A systematic review of musculoskeletal complaints, symptoms, and pathologies related to mobile phone usage

Impact of Nomophobia on Musculoskeletal Problems in the Upper Extremity among Adults: Implications for Occupational Therapy

Nomophobia (NO MObile PHone Phobia) is a psychological condition in which people are anxious of being cut off from their mobile phones and been associated with adverse consequences to physical and psychosocial health. The objective of this study was to measure the impact of nomophobia on musculoskeletal problems in the upper extremity among adults. The Nomophobia scale (NMP-Q) was used to measure addiction to smartphone use among 5,087 Middle Eastern adults. A snowball sampling approach was used to recruit the participants between March and June 2021. Results showed that nomophobia was evident in 1,119 participants (22%) with a mean NMP-Q score of 114.1 (SD 11.1). A total of 3,396 upper extremity symptoms were reported among our participants. The binomial logistic regression showed that NMP-Q score is a significant predictor of symptoms to the thumb only (β = 0.01, p = .026). This study has provided evidence of the negative physical consequences of addiction to smartphone use. Participants with thumb-related symptoms were more prone to sustain other concurrent upper extremity symptoms, probably due to their maladaptive habits of using the phone. Thus, it is important to increase awareness about the risks associated with the use of smartphones. Implications for occupational therapy are presented.

The association between smartphone addiction and thumb/wrist pain among medical students of Jazan University, Saudi Arabia, A cross-sectional study

Background

The past decade has witnessed a revolution in smartphones owing to their growing importance and various applications. However, excessive usage can lead to addiction and joint pain in the wrist/thumb area. Despite these negative effects, smartphones offer medical students access to the resources they need.

Objective

To determine the association between smartphone addiction and thumb/wrist pain among undergraduate students of Jazan University.

Methods

A cross-sectional self-administrated, online survey and online convenience sample technique was used. The collected data were analyzed using SPSS Software.

Results

This survey included 337 participants, of which two-thirds were female (66.8%) and the rest male (33.2%); 32.6% of the respondents were studying in the College of Medicine. Of the 337 participants, 32% reported experiencing pain in their wrists or at the back of their neck while using a smartphone. The study found an average Smartphone Addition Scale-Short Version (SAS-SV) score of 32.5 ± 8.0 out of 50 and a total Patient-Rated Wrist Evaluation score of 48.8 ± 14.7, with a pain score of 13.3 ± 11.0 and a function score of 35.5 ± 11.7. The study also revealed a significant association between smartphone addiction and thumb/wrist pain (P value = 0.029), with females and students of the College of Applied Medical Science associated with higher SAS-SV scores, thereby indicating higher smartphone addiction.

Conclusion

Significant correlation exists between smartphone addiction and thumb/wirst pain among medical students of Jazan University.

The association between mobile phone usage duration, neck muscle endurance, and neck pain among university students

The mobile phone is essential in daily life, especially during the pandemic. Prolonged use can cause postural issues, leading to common neck pain. This study aims to determine the correlation between mobile phone use duration, addiction, neck muscle endurance, and neck pain in university students. The study included 62 participants (30 female, 32 male) aged 18-35 years. Inclusion criteria required participants to have experienced neck pain at least twice in the past year and to have no other concomitant issues, as well as to volunteer for the study. Demographic information and daily mobile phone usage time were collected. Neck pain was assessed with the Visual Analogue Scale, smartphone addiction with the Smartphone Addiction Scale, and cervical muscle endurance was evaluated. Correlation analysis reveals a moderate relationship between neck pain severity (NPS) and cervical extensor muscle endurance (CEME), a strong relationship between NPS and cervical flexor muscle endurance (CFME), as well as a strong relationship among daily phone usage time (DPUT), CFME, and NPS, with a moderate relationship between DPUT and CEME. Participants were divided into two groups based on their DPUT, revealing that those who used their phone for four hours or more showed significantly higher levels of pain (p < 0.05) and reduced endurance in cervical flexor muscles. Our study found a strong correlation between neck pain, muscle endurance, and daily phone usage. Participants using their phones for more than four hours daily reported increased neck pain and decreased muscle endurance. We suggest integrating phone usage duration into neck pain assessments, promoting ergonomic practices, and offering detailed usage guidelines for users.

The prevalence of neck pain among online learning students: An observational study

Neck pain is among the most prevalent musculoskeletal disorders affecting the general population. During the 2019 coronavirus disease 2019 (COVID-19) pandemic, students have increasingly resorted to online learning, requiring prolonged use of electronic devices. This study aimed to investigate the prevalence of and factors influencing neck pain during online learning. The study employed a cross-sectional design. Eligible participants were nursing students who had been receiving online instruction for a duration exceeding 3 months. To develop the study instrument, the researchers integrated the study objectives with insights from an extensive literature review. This process culminated in the creation of a comprehensive online questionnaire designed to capture relevant data. The prevalence of neck pain among students was analyzed for both the pre-COVID-19 and during COVID-19 periods. The chi-square test was utilized to compare the occurrence of neck pain between these 2 periods, while binary logistic regression was employed to examine the association between various influencing factors and neck pain. This study revealed that out of the 426 students who participated in the study, 391 were female (91.8%) and 35 were male (8.2%). The prevalence of neck pain during online learning (62.7%) was significantly higher than before online learning (37.3%) (P < .05). A significant correlation was also found between neck pain and learning while lying on a bed or table, duration of use of electronic devices, and exercising habits (P < .05). The prevalence of neck pain among students has significantly increased during the COVID-19 pandemic. Future research should focus on evaluating the long-term impact of distance learning on undergraduate students. Additionally, it is imperative to develop and implement targeted intervention programs based on the identified influencing factors to mitigate the prevalence of neck pain and alleviate neck discomfort.

Changes in Chinese college students' mobile phone addiction over recent decade: The perspective of cross-temporal meta-analysis

In recent years, with the rapid advancement of Internet technology and the impact of the COVID-19 pandemic, mobile phones have been used more frequently, the development trend of mobile phone addiction among Chinese college students is a concern to society. This cross-temporal meta-analysis provides compelling evidence of the rising trend of mobile phone addiction in Chinese college students based on data from 42 independent studies (Sample Size = 49,544) over the past decade (2013-2022), and discuss the three important rising periods. Furthermore, extended research has revealed correlated factors of mobile phone addiction among Chinese college students, including gender, anxiety, depression, loneliness, stress, well-being, social support, and resilience. Additionally, the study identified the National internet penetration rate and the National GDP index as significant predictors of mobile phone addiction in Chinese college students. These findings not only reveal the changing trends of mobile phone addiction among Chinese college students, but also enrich the understanding of mobile phone addiction among this population and provide a reference for improving mobile phone addiction among in the future.

Prevalence and factors associated with lateral epicondylitis among hospital healthcare workers

Background

Hospital healthcare workers have been reported to have a high prevalence of musculoskeletal disorders, but their association with lateral epicondylitis (LE) is unknown. This study aimed to clarify the prevalence of LE and its associated factors among hospital healthcare workers.

Methods

The present study included all staff members of a secondary emergency hospital who provided their consent to participate. Participants with a history of elbow joint trauma were excluded from this study. The diagnostic criteria for definite LE were: (1) pain in the elbow joint within 2 weeks of the study; (2) pain in the lateral epicondyle region on resisted extension of the wrist with the elbow extended; and (3) tenderness in the lateral epicondyle. The diagnosis of LE was defined by meeting all criteria. Age, height, weight, sex, dominant hand, occupation, years of employment, smoking history, drinking history, personal computer usage history, and smartphone usage history were investigated using a questionnaire. A physical examination, in addition to evaluation of pain in the lateral epicondyle, grip strength and wrist extension strength were measured. A statistical analysis was used to assess the prevalence of LE and its associated factors. All investigations, including the diagnosis of LE, were performed by a single orthopedic specialist.

Results

We evaluated 544 individuals, corresponding to approximately 80% of all staff members. The median age was 39 years (interquartile range, 30-48). The study population included 154 males and 390 females. The occupations of the participants were as follows: nurses (n = 265), doctors (n = 47), clerks (n = 93), therapists (n = 27), certified care workers (n = 23), medical technologists (n = 22), pharmacists (n = 19), and others (n = 48). LE was diagnosed in 30 limbs/30 individuals with a prevalence of approximately 5.5%. There was no difference in the prevalence of LE among occupations (P = .85). A logistic regression analysis revealed that age (odds ratio, 1.05; 95% confidence interval 1.01-1.1; P = .01) and smoking history (odds ratio, 2.94; 95% confidence interval 1.01-8.56; P = .04) were independently associated with LE.

Conclusion

This study was conducted to evaluate the prevalence of LE among hospital healthcare workers. The prevalence of LE was 5.5%, and LE was independently associated with age and smoking history.

Smartphone addiction prevalence, patterns of use, and experienced musculoskeletal discomfort during the COVID-19 pandemic in a general Iranian population

BACKGROUND

Smartphone usage is an essential everyday tool in Iran, however problematic use has escalated and become a concern for the Iranian health policy system, particularly during and following the COVID-19 Pandemic. This study's aim was investigation of the prevalence of smartphone addiction, patterns of use, and the relationship to specific demographic characteristics and associated musculoskeletal disorders during the COVID-19 pandemic.

METHODS

A descriptive-analytical correlational study recruited participants from a population of convenience (n = 2344) who were smartphone owners with > 1 year of use. For demographic information an electronic self-report questionnaire collected age, sex, marital status, usage for daily hours, and patterns. To assess addiction levels, the 'Smartphone Addiction Scale-short version' (SAS-SV) patient-reported outcome measure was used (cut-off = 31). For experienced discomfort, the Extended Nordic Musculoskeletal Questionnaire (ENMQ) was used.

RESULTS

The participants (female = 66.6%, n = 1561, mean age = 29.07 ± 12.34 years, range 6-60 years) smartphone use averaged 5.75 ± 3.44 h/day. The general prevalence of smartphone addiction was 46.16% (females = 46.06%, males = 46.36%; married = 44.5%, single = 47.63%). School students had the greatest addiction (53.2%) and those with a higher education to or above a Master's degree were the lowest (39.38%). The highest pattern of use was for social networks at 89.1% of participants (female = 88.34%, male = 90.54%). The areas of highest reported discomfort were the eyes (43.5%) and neck (43.3%). A significant correlation was found between smartphone addiction and hours of daily usage, and the amount of usage increased during the COVID-19 pandemic period.

CONCLUSION

A high level of smartphone addiction in the Iranian population was found to have occurred during the COVID-19 pandemic. Those most affected were unmarried individuals and school students, with the predominant areas being the eyes and neck. Health decision-makers should consider these findings when developing recommendations and plans for public health, particularly those focused on students.

Prevalence of Thumb and Wrist Pain Among Smartphone Users in the Saudi Arabian General Population: A Cross-Sectional Study

Background This study aims to investigate the prevalence of thumb and wrist pain among smartphone users in the general population of Saudi Arabia, examining the potential links between the duration and frequency of smartphone usage, specific smartphone activities, and the occurrence of discomfort in the thumb and wrist. Methodology This descriptive cross-sectional study was conducted at Jazan University, Saudi Arabia, between July 2022 and June 2023. The questionnaire developed following an extensive literature review, covered demographic information, smartphone usage patterns, assessment of thumb or wrist pain, and evaluation of the impact of this discomfort. Descriptive statistical methods were employed, and relationships between thumb or wrist pain and demographic variables were analyzed using chi-square and Wilcoxon rank-sum tests. Results In total, 811 participants were included in this study. Approximately 322 (39.7%) study participants reported wrist or thumb pain. Notably, female sex (P = 0.001) and prolonged daily smartphone usage exceeding five hours (P = 0.045) were linked to thumb or wrist pain. Additionally, emailing on smartphones was linked to thumb or wrist pain (P = 0.04). Concerning smartphone ergonomics, the majority of respondents reported holding their phones with one hand (215, 66.77%), in a downward position (290, 90.06%), and with their wrists bent downward (136, 42.24%). Conclusions Our study highlights a relatively high prevalence of wrist and thumb pain among smartphone users in the general Saudi Arabian population. Furthermore, we identified a connection between prolonged smartphone use and wrist and thumb pain, with a more pronounced prevalence observed among females.

The relationship between smartphone usage position, pain, smartphone addiction, and hand function

BACKGROUND

The hand is the most frequently used part of the body during daily life activities. Any musculoskeletal problem that may occur in the hand can lead to loss of function.

OBJECTIVE

This study examined the relationship between the wrist and elbow position adapted during smartphone use, pain and discomfort, smartphone addiction, and hand function.

METHODS

Pain and discomfort were evaluated with the visual analog scale, wrist and elbow angle during phone use were evaluated with a universal goniometer, smartphone addiction was evaluated with the Smartphone Addiction Scale-Short Version, and functional status of the hand was evaluated with the Michigan Hand Outcomes Questionnaire.

RESULTS

A total of 120 university students (female: n= 60), with an average age of 22.71 ± 2.7 years, were included in this cross-sectional study. A relationship was found between the angle of the wrist and elbow during smartphone use and pain/discomfort (r= 0.692, p= 0.001), smartphone addiction (r= 0.575, p= 0.001), and hand function parameters (r= 0.20-0.55, p⩽ 0.05).

CONCLUSION

Due to the increased use of smartphones in today's environment, a preventive program should be developed in which texting for extended periods is avoided, along with frequent breaks to rest the hands, and stretching exercises for the upper extremities during rest.

Smartphone addiction and postural alterations in the cervical region in adolescents

OBJECTIVE

To evaluate smartphone addiction and postural alterations in the cervical region in adolescents.

METHODS

A cross-sectional study with 281 adolescents (15 to 19 years old), attending the 1st to the 3rd grades of High School, carried out between September and October 2019 in the city of Fortaleza, Ceará, Brazil. Data collection took place in two stages. In the first, they answered four self-administered questionnaires: sociodemographic questionnaire, health conditions and smartphone use, Nordic Musculoskeletal Symptom Questionnaire (NMQ), Self-Report Questionnaire (SRQ-20) and the Smartphone Addiction Inventory (SPAI-BR). In the second stage, they were submitted to photogrammetry using the Postural Assessment Software (SAPO) and anthropometric assessment (weight and height). The software SPSS Statistics version 23.0 was used for data analysis.

RESULTS

Of the total number of adolescents, 63.3% (n=178) showed smartphone addiction, using it for 5.8 hours (±3.5) during the week and 8.7 (±4.0) hours on the weekend. When analyzing postural alignment in the anterior view, a significant reduction in the lateral head tilt was observed when typing on the smartphone (p=0.002) compared to the anatomical position (baseline). In the lateral view, an increase in head anteriorization was observed during smartphone use (p<0.05). There was an association between smartphone addiction and head anteriorization (p<0.05).

CONCLUSIONS

The use of the smartphone in the typing position causes postural alterations in the cervical region, especially in adolescents with smartphone addiction. Therefore, health promotion measures that alert adolescents to the adverse effects caused by prolonged smartphone use are necessary.

Exercise intervention to reduce mobile phone addiction in adolescents: a systematic review and meta-analysis of randomized controlled trials

Background

The growing problem of adolescent mobile phone addiction has attracted significant attention, underscoring the importance of identifying approaches to address it. Exercise has been found to reduce adolescent mobile phone addiction; however, its mechanism remains unclear. This review aims to elucidate the potential moderating factors between exercise and mobile phone addiction based on previous studies to provide a reference for adolescents to effectively participate in exercise to reduce mobile phone addiction.

Methods

Articles were searched in the CNKI, Web of Science, Scopus, Cochrane, PsycINFO, and PubMed databases according to the inclusion criteria and followed the Preferred Reporting Items for Systematic Assessment and Meta-analysis (PRISMA). The quality of the literature was assessed by two independent reviewers using the Cochrane Collaboration Risk of Bias tool for methodological quality assessment. Meta-analysis was performed using Stata 15.1 software for Meta-analysis, standardized mean difference (SMD) was combined using a random effects model, and subgroup analysis was used to explore heterogeneity.

Results

A total of 12 studies, 17 samples, and 861 subjects were included in the meta-analysis, and all studies were randomized controlled trials. The findings revealed that the exercise intervention significantly reduced mobile phone addiction in adolescents (SMD = -3.11; 95% CI: -3.91, -2.30; p < 0.001). The intervention effect was moderated by multiple variables, such as the measurement tools, exercise intervention types, cycles, frequency, and duration of a single exercise intervention.

Conclusion

Our findings suggest that exercise could serve as an effective strategy for preventing or ameliorating mobile phone addiction in adolescents. Based on the results of this study, we encourage mobile phone-addicted adolescents to engage in a single exercise using a mix of skills for 30-60 min three or more times weekly for more than eight consecutive weeks.

Association Between Musculoskeletal Pain and Studying Hours Among Medical Students in Jeddah, Saudi Arabia

Introduction Musculoskeletal (MSK) disorders are one of the common health issues affecting people of various ages. The main risk factors for musculoskeletal pain are age, obesity, gender, level of education, psychosocial factors, occupational factors, decreased mobility and flexibility, and common factors such as consuming TV and video games. College students, especially medical students, are at a higher risk of these complaints as they have longer hours of studying than most faculties due to the competitiveness of their specialty. The objective of this study was to identify the relationship between musculoskeletal pain and studying hours in medical students in Jeddah, Saudi Arabia, and to increase awareness of this problem. Methods This cross-sectional study was conducted in 2022. Data was collected using an online questionnaire. A total of 314 participants were included in this study. The demographic variables, studying hours, studying locations, and postures were collected and analyzed. Results A total of 314 medical students were included in this study. The majority were males (71.0%) and, the mean age was 22.05±2.13 years. Most of them were sixth-year students, and most of them reported studying between three and four hours (40.1%), with the most common studying location reported being the students' home or residence (79.3%). The number of daily studying hours had no significant effect on the occurrence of musculoskeletal problems. Conclusion There was no significant relationship between the number of studying hours and the MSK pain. Clinical trials could be used to evaluate the most effective approaches to alleviate MSK pain in medical students.

The "Selfie Test": A Novel Test for the Diagnosis of Lateral Epicondylitis

Background: Lateral epicondylitis (LE) is one of the most diagnosed elbow pathologies. The purpose of this study was to determine the diagnostic test accuracy of a new test (selfie test) for the diagnosis of LE. Methods: Medical data were collected from adult patients who presented with LE symptoms and ultrasound findings that supported the diagnosis. Patients underwent a physical examination, including provocative tests for diagnosis as well as the selfie test, and were asked to fill out the Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire and subjectively rate the activity of their affected elbow. Results: Thirty patients were included in this study (seventeen females, 57%). The mean age was 50.1 years old (range of 35 to 68 years). The average duration of symptoms was 7 ± 3.1 months (range of 2 to 14 months). The mean PRTEE score was 61.5 ± 16.1 (range of 35 to 98), and the mean subjective elbow score was 63 ± 14.2 (range of 30 to 80). Mill's, Maudsley's, Cozen's, and the selfie tests had sensitivities of 0.867, 0.833, 0.967, and 0.933, respectively, with corresponding positive predictive values of 0.867, 0.833, 0.967, and 0.933. Conclusions: The selfie test's active nature, which allows patients to perform the assessment themselves, could be a valuable addition to the diagnostic process, potentially improving the accuracy of the diagnosis of LE (levels of evidence: IV).

Design guidelines for limiting and eliminating virtual reality-induced symptoms and effects at work: a comprehensive, factor-oriented review

Virtual reality (VR) can induce side effects known as virtual reality-induced symptoms and effects (VRISE). To address this concern, we identify a literature-based listing of these factors thought to influence VRISE with a focus on office work use. Using those, we recommend guidelines for VRISE amelioration intended for virtual environment creators and users. We identify five VRISE risks, focusing on short-term symptoms with their short-term effects. Three overall factor categories are considered: individual, hardware, and software. Over 90 factors may influence VRISE frequency and severity. We identify guidelines for each factor to help reduce VR side effects. To better reflect our confidence in those guidelines, we graded each with a level of evidence rating. Common factors occasionally influence different forms of VRISE. This can lead to confusion in the literature. General guidelines for using VR at work involve worker adaptation, such as limiting immersion times to between 20 and 30 min. These regimens involve taking regular breaks. Extra care is required for workers with special needs, neurodiversity, and gerontechnological concerns. In addition to following our guidelines, stakeholders should be aware that current head-mounted displays and virtual environments can continue to induce VRISE. While no single existing method fully alleviates VRISE, workers' health and safety must be monitored and safeguarded when VR is used at work.

Objective Evaluation of Active Interactions between the Operator and Display Screen Equipment Using an Innovative Acquisition System

The occupational risk of operators using display screen equipment (DSE) is usually evaluated according to the extent of time spent in active operator-DSE interactions. Risk assessment is based on activity data collected through questionnaires. We evaluated an original and innovative system that can objectively assess active operator-DSE interactions by collecting electrical impulses generated by the activation of mouse, keyboard and a camera that collects attentive eye-screen fixation. The main aim of this study was to evaluate the system's performance on an employee sample involved in the task of active reading and copying at a DSE workstation connected to the system. In the context of mandatory health surveillance at work, we enrolled 38 DSE operators with normal neuropsychological and eye assessments who were required to complete two predefined reading and writing tasks. The obtained results show that the system is able to collect activity data derived from operator-DSE interactions through screen fixation, keyboard tapping and mouse handling. In the copying task, the session duration as recorded by the system was highly related to the screen fixation time. In the copying task, mouse and keyboard activities were more strongly related to session duration than screen fixation. For the copying task, it was also possible to obtain individual profiles of operator-DSE interactions while performing the same standardized tasks. Collected data can allow an objective evaluation of active time spent by DSE operators at their workstations, thus allowing a more accurate occupational health risk assessment and management. Prospective analysis of individual operator-DSE interaction profiles can favor the setup of targeted preventive and organizational interventions from an of even wider worker wellbeing perspective.

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.

The association between mobile phone use and neuromusculoskeletal complaints

BACKGROUND

Mobile phones have become an essential component in our life. There are many concerns about the effects of prolonged mobile phone use on the upper extremity.

OBJECTIVE

This research aims to investigate the effects of prolonged mobile phone use on the neuromusculoskeletal system of the upper extremity in young adults in Jordan.

METHODS

A total of 228 subjects (age = 20.7±1.27 years) participated in this study. A structured questionnaire was used to collect data on sociodemographic variables, mobile phone size, hand/finger used for typing, duration of use daily, and the presence of musculoskeletal pain/syndromes and their location.

RESULTS

Statistically significant relations (p < 0.05) were found between the prolonged use of mobile phones and self-reported pain in neck/upper back, hands, and symptoms of cubital syndrome; between smaller hand-to-phone ratio and pain in neck/upper back and shoulders with the higher frequency of pain in females. Females and subjects with a smaller hand-to-phone ratio tend to use two hands (p < 0.05).

CONCLUSION

The results show an association between mobile phone use and self-reported pain. This study provides guidance for mobile phone manufacturers and regulatory agencies on the potential effects, the need for awareness programs that alert to musculoskeletal complaints, choosing the appropriate mobile phone, and changing using habits. Further investigations on a larger sample with quantitative measures on the kinematics and muscular activities are necessary to generalize and better interpret the results.

Relationship between musculoskeletal discomfort and cell phone use among young adults: A cross-sectional survey

BACKGROUND

Cell phone usage is highly prevalent among young adults. They are used for multiple purposes including communication, studies, social networking and entertainment. However, its excessive usage has been associated with adverse health outcomes.

OBJECTIVE

The objective was to find the association of cell phone usage with musculoskeletal discomfort (MSD) and its associated factors.

METHODS

A cross-sectional study was conducted on young adult students from a low-middle income country over a period of 3 months from December 2018 to February 2019. A structured questionnaire based on the Disabilities of the Arm, Shoulder and Hand (QuickDASH scoring) was used to record the musculoskeletal discomfort.

RESULTS

Out of 803 questionnaires, data of 754 (94%) were entered and the remaining questionnaires (n = 49) were discarded due to incomplete answers. The mean age was 20.83 (1.62) years. In our study, there were 194 (25.7%) males and 560 (74.3%) female participants. Neck and shoulder were the most frequently affected regions. A significant difference in QuickDASH score was observed between genders (p-value p ≤ 0.001). Left-handed individuals scored significantly higher on QuickDASH score compared to right-handed individuals (p < 0.05). Increased musculoskeletal discomfort was reported by individuals with daily cell phone use of more than four hours (p < 0.05). A positive significant correlation was found between continuous one hour cell-phone use and higher mean QuickDASH scores (correlation coefficient 0.124, p value 0.001). Shorter eye-to-screen distance was significantly associated with MSD (p < 0.05).

CONCLUSION

Musculoskeletal discomfort is associated with the female gender, duration of cell phone use and a small eye-to-screen distance.

Prevalence of Upper Limb Musculoskeletal Disorders and Their Association with Smartphone Addiction and Smartphone Usage among University Students in the Kingdom of Saudi Arabia during the COVID-19 Pandemic-A Cross-Sectional Study

This study aimed to investigate the prevalence of upper limb musculoskeletal disorders (MSDs) and their association with smartphone addiction and smartphone usage among university students in the Kingdom of Saudi Arabia during the COVID-19 pandemic. A total of 313 university students aged 18 years and older who owned a smartphone and used it during the preceding 12 months participated in this cross-sectional study. The prevalence of upper limb MSDs, smartphone addiction/overuse, and levels of physical activity were recorded using the standardized Nordic musculoskeletal questionnaire, the smartphone addiction scale (short version), and the international physical activity questionnaire (short form), respectively. Data collection was performed on campus between March and May 2021. Binary logistic regression was used to determine the association between the prevalence of upper limb MSDs and smartphone addiction/overuse and levels of physical activity. The 12-month prevalence of MSDs of the shoulder, elbow, and wrist/hand regions due to smartphone use among participants was found to be 20.13%, 5.11%, and 13.42%, respectively. Shoulder (odds ratio (OR) = 11.39, 95% confidence interval (CI) = 4.64−27.94, p < 0.001), elbow (OR = 15.38, 95% CI = 1.92−123.26, p = 0.01), and wrist/hand MSDs (OR = 7.65, 95% CI = 2.75−21.22, p < 0.001) were more prevalent among participants who were categorized as having smartphone addiction/overuse measures. Promoting awareness about the healthy use of smartphones, including postural education and decreasing screen time, is necessary to reduce smartphone-related MSDs.

Effects of a Traction Device for Head Weight Reduction and Neutral Alignment during Sedentary Visual Display Terminal (VDT) Work on Postural Alignment, Muscle Properties, Hemodynamics, Preference, and Working Memory Performance

The forward head posture of visual display terminal (VDT) users induces various physical and cognitive clinical symptoms. However, few studies have been conducted to identify and solve problems associated with VDT posture. This study aimed to examine the adverse effects of VDT posture and the positive effects of traction-combined workstations by measuring postural alignment, muscle properties, blood velocity, preference, and working memory. Thirty-four healthy VDT users (18 males and 16 females aged 20-30 years) participated in the experiment at three workstations, including conventional (VDT_C), head support (VDT_S), and upright (VDT_U) workstations. They conducted 2-back working memory task. The craniovertebral angle (CVA), muscle tone and stiffness, blood velocity and visual analogue discomfort scale (VADS) were measured to examine the influence of workstations. VDT_C showed increased muscle tone or stiffness in the levator scapulae (LS), suboccipital muscle (SM), and sternocleidomastoid muscle (SCM) and an increased reaction time (RT) in working memory. However, VDT_S showed decreased stiffness and tone of SM and improved comfort. In addition, VDT_U showed decreased stiffness or tone of the LS and SCM and improved blood velocity and RT. In conclusion, maintaining neutral alignment significantly improved working memory performance, muscle properties, and blood velocity.

The Relationship between Cellphone Usage on the Physical and Mental Wellbeing of University Students: A Cross-Sectional Study

(1) Background: The study aims to examine the use of cell phones on physical and mental health status and their impact on personality among university students. (2) Methods: A cross-sectional study was conducted using a semi-structured questionnaire. The association of physical and mental health variables with the demographic variables was examined using Pearson’s correlation and χ2-test. The binary logistic regression model was further used to predict the probabilities of negative impact on personality due to excessive use of cell phones. (3) Results: A total of 400 participants participated with a mean age of 24.45 ± 3.45 years. The average eye strain was more in High cell phone users HCPU than in LCPU and that difference was significant p = 0.000. The average neck pain was more in (HCPU) than Low cell phone users (LCPU) and there was a significant difference between the two groups with p = 0.006. The average weight gain was more in HCPU than LCPU and that difference was significant p = 0.000. Considering back pain, back pain was found more in HCPU as compared to LCPU with a statistical difference at p = 0.027. Cell phone usage significantly correlated with eye strain (r = 0.577, p = 0.000), neck pain (r = 0.543, p = 0.000), back pain (r = 0.611, p = 0.000), weight gain (r = 0.423, p = 0.000), depression (r = 0.430, p = 0.000), loneliness (r = −0.276, p = 0.002), and mood disorder (r = 0.608, p = 0.000). Eye strain, neck pain, and back pain was observed more in HCPU than in LCPU. HCPU felt they gained more weight when compared to the respondents in the LCPU group. HCPU felt more changes in mood and feeling low when compared to the LCPU, while LCPU group felt more lonelier when compared to the HCPU group. (4) Conclusions: The study highlights a significant association between excess use of cell phones and negative effects on physical and mental health wellbeing. Based on the results, it is recommended that more physical activities and alternative to minimize cell phone usage should be planned for the students. Public health policy makers and stakeholder need to address the ill effects of excessive use of cell phones through novel policies., especially young students, and alternatives to reduce their cell phone activities.

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.

Prevalence and Motives of Social Media Use among the Iranian Population

Background

Around the world, people are using social media (SM) for different purposes following a wide range of patterns. There is a paucity of studies addressing the issue in the Eastern Mediterranean region. In this population-based study, the frequency and patterns of SM use in Iran were investigated.

Materials and Methods

To explore the prevalence and motives of SM use, a sample of 1800 Iranian people aged 10-65 years old (53.5% female) were surveyed. Social media addiction (SMA) was assessed using the Bergen Social Media Addiction Scale.

Results

The results revealed that 88.5% (n = 1593) of the participants were SM users, and the average time spent by them in SM was 4.0 ± 3.9 hours. The most common motivations for SM use were communication with others (48.9%), receiving news (40.7%), and surfing the net (40.6%). Besides, burning eyes (31.0%), headache (26.8%), and sleep disturbance (25.1%) were the most common health problems experienced by SM users. The SMA prevalence was 23.1% (95% CI: 21.2, 25.1) (males: 23.8%; females: 22.5%), with a higher rate (26.0%) among adolescents and young people.

Conclusion

SM use and SMA appear to be real health challenges in Iran, particularly among youth. Consequently, to decrease the negative impacts of excessive SM use, exploring the motives behind SM use and designing population-based interventions are recommended.

Content comparison of neck pain outcome measures using the international classification of functioning, disability and health

The purpose of this study was to compare the content covered by existing neck pain measures based on the linkage to the International Classification of Functioning, Disability and Health (ICF) framework to examine the extent to which the existing measures represent ICF categories and to identify content gaps in existing measures that would inform further research. Ten commonly used measures were identified, and their content was linked to ICF categories using established coding systems. Two clinical experts reviewed every measure independently and identified the central meaningful concepts from individual items of each measure. A total of 177 concepts were identified from 193 items across 10 measures. Body functions were the most represented category across measures (23-64%). The representation of activities ranged from 14 to 61% whereas the representation of participation ranged from 6 to 31% across measures. The ProFitMap-Neck was the only measure that addressed the environmental factors. The ProFit-Map neck captured a majority of concepts from body structures and function and the neck outcome score captured maximum concepts from the activities and participation categories. A combination of ProFit-Map neck and Neck Outcome Score can be used with caution to obtain a more comprehensive assessment of the impact of neck pain on function, activities and participation.

The relationship between smartphone use and dry eye disease: A systematic review with a narrative synthesis

BACKGROUND

Emerging research findings suggest a potential relationship between smartphone use (SPU) and dry eye disease (DED), which has not been systematically reviewed.

OBJECTIVES

The aim of this study was to systematically review and synthesize evidence on the relationship between SPU and DED.

METHODS

A systematic search of Medline, EMBASE, CINAHL, and PsychINFO bibliographic databases from their inception to January 15, 2021. Study screening, full-text assessment, study selection and exclusion, data extraction, and quality assessment was performed independently by at least two review authors.

RESULTS

Four studies were included in the review (3 cross-sectional studies and 1 nonrandomized clinical trial). A narrative synthesis of findings was used due to heterogeneity among study designs and measures of association summarizing the relationship between SPU and DED. All included studies were conducted in South Korea and included school children, college students, or young adults. Three of the 4 included studies showed an association between SPU and DED.

CONCLUSIONS

There is some evidence that SPU is associated with DED. However, this evidence is limited by a small number of studies of satisfactory methodological quality. There is a great need for high-quality studies to further investigate the relationship between SPU and DED and identify mechanisms underlying this potential relationship. This information is important for raising public awareness about the negative effect of SPU on eye health and development of clinical guidelines for this potentially emerging SPU-driven eye condition.

Burden of neck pain and associated factors among smart phone user students in University of Gondar, Ethiopia

BACKGROUND

Mobile technology has spread rapidly around the globe. In 2018 the numbers of mobile subscribers in Ethiopia hit 66.2 million. Musculoskeletal complaints related to smartphone use in different body parts have been reported ranging from 8.2% to 89.9%. Neck pain has the highest prevalence rate, which ranges from 17.3% to 67.8%. However, there is limited evidence on the burden of neck pain related to Smartphone usage and no research is done in Ethiopia. Therefore, this study was conducted to determine the burden of neck pain and factors associated with smartphone use in Ethiopia.

PURPOSE

The objective of this study was to identify the prevalence and factors associated with neck pain among smartphone users at University of Gondar.

METHODS

Institutional based cross-sectional study was conducted from November to December 2019 to determine the prevalence and associated factors of neck pain, with a sample of 845 university student smartphone users at University of Gondar, Ethiopia. A self-administered questionnaire adapted from the Nordic musculoskeletal questionnaire was used to collect data. Independent variables which had a significant association were identified using logistic regression models. Results were reported by using texts and frequency distribution tables.

RESULTS

Out of 845 questionnaires distributed, 808 students responded; hence, the response rate was 95.6%. The overall prevalence of neck pain among smart phone users in the past 12 months was 47.4% (95% CI, 44.1-50.9%). Attending 5th year (AOR: 3.907, 95% CI: 1. 952-7.82) and 6th year (AOR: 2.93,95% CI: 1,304-6.59), regular physical exercise (AOR: 2.405, 95% CI: 1.549-3.734), cigarette smoking (AOR: 5.415, 95% CI: 2.685-10.919), residency (AOR: 1.681, 95% CI: 1.181-2.391), break while using smartphone (AOR: 3.253 95% CI: 2.252-4.699), used smartphone > 6 hour per day (AOR: 2.782 (1.528 95% CI: 1.528-5.063), used other devises (AOR: 3.158 95% CI: 2.128-4.689), number of social media used daily (AOR: 2.007 95% CI: 1.228-3.2788), used devise for playing game (AOR: 1.484 95% CI: 1.024-2.15) were factors significantly associated with neck pain.

CONCLUSION

The current study depicted that nearly half of the study participants reported neck pain in the past 12 months. Attending last year of university, personal characteristics, use of smart phone for longer period, playing game, not taking break, other electronic device use, increased number of social media use were associated with neck pain among smartphone users.

The effects of ergonomic intervention on the musculoskeletal complaints and fatigue experienced by workers in the traditional metal casting industry

This research aimed to evaluate the effects of ergonomic intervention on the musculoskeletal complaints and fatigue experienced by workers of the traditional metal casting industry that manually pour molten metal into molds. The workers' physical complaints are typically in the form of musculoskeletal complaints, which include (1) an activity aspect, (2) a physical aspect, and (3) a motivational aspect. The method used in this research was stratified random sampling. The subjects (n = 127) were divided into three groups, namely, the process cement department (PCD) group, the loam department (LD) group, and the black sand department (BSD) group. The evaluation was carried out using questionnaires based on musculoskeletal complaints and fatigue. Meanwhile, an assessment of musculoskeletal complaints and fatigue was conducted one month before the ergonomic intervention, and then during follow-ups at one and eight months after the ergonomic intervention. The results showed that the average reduction in musculoskeletal complaints and fatigue experienced by the workers in the LD group was lower than that of the workers in the PCD and BSD groups at one and eight months after the ergonomic intervention. The positive effects of the ergonomic intervention on musculoskeletal complaints were evident in terms of the back, waist, left and right thighs, right knee, right ankle, and left foot (p < 0.05). The positive effects of the ergonomic intervention on the level of activity-based fatigue were felt in the body and legs, and the feeling of wanting to lie down decreased. The motivational fatigue experienced by the workers manifested as difficulty in thinking, concentrating, and controlling behavior, while the physical fatigue experienced by the workers was in the form of headaches, back pain, excessive thirst, and feeling unwell (p < 0.05). It can be concluded that ergonomic intervention can reduce both musculoskeletal complaints and fatigue, especially by conducting a morning briefing, using ergonomic ladles when pouring molten metal into molds, and consuming nutritious food during break times.

Musculoskeletal symptoms among adult smartphone and tablet device users: a retrospective study

BACKGROUND

Previous literature suggests the use of smartphones and tablet devices may result in various postural and musculoskeletal disorders, predominantly of the neck and upper extremities. However, factors that contribute to the symptoms have not been adequately explored.

METHODS

This study aimed to investigate the prevalence and patterns (e.g. types, sites and temporal distributions) of musculoskeletal symptoms among adult smartphone and tablet device users. It also investigated device usage in terms of usage time, postures adopted during use, operational methods and purposes of device use in order to explain the symptom occurrences. Participants from eastern states of Australia retrospectively reported device usage and symptoms in the preceding two-week period, via an online survey. Data was analysed using Chi-square [χ2] analysis to determine the relationships between categorical variables; Mann-Whitney U tests to compare two groups (e.g. smartphone-only users versus tablet users) where dependant variables were ordinal; independent samples t-tests if dependent variables were continuous and approximated a normal distribution; and Spearman's correlation analysis to assess the relationships between pairs of continuous or ordinal variables.

RESULTS

Of the 207 participants, 59.9% reported musculoskeletal symptoms during or after device use; for 64.5% of these, symptoms began within the first 30 min (mostly between 15 and 30 min) of commencing usage. No statistically significant differences were observed between smartphone-only users and tablet device users in proportions reporting symptoms during device use (χ2 = .350, N = 207, p = .554). The most prevalent symptom was stiffness. The most prevalent symptom occurred in the neck (18.1% in smartphone-only users and 19.3% in tablet device users). Tablet users who were 18-24 year-old and used their device for more than 30 min in each usage session more often experienced symptoms (82.4% prevalence) than those who used a device for 30 min or less (52.2%) (χ2 = 4.723, N = 63, p = .030).

CONCLUSION

These findings suggest that user age, duration and frequency of usage, and type of device are important factors to consider in the formation of evidence-based guidelines to reduce experiences of musculoskeletal symptoms among smartphone and tablet device users. If usage was capped at < 15 min, the majority of smartphone and tablet device users would avoid symptoms.

The relationship between smartphone addiction and musculoskeletal pain prevalence among young population: a cross-sectional study

Background

In the literature, there have been debates as to whether smartphone use has negative effects on physical and mental health. The present study investigated the extent to which smartphone addiction impacts on musculoskeletal pain prevalence among university students.

Methods

The questionnaire consisted of three sections demographic information, the Smartphone Addiction Scale (SAS), and the modified Nordic Musculoskeletal Questionnaire.

Results

A total of 249 participants were included in this cross-sectional study. The body parts that were reported with highest prevalence of musculoskeletal pain were the upper back (70.3%), neck (65.9%), and wrists/hands (68.7%). The SAS scores were correlated with duration of smartphone use on a typical day (P = 0.001), duration of owning a smartphone (P = 0.027), and musculoskeletal pain prevalence in the neck (P = 0.001), wrists/hands (P = 0.001), shoulders (P = 0.025), and upper back (P = 0.023). The SAS score was significantly associated with prevalence of musculoskeletal pain in the neck (odd ratio [OR], 1.08; 95% confidence interval [CI], 0.98-1.10; P = 0.002), wrists/hands (OR, 1.07; 95% CI, 0.97-1.09; P = 0.001), and upper back (OR, 1.10; 95% CI, 0.98-1.11; P = 0.033).

Conclusions

The findings indicated that the upper back, neck, and wrists/hands have a higher prevalence of musculoskeletal pain among smartphone users, particularly those with a smartphone addiction. Smartphone addiction scores were correlated with duration of smartphone use on a typical day, duration of owning smartphone, and musculoskeletal pain prevalence in the neck, wrists/hands, shoulders, and upper back.

Fear of Missing Out and Smartphone Addiction Mediates the Relationship Between Positive and Negative Affect and Sleep Quality Among Chinese University Students

BACKGROUND AND AIMS

The widespread use of social media on smartphones has lead to the fear of missing out (FoMO) and smartphone addiction among a minority of adolescents and adults. However, few studies have investigated the impact of trait affect on sleep quality via FoMO and smartphone addiction. The present study examined whether FoMO (trait-FoMO and state-FoMO) and smartphone addiction mediated the relationship between positive affect (PA)/negative affect (NA) and sleep quality, and the prevalence of sleep disturbance among Chinese university students.

METHODS

The sample comprised 1,164 university students and they completed a survey which included the Chinese Trait-State Fear of Missing Out Scale (T-SFoMOS-C), Mobile Phone Addiction Index (MPAI), International Positive and Negative Affect Scale Short-Form (I-PANAS-SF), and the Pittsburgh Sleep Quality Index (PSQI).

RESULTS

The prevalence of sleep disturbance was found to be 15.98% among Chinese university students. The serial multiple mediation effects indicated that PA directly impacted on sleep quality, but the mediation effects of trait-FoMO and state-FoMO were not found. NA impacted on sleep quality via the mediation effects of trait-FoMO/state-FoMO and smartphone addiction.

CONCLUSION

Negative affect was positively associated with poor sleep quality, which was partially mediated by FoMO and smartphone addiction among Chinese university students. Individuals with high negative affect were more likely to have high levels of FoMO and were more prone to smartphone addiction as well as experiencing poor sleep quality. These findings provide an evidence base for emotion management, prevention of smartphone addiction, and sleep improvement.