 2.09; 95% CI: 1.66  to 2.63). Risk factors supported by moderate evidence were high stress (OR = 1.61, 95% CI: 1.02 to 2.52) and female gender (OR = 1.69, 95% CI: 1.52 to 1.87).

CONCLUSION

This study obtained 11 main risk factors affecting college students neck pain, including improper use of the pillow, lack of exercise, improper sitting posture, history of neck and shoulder trauma, senior grade, staying up late, long-term electronic product usage daily, long time to bow head, high stress, emotional problems and female gender.

Smartphone use affects gait performance, spinal kinematics and causes spinal musculoskeletal discomfort in young adults

BACKGROUND

Smartphone use may lead to alterations in spinal kinematics and musculoskeletal discomfort.

OBJECTIVES

The aim of this study was to evaluate the effect of smartphone use on spinal kinematics, and to examine the relationship between smartphone addiction, spinal discomfort, and gait parameters.

DESIGN

Cross-Sectional Study.

METHODS

The study included 42 healthy adults aged 18-30 years. A photographic method was used for spinal kinematic evaluation in sitting, standing and at the end of a 3-min walk. GAITRite electronic walkway was used for spatiotemporal gait parameters. Smartphone addiction was evaluated with the Smartphone Addiction Scale - Short Version (SAS-SV). The Cornell Musculoskeletal System Discomfort Questionnaire (CMDQ) was used to evaluate feelings of discomfort and pain.

RESULTS

There was an increase in head, cervical, and thoracic flexion angles while sitting, standing, and at the end of a 3-min walk. Similarly, an increase in thoracolumbar and lumbar flexion angles was observed only in the sitting position (p < 0.05). While using a smartphone during walking, cadence, walking speed, step length decreased, while step duration and double support duration increased (p < 0.05). A statistically significant correlation was determined between the SAS-SV and CMDQ scores (p < 0.05).

CONCLUSION

The study showed that smartphone use has an impact on spinal kinematics during sitting, standing and at the end of a 3 min-walk, as well as on the spatiotemporal parameters of gait. This study suggest that smartphone addiction should be taken into consideration due to its potential to cause musculoskeletal discomfort and there may be a need to raise public awareness on this matter.

Prevalence of Static Balance Impairment and Associated Factors of University Student Smartphone Users with Subclinical Neck Pain: Cross-Sectional Study

The aim of this study was to assess the prevalence of static balance impairment in university student smartphone users with subclinical neck pain and identify the associated risk factors. Because of rapid and widespread smartphones use, and the subsequent effect on neck pain in university students, it is essential to determine the prevalence of balance impairment and associated factors in this population. Simple random sampling was completed among eighty-one participants in this cross-sectional study. A self-reported questionnaire, fitted precisely for smartphone users, was used prior to clinical assessment by the Balance Error Scoring System. Both simple and multiple logistic regressions were used to analyze the prevalence of static balance impairment and associated factors. The prevalence of static balance impairment in university student smartphone users with subclinical neck pain was 74.07% (95% CI: 64.32 to 83.82). The significant risk factors were "daily smartphone use ≥ 4 h'' (AOR: 19.24 (95% CI 4.72 to 78.48) p = 0.000), "≥4 years of smartphone use" (AOR: 5.01 (95% CI 1.12 to 22.38) p = 0.035), and "≥7 neck disability index score'' (AOR: 12.91 (95% CI 2.24 to 74.45) p = 0.004). There was a high prevalence of static balance impairment in university smartphone users with subclinical neck pain. University student smartphone users with subclinical neck pain who met at least one of the risk factors should realize their static balance impairment.

Physical Performance Tests in Adult Neck Pain Patients with and without Clinical Myelopathic Signs: A Matched Case-Control Study

Patients with neck pain may experience cervical myelopathy, this may be detected by clinical myelopathic signs, although they did not have any symptom of myelopathy, except having neck pain. Decreasing physical performance is one symptom of cervical myelopathy that can lead to reduced quality of life in the elderly, however, in adult neck pain with clinical myelopathic signs have not been evaluated. Therefore, this research aimed to compare physical performance in two groups of adult patients with neck pain: those with and without clinical myelopathic signs. A total of 52 participants, gender, age, and body mass index (BMI) matched were allocated into 2 groups of 26 subjects with neck pain, those with, and without, clinical myelopathic signs. The grip and release test, nine-hole peg test, ten second step test and foot-tapping test were evaluated. The group of neck pain participants with clinical myelopathic signs exhibited greater impairment in all the tests than the group without clinical myelopathic signs (p < 0.001). Effect sizes (Cohen’s d) were grip and release test: 2.031, nine-hole peg test: 1.143, ten second step test: 1.329, and foot-tapping test: 0.798. Neck pain participants with clinical myelopathic signs demonstrated reduced physical performance. Physical performance tests may need to assessed in adult patients with neck pain who had clinical myelopathic signs.

Time Trends in the Incidence of Spinal Pain in China, 1990 to 2019 and Its Prediction to 2030: The Global Burden of Disease Study 2019

BACKGROUND

With increasing life expectancy in China, the associated burden of low back and neck pain (spinal pain) on the healthcare system increases, posing a substantial public health challenge. This study aimed to investigate trends in spinal pain incidence across China from 1990 to 2019 and to predict incidence trends between 2020 and 2030.

METHODS

Data were derived from the Global Burden of Disease Study (GBD) 2019. The annual percentage change (APC) and average annual percentage change (AAPC) between 1990 and 2019 were calculated using Joinpoint regression analysis. The effects of age, period, and cohort on spinal pain were estimated by an age-period-cohort model. An autoregressive integrated moving average (ARIMA) model was used to forecast incidence trends from 2020 to 2030.

RESULTS

From 1990 to 2019, the age-standardized incidence rate (ASIR) of low back pain (LBP) significantly decreased in both male and female subjects, while the ASIR of neck pain (NP) slightly increased regardless of sex. Joinpoint regression analysis showed that the incidence rates of LBP decreased in all age groups, and incidence rates of NP increased after 45 years old among men and women. The age effects showed that the relative risks (RR) of LBP incidence increased with age, and the group aged 40-49 years had the highest RR for NP incidence, regardless of sex. Period effects showed that the risk of NP continuously increased with increasing time periods, but not in LBP. The cohort effect showed a continuously decreasing trend in later birth cohorts. The prediction results of the ARIMA model show that the ASIR of NP in both male and female subjects in China shows an increasing trend in the next 10 years, and the ASIR of LBP increased in male but decreased in female subjects.

CONCLUSION

Spinal pain has remained a major public health burden over the past 30 years in China and will likely increase further with population aging. Therefore, spinal pain should be a priority for future research on prevention and therapy, and is especially critical as the aging population increases in China.