The Head Down Generation: Musculoskeletal Symptoms and the Use of Smartphones Among Young University Students

Associations between personality and problematic internet use among Chinese adolescents and young adults: A network analysis

BACKGROUND

With the number of internet users booming, problematic internet use (PIU) has become a public health threat. This study aims to figure out the inter-relationships between PIU symptoms and personality traits with network-based analysis among young people and to discuss the gender difference in the above networks.

METHODS

Based on a national cross-sectional study in 2022, 4655 Chinese adolescents and young adults aged 14 to 25 were included. We adopted the 6-item Short-Form Problematic Internet Use Questionnaire (PIUQ-SF-6) and the 10-item version of the Big Five Inventory (BFI-10) to measure PIU and personality traits, respectively. Network analysis was used to identify influential nodes and edges and compare the network models between male and female participants.

RESULTS

The mean age of 4655 participants was 19.84, and 52.1 % (2424) of them were females. There are differences in age and gender between participants with and without PIU (P < 0.05). The network of personality and PIU showed that 22 out of the 28 edges were estimated to be nonzero, and "obsession-neuroticism" was the strongest positive edge between the two communities. Central symptoms (i.e., "obsession" and "control disorder") and bridge symptoms (i.e., "obsession" and "neuroticism") have been identified. Gender differences existed in network global strength: female = 3.71, male = 3.18 (p < 0.001).

LIMITATIONS

The cross-sectional study needs more evidence to build causal inference.

CONCLUSIONS

The results of PIU-personality networks may contribute to the personalized prevention and treatment of PIU. The gender difference in PIU-personality networks also requires more attention and discussion.

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.

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.

Effect of physical exercise on sleep quality in college students: Mediating role of smartphone use

OBJECTIVE

To investigate the effect of physical exercise on sleep quality and the mediating effect of smartphone use behavior in college students.

METHODS

A cross-sectional study design was adopted. An online survey of 5,075 college students was conducted using the Physical Activity Rating Scale-3, the Pittsburgh Sleep Quality Index, and the Mobile Phone Addiction Tendency Scale.

RESULTS

The sleep quality of college students was poor, and the proportion of college students with good sleep quality was 23.567%. A significant correlation existed between sleep quality and physical exercise (r = -0.159, P < 0.001) and mobile phone addiction (r = 0.355, P < 0.001). Physical exercise can predict sleep quality in college students (β = -0.011, P < 0.001). Smartphone use plays a part in mediating the process by which physical exercise affects sleep quality.

CONCLUSION

Chinese college students have poor sleep quality. Physical exercise and smartphone use behavior are important factors affecting the sleep quality of college students. Physical exercise can directly predict the sleep quality of college students and can predict the sleep quality of college students through the mediating effect of smartphone use behavior.

Neck and Upper Extremity Musculoskeletal Symptoms Secondary to Maladaptive Postures Caused by Cell Phones and Backpacks in School-Aged Children and Adolescents

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.

Effect of Mobile Phone Addiction on Physical Exercise in University Students: Moderating Effect of Peer Relationships

OBJECTIVE

The influence of mobile phone addiction (MPA) on physical exercise in university students was explored, and peer relationships were introduced as a moderating variable.

METHODS

A cross-sectional study design was adopted, and an online survey questionnaire was conducted to investigate two universities in Nantong City, Jiangsu Province, and Chongzuo City, Guangxi Zhuang Autonomous Region. A total of 4959 university students completed the questionnaire. Measurement tools included the Mobile Phone Addiction Tendency Scale, the Physical Activity Rating Scale, and the Peer Rating Scale of university students.

RESULTS

University students scored 39.322 ± 15.139 for MPA and 44.022 ± 7.735 for peer relationships, with 87.8% of their physical exercise, in terms of exercise grade, being classified as medium or low intensity. The MPA of the university students was negatively correlated with peer relationships (r = -0.377, p < 0.001) and physical exercise behavior (r = -0.279, p < 0.001). The moderating effect of peer relationships on the MPA-physical exercise behavior relationship was significant (ΔR² = 0.03, p < 0.001).

CONCLUSIONS

The physical exercise of university students was at a medium or low intensity. The more serious the university students' addiction to mobile phones was, the lower the amount of physical exercise. The physical activity of males was higher than that of females. MPA and peer relationships were the limiting factors of the physical exercise behavior of university students. Under the lower effect of peer relationship regulation, MPA had a greater negative impact on physical exercise behavior. The data from this research can provide theoretical support to improve the participation of university students in physical activities.

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 pain, sleep quality and migraine with level of physical activity in college students during the COVID-19 pandemic

Background

The COVID-19 pandemic has negative impacts on general health of the population, social isolation can contribute to the emergence of various dysfunctions.

Objective

To investigate the association musculoskeletal pain, sleep quality and migraine with the level of physical activity during the COVID-19 pandemic in college students.

Method

Data were collected through a sociodemographic questionnaire containing questions regarding sample characterization, the Nordic Musculoskeletal Questionnaire (NMQ), Pittsburgh Sleep Quality Index (PSQI), Migraine Disability Assessment (MIDAS) and the International Physical Activity Questionnaire (IPAQ).

Results

In the correlation made between the data at the beginning of the pandemic, there was a direct relationship between PSQI and the number of days with pain (p < 0.001), the Initial MIDAS score (p < 0.001) and the initial pain intensity (p < 0.001). There was a direct relationship between PSQI scores and age (p = 0.044), MIDAS (p < 0.001) and pain intensity (p < 0.001). We identified a direct relationship between MIDAS and the number of days with pain (p < 0.001) and pain intensity (p < 0.001).

Conclusion

Social isolation, during the COVID-19 pandemic, probably potentiated painful symptoms in various parts of the body, worsening sleep quality and migraine. In addition, there is a strong evidence that the decrease in physical activity during the pandemic is associated with sleep quality, with the number of days with musculoskeletal pain and migraine.

Global sagittal alignment after surgery of right thoracic idiopathic scoliosis in adolescents and adults with and without thoracic hypokyphosis

This study aimed to characterize global sagittal alignment in adolescent idiopathic scoliosis (AIS) with normal kyphosis (NTK, kyphosis > 10°) and with thoracic hypokyphosis (THK, kyphosis < 10°), before and after posterior spinal fusion, and compare them with asymptomatic controls. 27 AIS girls and young adults with right thoracic curves were included (seventeen with age ≤ 18 years, then age > 21). Biplanar radiographies were acquired at baseline, immediate post-operatively, 1-year and 2-year follow-up, and 3D reconstruction of the spine and pelvis was performed. NTK and THK showed different global sagittal alignment, as well as differences compared to controls. AIS with THK at baseline had higher SVA/SFD (2.0 ± 2.9 vs - 0.4 ± 1.9; P < 0.05) and OD-HA (0.2 ± 1.4° vs - 1.3 ± 1.6°; P < 0.05) than controls, indicating that THK had compensated balance with unusual forward leaning posture. Immediately post-operation, SVA/SFD remained high (1.3 ± 3.0) while OD-HA reversed (- 1.2 ± 1.7°), indicating that THK patients had found partially compensated balance. After 2-yeas, both SVA/SFD (- 1.3 ± 2.1) and OD-HA (- 1.4 ± 0.9°) were normalized. The changes in global sagittal alignment and mechanism of balance are different in AIS with or without THK. As the head plays a critical role on balance during immediate and delayed post-operation, OD-HA can be complementary parameter for assessing global balance during post-operative follow-up of AIS patients with THK.

Neck pain associated with smartphone overuse: cross-sectional report of a cohort study among office workers

PURPOSE

The aim of the current study was to investigate the extent of smartphone use, possible correlation with neck pain and/or psychological impairment in office workers.

METHOD

A convenience sample of 1,602 office workers who were using smartphone for prolonged periods (≥ 4 years) participated in a cross-sectional report of a cohort study, assessing demographic, abnormal symptoms of pain in the neck, physical activity, and psychological behavior characteristics. Participants were assessed using a short version of the Smartphone Addiction Scale (SAS-SV), Depression, Anxiety and Stress Scales (DASS-42) questionnaire, as well as International Physical Activity Questionnaire-Short Form (IPAQ-SF). Multiple logistic regression model was conducted to evaluate the adjusted effect of smartphone overuse on nuchal symptoms.

RESULTS

The prevalence of neck pain among the office workers was 30.1%. Significantly more female (33.3% vs. 24.5%) and younger (42.2 vs. 43.2 years) employees reported to have neck pain. Overall in 326 (20.3%, 95% CI: 18.4%-22.4%) of studied subjects had, SAS score ≥ 31 and ≥ 33 for male and females, respectively, and so smartphone overuse (SO) was diagnosed. The results of multiple logistic regression model revealed that those with SO were approximately 6 times more likely to have neck pain (95% CI: 4.44-8.09, P < 0.001).

CONCLUSIONS

Smartphone overuse in office workers significantly increases the chance of neck pain by 6 times. Hence SO has been associated with, not only somatic complaints, but also psychological distress such as anxiety, stress, and depression. This may necessitate adherence to neck-school, when smartphone use is associated with neck pain.

Prevalence of mobile device-related musculoskeletal pain among working university students: a cross-sectional study

The aim of the present study was to investigate usage patterns of mobile devices and their impact on users' musculoskeletal system among working university students in Slovenia at the Faculty of Chemistry and Chemical Technology of the University of Ljubljana. An Internet-based survey was sent to students' e-mail addresses and students provided information about usage patterns and reported on musculoskeletal pain (MSP) that may relate to mobile device usage in the past 12 months. A total of 535 students (63% females and 37% males) aged 18 years or older completed the survey and fulfilled the inclusion criteria. The results showed that the prevalence of MSP was 39.6%. Most musculoskeletal symptoms were reported in the back (57.1%) and shoulder (50%). Statistically significant differences in exposure to mobile devices and MSP between genders were found (p < 0.05). This study highlights the importance of knowledge of mobile device ergonomics among working students.

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

BACKGROUND

In the past decade, mobile phone usage rates have increased and there have been concerns that overuse of mobile phones may contribute to various musculoskeletal (MSK) problems.

OBJECTIVES

The aim of the present study was to systematically review available literature on the prevalence of MSK complaints, symptoms, and pathologies associated with mobile phone use.

STUDY DESIGN

Systematic review.

METHOD

In this systematic review, Medline (Pubmed), Wiley, WOS, and EMBASE electronic databases were searched for studies published in English between January 1, 2000 and March 25, 2019 using the following. KEY TERMS: 'mobile phone', 'smartphone', 'musculoskeletal pain', 'pain', 'musculoskeletal symptoms', and 'musculoskeletal pathology'.

RESULTS

The search strategy identified 196 papers, of which 18 met the inclusion criteria. Among the studies included in the systematic review, five were high quality, twelve were of acceptable quality, and one was of low quality. The review demonstrated that the prevalence of MSK complaints among mobile phone users ranged 8.2%-89.9%, and that neck and upper back complaints had the highest prevalence rates ranging from 55.8% to 89.9%. The most common MSK symptom associated with mobile phone use was pain. Myofascial pain syndrome, fibromyalgia, thoracic outlet syndrome, tendonitis, and De Quervain's syndrome were the most commonly associated MSK pathologies.

CONCLUSION

The evidence concerning MSK complaints among mobile phone is somewhat limited because the data were obtained from cross-sectional and case-control study results. Consequently, there is need for higher quality and prospective studies to better understand the relationship between mobile phone use and MSK symptoms and pathologies.

Evaluating the relationship between smartphone addiction/overuse and musculoskeletal pain among medical students at Qassim University

Background:

Smartphone use has greatly increased in recent days, and most of the daily tasks are done through these devices. As a result, long time use may involve bad posture that may result in musculoskeletal pain. Therefore, it is important to evaluate the association between addiction/overuse of smartphones and musculoskeletal pain.

Aim:

To determine the prevalence of addictive/overuse of smartphones among medical students and to investigate if there is an association between smartphone addiction and musculoskeletal pain.

Method:

A cross-sectional study conducted at Qassim University, medical college. The Smartphone Addiction Scale Short Version (SAS-SV) was used to measure the level of smartphone addiction while the Nordic musculoskeletal questionnaire (NMQ) was utilized to evaluate the musculoskeletal pain.

Results:

The prevalence of smartphone addiction among medical students was relatively high (60.3%). The most frequent pain related to smartphone addiction was in the neck (60.8%), followed by lower back (46.8%), shoulder (40.0%). The academic year level was statistically associated with the level of smartphone addiction. Moreover, we found a significant relationship between musculoskeletal pain and smartphone addiction at certain body regions, neck, wrist/hand and knees, Other musculoskeletal parameters included in the test were found to have no statistically significant association.

Conclusion:

More than half of the medical students identified as addicted to smartphones. The most common musculoskeletal pain was the neck, lower back, and shoulder. The academic year level found to have a significant association with the level of smartphone addiction while musculoskeletal pain such as neck, wrist, and knee were the independent significant factors of smartphone addiction; therefore, it is important to educate the community about the effect of being addicted to smartphone use in order to prevent the consequences of this behavior.