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Souza VK, Schneider IJC, Registro Fonseca MDC, Kuriki HU, Marcolino AM, Barbosa RI. Text neck is not associated with neck and upper limb disability in young adults who use smartphones. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:1187-1194. [PMID: 38369595 DOI: 10.1007/s00586-024-08139-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 12/15/2023] [Accepted: 01/10/2024] [Indexed: 02/20/2024]
Abstract
PURPOSE The objective of the present study was to correlate neck and upper-limb disabilities with neck flexion in university students who are smartphone users. While handling smartphones, a posture with sustained neck flexion known as "Text Neck" is usually adopted, and some authors related to musculoskeletal symptoms on the neck and the upper limb. However, recent studies state that such an association is questionable. METHODS This is an observational study when evaluating 192 university students through questionnaires such as the Neck Disability Index (NDI), Disabilities of Arm, Shoulder, and Hand (DASH), besides the maximal neck flexion, grip and lateral pinch strength of the participants. RESULTS The sociodemographic questionnaire demonstrated that most participants had used the device for 5 to 10 years, for five or more hours per day. The DASH questionnaire scores presented an average of 7.2 points, while the data regarding grip and lateral pinch strength showed averages of 29.5 kgf and 8.8 kgf, respectively. The NDI questionnaire scores presented an average of 10.5. The average range of motion of the maximum neck flexion was 27°. CONCLUSION There was no association between neck flexion with the DASH and NDI or the grip and lateral pinch strength after the correlation and binary logistic regression analyses. The results show that the scores of DASH, NDI, hand grip and lateral pinch strength, have no association with the maximum neck flexion.
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Affiliation(s)
- Vitor Kinoshita Souza
- Post-Graduate Program in Rehabilitation Sciences, Laboratory of Assessment and Rehabilitation of the Locomotor System, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira 150, Araranguá, Santa Catarina, CEP 88905-120, Brazil.
| | - Ione Jayce Ceola Schneider
- Post-Graduate Program in Rehabilitation Sciences, Laboratory of Assessment and Rehabilitation of the Locomotor System, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira 150, Araranguá, Santa Catarina, CEP 88905-120, Brazil
| | - Marisa de Cássia Registro Fonseca
- Post-Graduate Program in Functional Rehabilitation and Performance, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Heloyse Uliam Kuriki
- Post-Graduate Program in Rehabilitation Sciences, Laboratory of Assessment and Rehabilitation of the Locomotor System, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira 150, Araranguá, Santa Catarina, CEP 88905-120, Brazil
| | - Alexandre Márcio Marcolino
- Post-Graduate Program in Rehabilitation Sciences, Laboratory of Assessment and Rehabilitation of the Locomotor System, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira 150, Araranguá, Santa Catarina, CEP 88905-120, Brazil
| | - Rafael Inácio Barbosa
- Post-Graduate Program in Rehabilitation Sciences, Laboratory of Assessment and Rehabilitation of the Locomotor System, Federal University of Santa Catarina (LARAL/UFSC), Rua Pedro João Pereira 150, Araranguá, Santa Catarina, CEP 88905-120, Brazil
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Grasser T, Borges Dario A, Parreira PCS, Correia IMT, Meziat-Filho N. Defining text neck: a scoping review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:3463-3484. [PMID: 37405530 DOI: 10.1007/s00586-023-07821-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/02/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Text neck is regarded as a global epidemic. Yet, there is a lack of consensus concerning the definitions of text neck which challenges researchers and clinicians alike. PURPOSE To investigate how text neck is defined in peer-reviewed articles. METHODS We conducted a scoping review to identify all articles using the terms "text neck" or "tech neck." Embase, Medline, CINAHL, PubMed and Web of Science were searched from inception to 30 April 2022. We followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMAScR) guidelines. No limitation was applied for language or study design. Data extraction included study characteristics and the primary outcome relating to text neck definitions. RESULTS Forty-one articles were included. Text neck definitions varied across studies. The most frequent components of definitions were grouped into five basis for definition: Posture (n = 38; 92.7%), with qualifying adjectives meaning incorrect posture (n = 23; 56.1%) and posture without a qualifying adjective (n = 15; 36.6%); Overuse (n = 26; 63.4%); Mechanical stress or tensions (n = 17; 41.4%); Musculoskeletal symptoms (n = 15; 36.6%) and; Tissue damage (n = 7; 17.1%). CONCLUSION This study showed that posture is the defining characteristic of text neck in the academic literature. For research purposes, it seems that text neck is a habit of texting on the smartphone in a flexed neck position. Since there is no scientific evidence linking text neck with neck pain regardless of the definition used, adjectives like inappropriate or incorrect should be avoided when intended to qualify posture.
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Affiliation(s)
- Tatiana Grasser
- Centro Universitário Augusto Motta, UNISUAM, Rua Dona Isabel 94, Bonsucesso, Rio de Janeiro, RJ, CEP 21041-010, Brazil.
- Instituto Federal de Educação, Ciência e Tecnologia do Tocantins, Palmas, Brazil.
- Instituto Federal de Educação, Ciência e Tecnologia do Paraná, Curitiba, Brazil.
| | - Amabile Borges Dario
- Faculty of Medicine and Health, Sydney School of Health Sciences, University of Sydney, Sydney, Australia
| | | | - Igor Macedo Tavares Correia
- Centro Universitário Augusto Motta, UNISUAM, Rua Dona Isabel 94, Bonsucesso, Rio de Janeiro, RJ, CEP 21041-010, Brazil
| | - Ney Meziat-Filho
- Centro Universitário Augusto Motta, UNISUAM, Rua Dona Isabel 94, Bonsucesso, Rio de Janeiro, RJ, CEP 21041-010, Brazil
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Neck and Upper Extremity Musculoskeletal Symptoms Secondary to Maladaptive Postures Caused by Cell Phones and Backpacks in School-Aged Children and Adolescents. Healthcare (Basel) 2023; 11:healthcare11060819. [PMID: 36981476 PMCID: PMC10048647 DOI: 10.3390/healthcare11060819] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/26/2023] [Accepted: 03/06/2023] [Indexed: 03/15/2023] Open
Abstract
Technology is an essential part of our lives. Nowadays, it is almost impossible to leave the house without a cell phone. Despite the wide range of benefits of cell phones and handheld electronic devices, this evolution of technology has not come without a price. The pandemic of cell phone use among children and young adolescents has led to the emergence of a set of musculoskeletal (MSK) symptoms that have not been seen before in this age group. These symptoms can range from neck and shoulder discomfort to pain, peripheral neurological symptoms of the upper extremity, and long-term complications such as disk prolapse and degenerative disk disease of the cervical spine. This clinical presentation is known as “text neck syndrome.” In addition to MSK symptoms, text neck syndrome could also include eye and ear symptoms, psychological problems, peripheral neurological symptoms, and poor academic performance. Multiple mechanisms have been discussed by which cell phone use causes MSK symptoms. Maladaptive postures, a decrease in physical activity leading to obesity, and the direct effect of electromagnetic radiation are some of the mechanisms by which long-term use of cell phones leads to the clinical presentation of text neck syndrome and its long-term consequences. The purpose of this article is to review the literature, discuss the epidemiology of cell phone use and MSK symptoms associated with its use in children and adolescents, describe its clinical presentation, explain the pathophysiology behind it, and provide preventative guidelines that can be used by this age group to allow for the continued use of these electronics without harmful effects on their posture and long-term health.
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Abstract
STUDY DESIGN Observational cross-sectional study. OBJECTIVE The aim of this study was to investigate the association between text neck and neck pain (NP) in adults. SUMMARY OF BACKGROUND DATA It has been hypothesized that the inappropriate neck posture adopted when texting and reading on a smartphone, called text neck, is related to the increased prevalence of NP. METHODS The sample was composed of 582 volunteers aged between 18 and 65 years. Sociodemographics, anthropometrics, lifestyle, psychosocial, NP, and smartphone use-related questions were assessed by a self-reported questionnaire. Text neck was assessed by measuring the cervical flexion angle of the participants standing and sitting while typing a text on their smartphones, using the Cervical Range of Motion (CROM) device. RESULTS Multiple logistic regression analysis and linear regression analysis showed the cervical flexion angle of the standing participant using a smartphone did not associate with the prevalence of NP (odds ratio [OR] = 1.00; 95% confidence interval [CI]: 0.98-1.02; P = 0.66), NP frequency (OR = 1.01; 95% CI: 1.00-1.03; P = 0.056), or maximum NP intensity (beta coefficient = -5.195 × 10-5; 95% CI: -0.02 to 0.02; P = 0.99). Also, the cervical flexion angle of the sitting participant using the smartphone did not associate with NP (OR = 0.99; 95% CI: 0.98-1.01; P = 0.93), NP frequency (OR = 1.01; 95% CI: 0.99-1.02; P = 0.13), or maximum NP intensity (beta coefficient = 0.002; 95% CI: -0.002 to 0.02; P = 0.71). CONCLUSION Text neck was not associated with prevalence of NP, NP frequency, or maximum NP intensity in adults.Level of Evidence: 4.
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Lai J, Ji G, Zhou Y, Chen J, Zhou M, Mo J, Zheng T. Apoptosis of endplate chondrocytes in cervical kyphosis is associated with chronic forward flexed neck: an in vivo rat bipedal walking model. J Orthop Surg Res 2021; 16:5. [PMID: 33397370 PMCID: PMC7784390 DOI: 10.1186/s13018-020-02124-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 11/27/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND This study was undertaken to establish a rat bipedal walking model of cervical kyphosis (CK) associated with chronic forward flexed neck and assess the effects of chronic forward flexed neck on endplate chondrocytes. METHODS Forty-eight 1-month-old Sprague-Dawley rats were randomly divided into 3 groups: forward flexed neck group (n = 16), bipedal group (n = 16), and normal group (n = 16). Cervical curves were analyzed on a lateral cervical spine X-ray using Harrison's posterior tangent method before the experiment and at 2-week intervals for a 6-week period. Histologic changes in cartilaginous endplate chondrocytes were observed using hematoxylin and eosin (H&E) staining, transmission electron microscopy (TEM), and terminal deoxyribonucleotidyl transferase (TdT)-mediated dUTP nick-end labeling. RESULTS Radiographic findings suggested a significantly decreased cervical physiological curvature in the forward flexed neck group over the 6-week follow-up; normal cervical curves were maintained in other groups. The average cervical curvature (C2-C7) was - 7.6 ± 0.9° in the forward flexed neck group before the experiment, - 3.9 ± 0.8° at 2 weeks post-experiment, 10.7 ± 1.0° at 4 weeks post-experiment, and 20.5 ± 2.1° at the last follow-up post-experiment. Histologically, results of H&E staining unveiled that cartilaginous endplate chondrocytes were arranged in an irregular fashion, with the decreased number at the observation period; the incidence of apoptotic cells in the forward flexed neck group was noticeably higher at the 6-week follow-up than that in other groups. CONCLUSIONS CK developed as the result of chronic forward flexed neck. Histologic changes suggested that chondrocyte apoptosis may play a critical role in the development of cervical kyphotic deformity associated with chronic forward flexed neck.
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Affiliation(s)
- Jinliang Lai
- Emergency Department, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China
| | - Guanglin Ji
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China
| | - Yuqiao Zhou
- Gannan Medical University, Ganzhou, 341000, China
| | - Jincai Chen
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China
| | - Min Zhou
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China
| | - Jianwen Mo
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China.
| | - Tiansheng Zheng
- Department of Orthopedics, First Affiliated Hospital of Gannan Medical University, Ganzhou, 341000, China.
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Posture and time spent using a smartphone are not correlated with neck pain and disability in young adults: A cross-sectional study. J Bodyw Mov Ther 2020; 26:220-226. [PMID: 33992248 DOI: 10.1016/j.jbmt.2020.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 08/31/2020] [Accepted: 09/14/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the impact of smartphone use on neck impairment and functional limitation in university students. METHODS A cross-sectional correlational study was conducted in a sample of students selected through convenience sampling between September 2016 and March 2017. The inclusion criteria were university students at the School of Medicine and Surgery, routine/daily use of mobile devices with advanced computing and connectivity capability built on an operating system, and aged 18-30 years. Participants completed questionnaires that measured general characteristics of smartphone use and demographic characteristics. Neck pain was assessed using a visual analogue pain score (VAS) and a pain drawing (PD); disability status was measured using the Neck Disability Index (NDI-I); and cervical postures while using the phone were captured using the Deluxe Cervical Range of Motion (CROM) device. RESULTS A total of 238 volunteers were recruited (22.4 ± 2.2 years of age, 53.4% males), 35.9% of whom were overweight (>25 BMI). Regarding neck pain, 42.4% reported mild pain, 8.4% had moderate pain, and the remaining 49.2% had no pain. NDI-I and VAS were 3.8 ± 3.8 and 13.6 ± 18.4 mm, respectively. The pain categories did not influence the variables. No significant correlations were observed between the number of hours spent and posture (CROM) while using a smartphone and neck pain and NDI-I. CONCLUSION While half of young medical students reported neck pain, the use of smartphones was not correlated with neck pain and disability. While we wait for future prospective studies, there is no reason to recommend a change in smartphone use habits among young adults in the meantime.
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