Correlation among smartphone addiction, craniovertebral angle, scapular dyskinesis, and selected anthropometric variables in physiotherapy undergraduates

Perceived impact of a smartphone application: Knowledge, awareness, attitudes, and intention to change an abnormal neck posture among smartphone-addicted undergraduates

Objectives: This study explored the perceived impact of a smartphone app on awareness, knowledge, attitudes, help-seeking, behavior change, and intention to change an abnormal posture of the neck while using smartphones among undergraduates addicted to smartphone use. Patients and methods: This descriptive survey involved smartphone-addicted undergraduates recruited between February 2022 and July 2022. The self-administered questionnaires used for gathering the data were a smartphone addiction survey and a mobile app rating scale on app-specific query assessing changes in awareness, knowledge, attitude, intention to change, health-seeking, and behavior change. Results: The questionnaire was completed by 316 participants (218 females, 98 males; mean: 20.7±2.6 years; range, 16 to 35 years). One hundred forty-two (44.9%) of the respondents strongly agreed that the app improved awareness, while 143 (45.3%) strongly agreed that the app improved knowledge about the significance of addressing abnormal posture of the neck while using smartphones. One hundred thirty-two (41.8%) were of the opinion that the app could change participant attitudes, and 135 (42.7%) agreed that the app could increase intentions toward improving abnormal posture of the neck. One hundred eighteen (37.3%) participants agreed that the app could promote help-seeking for abnormal posture of the neck. Respondents' age had a negative weak correlation with intention to treat (r=-0.191, p=0.001) and help-seeking (r=-0.199, p=0.0001). Conclusion: Most of the respondents in this study agreed that the CerviTech app could increase awareness, knowledge, attitude, intention to change, help-seeking, and behavior change of abnormal posture of the neck while using smartphones, with significant impact according to the age of the respondents regarding the intention to change and help-seeking behavior.

Is it Time to Normalize Scapular Dyskinesis? The Incidence of Scapular Dyskinesis in Those With and Without Symptoms: a Systematic Review of the Literature

Background

Up to 67% of adults experience shoulder pain in their lifetime. Numerous factors are related to the etiology of shoulder pain, one of which is thought to be scapular dyskinesis (SD). Given the prevalence of SD among the asymptomatic population a concern is that the condition is being medicalized (clinical findings suggested to require treatment but is ultimately a normal finding). Therefore, the purpose of this systematic review was to investigate the prevalence of SD among both symptomatic and asymptomatic populations.

Methods

A systematic review of the literature up to July of 2021. Relevant studies identified from PubMed, EMBASE, Cochrane and CINAHL were screened utilizing the following inclusion and exclusion criteria; inclusion: (a) individuals being assessed as having SD, including reliability and validity studies (b) subjects aged 18 or older; (c) sport and non-sport participants; (d) no date restriction; (e) symptomatic, asymptomatic, or both populations; (f) all study designs except case reports. Studies were excluded if: (a) they were not published in the English language; (b) they were a case report design; (c) the presence of SD was part of the studies inclusion criteria; (d) data were not present distinguishing the number of subjects with or without SD; (e) they did not define participants as having or not having SD. Methodological quality of the studies was assessed utilizing the Joanna Briggs Institute checklist.

Results

The search resulted in 11,619 after duplicates were removed with 34 studies ultimately retained for analysis after three were removed due to low quality. A total of 2,365 individuals were studied. Within the studies for the symptomatic athletic and general orthopedic population there were 81% and 57% individuals with SD, respectively, and a total of 60% among both symptomatic groups (sport and general orthopedic population). Within the studies for the asymptomatic athletic and general population there were 42% and 59% individuals with SD, respectively, and a total of 48% among both asymptomatic groups (sport and general orthopedic population).

Limitation

A strict inclusion and exclusion criteria was used to identify studies that provided the appropriate data for the purpose of this study. There was a lack of consistency for measuring SD across studies.

Conclusion

A considerable number of individuals with shoulder symptoms do not present with SD. More revealing is the number of asymptomatic individuals who do present with SD, suggesting that SD may be a normal finding among nearly half of the asymptomatic population.

Level of Evidence

2a.

Effect of tablet tilt positioning on ergonomic risks and respiratory function

The static posture associated with continuous tablet use can lead to musculoskeletal disorders of the neck and upper extremities as well as respiratory function disorders. We hypothesized that 0-degree tablet placement (flat on a table) would affect ergonomic risks and respiratory function. Eighteen undergraduate students were divided into two groups (n = 9 per group). In the first group, the tablet was placed at a 0-degree angle, whereas in the second group, it was placed at a 40- to 55-degree angle on a student learning chair. The tablet was used continuously for 2 h for writing and internet use. Rapid upper-limb assessment (RULA), craniovertebral angle, and respiratory function were assessed. There was no significant difference in respiratory function, including forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), and FEV₁/FVC, between the groups (p = 0.09) or within groups. However, there was a statistically significant between-group difference in RULA (p = 0.001), with the 0-degree group having a greater ergonomic risk. There were also significant within-group differences between pre- and posttest. The CV angle differed significantly between groups (p = 0.03), whereby the 0-degree group had poor posture, as well as within the 0-degree group (p = 0.039), though not within the 40- to 55-degree group (p = 0.067). Undergraduate students who place their tablets at a 0-degree angle face increased ergonomic risks and higher potential for developing musculoskeletal disorders and poor posture. Thus, elevating the tablet and instituting rest intervals may prevent or decrease the ergonomic risks among tablet users.

Meaning in life and smartphone addiction among Chinese female college students: The mediating role of school adjustment and the moderating role of grade

Background

The fact that female college students are more addicted to smartphones than male college students has raised public concerns. However, previous studies have rarely explored the mechanism of female college students' smartphone addiction. Previous studies have shown that identity may affect the formation process of female college students' smartphone addiction, and the identity of female college students in different grades may be different. Nonetheless, few studies have explored the grade differences in the formation process of female college students' smartphone addiction.

Methods

The present study examined the relationship between meaning in life, school adjustment, and smartphone addiction among Chinese female college students using a moderated mediation model in which school adjustment played a mediating role and grade played a moderating role. A total of 1,076 Chinese female college students (Age: 19.83 ± 1.11; 369 freshmen, 379 sophomores, and 328 juniors) completed an online questionnaire regarding meaning in life, school adjustment, and smartphone addiction.

Results

(1) School adjustment mediated the relationship between meaning in life and smartphone addiction. (2) School adjustment had a partial mediating effect between meaning in life and smartphone addiction for female freshmen and sophomores, but it did not exist among female juniors. (3) The influence of school adjustment on female sophomores' smartphone addiction was significantly stronger than that of female freshmen.

Conclusion

The findings of this study advance our understanding of the potential impacts of meaning in life on smartphone addiction and provide a grade perspective for targeted prevention or intervention with female college students' smartphone addiction.

Relationships between cervical sagittal posture, muscle endurance, joint position sense, range of motion and level of smartphone addiction

BACKGROUND

Frequent smartphone use in a pathological way forces the user to adopt a compromised posture. This gradually results in changes to both the postural and musculoskeletal systems. This study's objectives were evaluation of head posture, muscle endurance, neck range of motion (ROM) and joint position sense in two separate smartphone user groups, one 'Addicted', the other 'Non-Addicted'.

METHODS

A sample of convenience (n = 60) was recruited from medical students (age 24.57 ± 4.38, 53.3% male) with a history of smartphones use > 2 h/day for 1-year. Based on the cut-off values of the smartphone addiction scale-short version (SAS-SV), participants were entered into each group (cut-off for male ≥ 31, female ≥ 33). Neck muscle endurance time, joint position error and cervical ROM, along with forward head posture parameters of craniovertebral angle (CVA), shoulder angle (SA), sagittal head angle (SHA) and forward head distance (FHD)) were evaluated. A Mann-Whitney test and Spearman correlation coefficient were used to determine the difference between groups and the correlations between variables.

RESULTS

The difference between 'Addicted' and 'Non-Addicted' groups was confirmed by the values for SAS-SV scores (25.23 ± 5.5 versus 43.9 ± 6.61) (p < 0.001). There were statistically significant differences between groups for the CVA and FHD parameters (p < 0.001). Further, the neck extensor muscle endurance (97 ± 3.79 versus 74.86 ± 2.23 s), was significantly different between groups (p = 0.010) but not after Bonferroni correction. There was no notable difference in the neck flexor muscle endurance, joint position error, SA, and SHA parameters between groups (p > 0.05).

CONCLUSIONS

There is a positive correlation between smartphone addiction and both decreased extensor muscle endurance and changes in neck postural alignment.

Senthil Nathan, G. Mohan Kumar. Efficacy of physiotherapy intervention on craniovertebral and craniohorizontal angle using on protractor mobile app and neck muscle strength in chronic nonspecific neck pain

Introduction and Aim: The chronic nonspecific neck pain is common in all age groups since it is non-specific it may be due to any reasons right from school children to elderly. Factors like muscle strain, worn joints, nerve compression, poor posture, neck pain are found to reduce the cervical angle. The aim of the study is to find the efficacy of physiotherapy intervention on craniovertebral angle, craniohorizontal angle, neck muscle strength and hand grip in subjects with chronic nonspecific neck pain.   Materials and Methods: The subjects with chronic nonspecific neck pain (n=30) were selected randomly from the physiotherapy outpatient department of ACS medical college and hospital as per inclusion criteria and divided into two groups. The pre-test and post-test measurements of craniovertebral and craniohorizontal angles, craniovertebral angle were measured using on protractor mobile app. The neck muscle strength was measured using modified dial sphygmomanometer and hand grip was measured using hand held dynamometer. Group A received craniocervical flexion exercise and group B received stretching and strengthening for a period of 12 weeks. Post test was conducted after 12 weeks.   Results: The comparison within Group A and Group B pre- and post-test values in both groups showed highly significant difference in mean values at P ? 0.001, but group A which has a higher mean value is more effective in craniovertebral angle, craniohorizontal angle, neck muscle strength (Flexor and Extensor) and hand grip.   Conclusion: The craniocervical flexion exercise given to chronic nonspecific neck pain patients was found to reduce neck pain by improving the neck muscle strength, hand grip strength and by correcting the craniocervical and craniohorizontal angles.

Perspectives and Experiences of Smartphone Overuse among University Students in Umm Al-Qura University (UQU), Saudi Arabia: A Qualitative Analysis

Smartphone overuse and addiction is a growing concern worldwide. However, there are limited studies about smartphone addiction and its impacts on university students in Saudi Arabia. This qualitative study aimed to elicit students’ and university staff’s perspectives and experiences about smartphone overuse/addiction in Umm Al-Qura University (UQU), Saudi Arabia. Fifteen undergraduate students and 18 university staff (13 lecturers and five professionals) were recruited for the purpose of this study. The study data were collected using semi-structured interviews and analysed using thematic analysis. The qualitative data comprising 33 participants (students and staff) identified four major themes including the perception of smartphone use; causes of smartphone overuse; negative impacts of smartphone overuse; and strategies to reduce the overuse of smartphone. The overall findings confirmed that students and staff alike held both positive and negative perceptions about using a smartphone. Potential factors leading to smartphone overuse included personal factors (extended free time and low self-confidence, irresponsibility/escaping certain social gatherings/passing the time); smartphone factors (reasonable price, attractive advertisements (ads), and engaging smartphone Apps); and social factors (social pressure and fear of losing a connection). The main negative impacts of smartphone overuse were found to be related to low academic productivity, poor physical health (body pain, lack of sleep, and low exercise), compromised mental well-being (stress and negative emotions), and decreased socialisation (social isolation and a reduction in face-to-face communication). Our findings suggested that awareness campaigns about smartphone overuse, promoting family and social events, encouraging physical activities, and limiting internet use can reduce smartphone usage among university students. This finding has significant implications for decision-makers.

Smartphone Addiction Prevalence and Its Association on Academic Performance, Physical Health, and Mental Well-Being among University Students in Umm Al-Qura University (UQU), Saudi Arabia

Smartphone use can lead to smartphone addiction, which is a growing concern worldwide. However, there are limited studies about smartphone addiction and its impacts on university students in Saudi Arabia. This study aims to fill this gap. This is a quantitative study conducted among undergraduate students in Umm Al-Qura University (UQU), Saudi Arabia from May 2019 and February 2021. Study data were collected using both online and hard copy administered surveys. A self-administered questionnaire, Grade point average, Smartphone Addiction Short Version, and Kessler Psychological Distress scales were used to assess the outcomes. A total of 545 undergraduate students, mostly females, aged ≤21 years old and lived with large family sizes. More than half owned a smartphone for 5–8 years and the majority used their smartphone on average 6–11 h per day for social networking (82.6%), entertainment (66.2%) and web surfing (59.6%). Most of the participants were smartphone-addicted (67.0%). Logistic regression analysis showed that age ≤ 21, not gainfully employed, small family size and high family income were the main significant socio-demographic predictors of smartphone addiction. Smartphone-addicted participants were more likely to: have lower academic performance (GPA); be physically inactive; have poor sleep; be overweight/obese; have pain in their shoulder (39.2%), eyes (62.2%) and neck (67.7%) and have a serious mental illness (30.7%). This finding has significant implications for decision makers and suggests that smartphone education focusing on the physical and mental health consequences of smartphone addiction among university students can be beneficial.

Inter and Intra-Rater Reliability of Measuring Photometric Craniovertebral Angle Using a Cloud-Based Video Communication Platform

Objective:

Due to social distancing guidelines during the Coronavirus (COVID-19) pandemic, most providers and patients have wanted to avoid close contact. This makes physical therapy (PT) assessments difficult because of the lack of empirical evidence about the reliability of various clinical measurements performed in a virtual environment. One such procedure is the photometric measurement of craniovertebral (CV) angle. Craniovertebral angle measurement is usually performed in an outpatient setting and is defined as the acute angle formed between a straight line connecting the spinous process of C7 to the tragus of the ear, and the horizontal line passing through the spinous process of the C7. Although the photometric measurement of CV angles is considered both valid and reliable in the clinics, no empirical evidence exists about the CV angle measurement reliability when performed in a virtual environment. Thus, the purpose of this study was to assess the inter- and intra-rater reliability of photometric CV angle measurement using a cloud-based video communication platform. Number of Subjects: 66 subjects (57 females).

Methods:

All measurements were performed by two final year PT students who had completed the musculoskeletal part of the curriculum and were blinded to each other's measurements. Each subject was photographed in two postures over a HIPAA-compliant video-based telehealth platform: (1) normal/relaxed posture and (2) ideal posture (posture the subject considered good). Student researcher 1 measured the CV angle in both the relaxed posture and ideal posture, while student researcher 2 measured the CV angle only in the relaxed posture. Each subject's CV angle measurement was performed three times on three separate days and the means were used for further analysis. The shape of the CV angle frequency distribution was assessed using kurtosis and skewness values. Rater reliability was assessed using intraclass correlation coefficients (ICC), and interpreted based on the guidelines provided by Portney and Watkins (2009).

Results:

The CV angles were normally distributed in both relaxed and ideal postures. The mean and standard deviation (SD) of relaxed posture was 50.7o ± 6.3o with kurtosis and skewness of 0.67 and −0.74 respectively. The mean and SD of ideal posture was 55.5o ± 5.4o, with kurtosis and skewness of 0.1 and −0.54 respectively. The ICC for inter-rater reliability in the relaxed posture was 0.88 and the ICC for intra-rater reliability for relaxed posture was 0.91.

Conclusions:

Craniovertebral angles were normally distributed in the sample. An acceptable level of inter- and intra-rater reliability can be attained when measuring CV angle using a cloud-based video communication platform.