Association between Smartphone Addiction and Breathing Pattern in Sedentary Young College-Going Students - A Cross-Sectional Study

BACKGROUND

The number of smartphone users has progressively increased worldwide. Altered biomechanics of the cervicothoracic spine and ribcage could limit the chest wall function that affects the respiratory muscles strength, reducing diaphragm function in smartphone users. This study aimed to compare breathing patterns between smartphone-addicted and -nonaddicted user groups.

OBJECTIVE

To find the association between excessive smartphone use and breathing pattern in sedentary young college-going students.

MATERIALS AND METHODS

This cross-sectional study includes 230 participants. The participants were screened for the inclusion and exclusion criteria and were asked to fill out a Smartphone Addiction Scale questionnaire. These breathing patterns were then assessed by self-evaluation of breathing questionnaire (SEBQ), manual assessment of respiratory motion (MARM), breath-holding test, and capnography.

RESULTS

The correlation of smartphone-addicted and -nonaddicted groups with breathing patterns was performed by Spearman rank correlation. Results show no significant association between the smartphone-nonaddicted and -addicted users.

CONCLUSION

This study concluded that excessive smartphone use and breathing patterns are not associated.

Investigation of grip strength, pain threshold, pain tolerance and function in smartphone users

PURPOSE/AIM OF THE STUDY

Few studies have demonstrated the effects of smartphone use on grip strength and upper extremity function. The present study was purposed to compare smartphone users' grip/lateral pinch strength, pain threshold/tolerance and upper limb function.

MATERIALS AND METHODS

A prospective cross-sectional study was conducted with 241 individuals. Participants were divided into three groups with the cut-off values of the Smartphone Addiction Scale (SAS). The Edinburgh Handedness Inventory (EHI) was used to determine the dominant side. Thumb pain threshold and tolerance were evaluated with the algometer. A hand dynamometer measured the grip and lateral pinch strength. Upper extremity functions were evaluated with the Shortened Disabilities of the Arm, Shoulder and Hand Questionnaire (Quick-DASH).

RESULTS

Handgrip strength of the dominant/non-dominant extremities and Quick-DASH scores were higher in low-level smartphone users (p < 0.05). There was no significant difference between the groups on lateral pinch strength and pain threshold/tolerance (p > 0.05). Smartphone usage significantly affected dominant and non-dominant hand grip strength (Standardized β1 = -0.15, β2 = -0.15, p < 0.05). In addition, the smartphone use level negatively affected dominant lateral pinch strength (Standardized β = -0.12, p = 0.05). On the other hand, smartphone use positively affected upper extremity function (Standardized β = 0.17, p < 0.05).

CONCLUSIONS

As smartphone addiction increases, standard handgrip strength and functionality decrease. Pain threshold/tolerance is not affected by smartphone use. Future studies should focus on fine motor skills to present a more comprehensive upper limb function evaluation.

Use of Smartphones as a Risk Factor for the Development of Morbidities in the Wrist and Fingers

Objective  To investigate the long-term use of smartphones as a risk factor for the development of morbidities in the wrist and fingers. Methods  The present is a descriptive, exploratory study with a quantitative approach based on injury prevalence among one hundred smartphone users of a private university in the state of Pernambuco, Northeastern Brazil. We applied a semi-structured questionnaire and the Boston Carpal Tunnel Questionnaire (BCTQ), as well as the Visual Analog Scale (VAS) and the Finkelstein, Phalen, reverse Phalen, and Tinel signal tests on the wrist. Results  The average of the sample was of 22.73 years, with a prevalence of single, right-handed female participants. Most of them had been using smartphones for 5 to 10 years, and 85% reported discomfort in the wrist and fingers while using the device, with numbness as the most prevalent symptom. Most clinical tests were negative, and the Finklestein test showed greater positivity. The BCTQ is composed of a symptom severity scale (S scale) and a functional status scale (F scale): the overall score on the S scale was of 1.61, indicating mild to moderate symptoms, and the F scale revealed that the symptoms did not affect functionality. Conclusion  There was a significant correlation between the length of use of smartphones and discomfort in the wrist and fingers; as such, smartphones are a risk factor for the development of morbidities.

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.

Effects of lying posture and task type on muscle fatigue, visual fatigue, and discomfort while using a smartphone on the bed

BACKGROUND

Neck-shoulder and arm musculoskeletal disorders in smartphone use have attracted increasing attention.

OBJECTIVE

This study aimed to examine the effect of different lying postures and task types by comparing the electrooculography (EOG) responses, perceived discomfort, and the activity of neck-shoulder and arm muscles while using a smartphone on the bed.

METHODS

Twenty participants were recruited to perform 30-min tasks (texting/ watching video) while holding the smartphone in three different lying postures (half-lying/lying/side-lying). Subjective discomfort, muscular activities including the abductor pollicis brevis (APB), upper trapezius (UT), and extensor carpi radialis (ECR), and EOG signals were simultaneously monitored.

RESULTS

The results showed that the perceived discomfort of measured body parts increased significantly over time in all postures. Watching video significantly increases muscle activities of APB and UT and decreases blink frequency and blink duration. Compared to lying or half-lying, the side-lying posture has the highest blink frequency, blink duration, and muscle activities in ECR and UT.

CONCLUSION

The findings of this study indicate that side-lying posture should be avoided while using a smartphone on the bed. It provides an understanding of the association between the postures of using smartphones on the bed and fatigue, which can help prevent muscle and visual fatigue in smartphone use.

Relationships of Mobile Phone Use with the Functions and Disabilities of Neck and Upper Extremity

Aim: To determine the effects of mobile phone use on fine motor functions, neck, and upper limb disability values.Methods: Time duration of mobile phone use was recorded for a week. Rapid Upper Limb Assessment (RULA) was used to determine the risk level about posture while texting message on phones. Neck Disability Index (NDI) for neck pain and functional disability of neck on activities of daily life, Disabilities of the Arm, Shoulder, and Hand-Function/Symptom (DASH-FS) for the limitation in the functions of upper limb, Jebson Taylor Hand Function test for fine motor function.Results: Two hundred and seventy individuals (141 women, 129 men) whose mean ages were 21,48±1,86 years were included. While a significant correlation between duration of phone use and NDI score was specified (r=0,172; p=0,005), no significant correlation was found between duration of phone use and DASH-FS scores (r=0,092; p=0,130). It was found that there was a negative significant relationship between the duration of phone use and the total function score of the left hand and throwing small objects (p&lt;0,01). According to RULA 95,6% of individuals have unacceptable phone usage postures, but no significant relationship was found between ergonomic risk level and NDI values, DASH-FS values, and hand functions (p&gt;0,05).Conclusion: Although increased duration of phone use could cause neck problems, manual ability may be positively affected. In addition, since most participants have a poor posture while using a mobile phone, it is thought that this may be a risk factor for more musculoskeletal problems in older ages.

The prevalence of bad posture and musculoskeletal symptoms originating from the use of gadgets as an impact of the work from home program of the university community

During the COVID-19 pandemic, the Universitas Indonesia (UI) implemented a work from home program (WFH) to curb the spread of the coronavirus, as the use of gadgets including mobile phones and tablets were becoming prolonged and more frequent. As a result, musculoskeletal symptoms in certain limbs due to awkward posture sprang up. Therefore, the aim of this study was to quantify the degree of the use of these devices among UI community during the WFH initiative, as well as to identify musculoskeletal complaints resulting from defective postures. Consequently, this cross-sectional survey employed an online-based questionnaire, and the minimum number of respondents was 1080, as calculated using Slovin Formula. Meanwhile, a total of 1083 individuals, including lecturers (118), students (709), and managerial staff (256), obtained from 14 faculties, three schools, as well as administrative centres, volunteered to respond to the online poll. Apparently, 95% of the scholars owned mobile phones while only 16% possessed tablets, and 56% had used phones for over 10 years. The typical posture when using mobile devices was a reclining position on a sofa or mattress for a duration of 1–3 h as recounted by 34.6%. Also, sitting at a table for less than 30 min was reported by 25.3% of the subjects who used tablets. Furthermore, 70.5% of the respondents complained of musculoskeletal discomfort, particularly in the neck (86.4%), lower back (75.9%), and right & left shoulders (76.2%). In addition, the postures significantly related to these grievances included sitting at a table, alongside a prone position whilst using a mobile phone, as well as a latent or floor-sitting posture when using a laptop, whether at a table or not. Therefore, it is essential to do stretching, limiting usage time, look away every 20 min at an object that is about 20 feet away for a full 20 s when using a gadget and having adequate rest time to reduce musculoskeletal complaints.

Application of the best-worst method approach for prioritizing risk factors of musculoskeletal disorders among mobile device users: A case study

BACKGROUND: Musculoskeletal disorders (MSDs) are the most common work–related health issues among mobile device (MD) users due to long hour of working during homestay. Various researches have been carried out earlier for identifying the MSD risk factors, though the risk factors’ priority and weightage play an important role for risk management. OBJECTIVE: In the current study, the priority and weightage for MSD risk factor (individual factor, personal factor, psychosocial factor, and subfactors in each factor) were identified using the best–worst method (BWM) for MD users through a case study. METHOD: A framework was proposed for evaluating the risk hierarchy. The rating data provided by decision–makers was analysed using BWM for optimistic risk factor outcomes. A sensitivity analysis was also performed on the prioritized risk factors/subfactors for the consistency check. RESULTS: Research results revealed that personal factor was the most prominent risk factor of MSDs, followed by psychosocial factor and individual factor. Further, the total time spent and gender were identified as most and least dominating risk subfactor of MSDs respectively. The evaluated priority and weightage of MSD risk factors were further validated using sensitivity analysis. CONCLUSION: The obtained outcomes may be helpful in reducing the MSDs risk factors among the MD users by ergonomic improvement.

Orthopaedic Injuries Associated With Cell Phone Use Resulting in Emergency Department Visits: A 20-Year Analysis

INTRODUCTION

Cell phones are an integral part of daily life but are distractors that can contribute to injury. The present study uses a large national emergency department (ED) database to evaluate the frequency, anatomic location, and type of injuries associated with cell phone use. We hypothesize that orthopaedic injuries related to cell phone use have increased over time and affect certain body parts and age groups more than others.

METHODS

The 1999 to 2018 Nation Electronic Injury Surveillance System was queried for cell phone-related injuries leading to ED visits (injuries to the head or face or involving a landline were excluded). Demographics, type of orthopaedic injury, and body part injured were tabulated, and injuries were then classified over time as direct mechanical or cell phone use-associated, as well as related to texting compared with talking.

RESULTS

A weighted national total of 44,599 injuries met inclusion criteria. A marked increase was noted in the incidence of cell phone use-associated injuries over the time (2,900%). Injuries occurred in persons with mean ± standard deviation age of 36.6 ± 19.9 years old, predominantly in women (60.6%), at home (32.8%) or on the street (22.4%), and while walking (31.6%) or driving (18.16%). The distribution of orthopaedic injuries was defined and occurred most frequently in the neck, lower torso/hip, and ankle. The most common types of injuries were sprain/strain (56.8%) and fracture (32.6%). The proportion of fracture injury types was significantly greater in adults aged greater than 65 (P < 0.001). The proportion of injuries related to texting on a cell phone was greatest in the 13- to 29-year-old age group and declined as age increased.

DISCUSSION

Orthopaedic injures related to cell phone use resulting in ED visits have markedly increased over time. The distribution and characteristics of such injuries can be used in targeted public health education and policy development.

Problematic smartphone use is associated with de Quervain's tenosynovitis symptomatology among young adults

BACKGROUND

Previous research has reported an association between texting messages sent and De Quervain's tenosynovitis (DQT) symptomatology. However, these studies do not report smartphone dependence and DQT symptomatology.

OBJECTIVE

We aimed to evaluate the association between problematic smartphone use (PSU) and DQT symptomatology among young adults.

DESIGN

Analytical cross-sectional study.

METHODS

We included adults between 18 and 25 years and evaluated DQT symptomatology's presence using the Finkelstein test. We used Experiences Related to Mobile Phone Use Questionnaire to measure the PSU. We carried out a generalized linear model from the Poisson family. We calculated the crude and adjusted prevalence ratios (PR) with their 95% confidence interval (CI).

RESULTS

In total, we analyzed 491 subjects, the majority were women (52%), and the median age was 20 years. Of the total study population, 53% had positive results in the Finkelstein test, while 53% of the population had PSU. After adjusting our generalized linear model for confounders variables, we found that there is a higher prevalence of DQT symptomatology in those participants with occasional PSU and frequent PSU compared with participants without PSU, (aPR = 1.73, 95% CI: 1.47-2.05) and (aPR = 1.61; 95% CI: 1.29-2.00); respectively. We also found a higher prevalence of DQT symptomatology related to the number of hours per day in smartphones, pain with smartphones in the last week and using WhatsApp.

CONCLUSION

We found a higher prevalence of De Quervain's tenosynovitis symptomatology in the people with problematic smartphone use.

Ergonomics factors influencing school education during the COVID-19 pandemic: A literature review

BACKGROUND

The school is one of the most critical social, educational, and training institutions and the main pillar of education in society. Education and, consequently, educational environments have the highest effect on the mentality, development, growth, welfare, concentration, performance, and learning efficiency of students.

OBJECTIVES

The present study aimed to examine the effects of environmental ergonomics on the learning and cognition of pre-school students during the COVID-19 pandemic.

METHODS

The study was carried out as a review article using some keywords, namely "children", "learning", "pre-school", "COVID-19", "ergonomics", and "environmental factors". Scopus, PubMed, Science Direct and Web of Science were searched to find related articles.

RESULTS

Factors like color, form, and layout of classrooms, lighting and ventilation, interior decoration, and educational equipment are effective in creating interest and motivation for students to learn.

CONCLUSIONS

A review of these articles showed that the presence of ergonomics in educational spaces for children increases the quality of learning and reduces stress and anxiety, and by observing health protocols, a healthy and safe environment can be provided for students.

Prevalence of mobile device-related lower extremity discomfort: a systematic review

Mobile device users often experience musculoskeletal discomfort due to the intensive use of these devices in static body postures. Prolonged sitting and standing at work and in free time are risk factors for various diseases and all-cause mortality. Prolonged static postures are the main cause of lower extremity discomfort. A systematic search of the articles was conducted in four different electronic databases. All selected papers were appraised using a critical appraisal tool. Fourteen studies were selected for the review. The prevalence of musculoskeletal complaints ranged from 0.4 to 72.9%. Mobile device-related lower extremity discomfort ranged from 0.4 to 9.6%. The most common body posture among mobile device users in the selected studies was sitting. There is some evidence for the association between lower extremity pain and mobile device use. Experts should take this review as a basis to provide appropriate and effective ergonomic measures, especially for working mobile device users.

Musculoskeletal pain and risk factors associated with smartphone use in university students

Background:

Smartphone has become a very popular necessity among students. An individual has to look at their phone's small monitor and perform repetitive movements in an awkward posture for a prolonged duration.

Objectives:

To assess the prevalence of musculoskeletal pain and associated risk factors in university students because of smartphone usage.

Subjects and Methods:

A cross-sectional study was conducted with 2000 university students using a semi-structured questionnaire comprising demographic profile, smartphone usage characteristics, presence of musculoskeletal pain, and specific area of pain according to the body region.

Results:

Among the 2000 students, 44.05% reported musculoskeletal pain. The most common sites of pain were the neck (34.2%), thumb (17.45%), lower back (16.7%), and elbow (16.6%). There was an association between prevalence of musculoskeletal pain with the size of the smartphone (P = 0.005), the predominant purpose of smartphone usage (P = 0.002), position preferred while using smartphone (P = 0.000), and the level at which smartphone is held during usage (P = 0.05). Logistic regression analysis revealed that the strongest predictor of musculoskeletal pain was the size of the smartphone.

Conclusion:

The study reported that the prevalence of pain in smartphone users is high with common sites being neck, thumb, and lower back region. Also, the size of the smartphone had a significant association with musculoskeletal 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.

A Review of De Quervain’s Stenosing Tenovaginitis in the Context of Smartphone Use

Background: De Quervain tenosynovitis (DQT) has been associated with repetitive movements of the radial first dorsal compartment. Since 2007, smartphones have become ingrained in society. Their functionality is primarily performed by dexterity of the user’s thumb(s). The aim of this study was to review the current literature regarding the correlation between DQT and smartphone usage as a systematic review has not previously been presented.

Methods: A literature review was conducted electronically using the EMBASE, PubMed, Cochrane and MEDLINE search libraries during May of 2019. Studies eligible for inclusion were English-language studies assessing the link between mobile phone use and DQT. Included studies were required to report on focused outcomes. Only original data studies were included. Case studies, those with data sets collected prior to 2007, foreign language research were excluded.

Results: A positive Finkelstein’s result within the cohorts was found in a mean of 51.54% of participants. Odds ratios (OR) of 1.5 to 2.3 were found with increasing frequency of text messages and DQT. Females were found to have a higher frequency of text messages daily. Internet browsing and gaming on mobile phones were associated with an OR of 2.21 and 2.61 respectively. DQT associated pain correlated to a mild disruption in daily tasks. On a visual analogue scale, this pain was represented as a 4 out of 10.

Conclusions: In conclusion, there appears to be a linear association between frequency of text messages and incidence of DQT. Additionally, there is an association between DQT pain and a mild disruption to daily activities other than mobile phone use.

In Vivo Measurement of Thumb Joint Reaction Forces During Smartphone Manipulation: A Biomechanical Analysis

The relationship between arthritis or repetitive stress injuries (RSIs) in thumbs and rapidly increasing hours of smartphone usage is not fully elucidated. We evaluated axial joint reaction forces (AJRFs) and thumb torques in 19 healthy subjects performing typical smartphone tasks, which included tapping, tap game, and swiping. We measured force and torque when a subject tapped or swiped the panel of the smartphone and analyzed the motions of each joint using surface markers and motion capture systems. We calculated AJRFs and torques on each thumb joint using inverse dynamics. The results were then compared with representative activities such as computer keyboard typing and handwriting. The mean AJRFs/torques at the thumb carpometacarpal joint (CMCJ) while tapping the smartphone and tap gaming were 12.5 N/95.5 N mm and 21.1 N/187.21 N mm, respectively. AJRFs and torques were significantly higher during tap gaming activities than during simple tapping subtasks (p = 0.003 and p < 0.001, respectively). Compared with those during computer keyboard typing, the mean AJRFs and torques at the CMCJ during smartphone tapping was 3 (p = 0.075) and 1.4 times (p = 0.680) larger, respectively. Considering the rapidly increasing dependency on smartphones in our daily lives, long-term exposure of the thumb to repetitive AJRFs and torques may lead to an acceleration of arthritis or aggravation of RSIs in thumbs. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2437-2444, 2019.

Clinical and Ultrasonic Evaluation of the Thumb: Comparison of Young Adults With and Without Thumb Pain With Text Messaging

OBJECTIVE

The aim of this study was to compare clinical and ultrasound findings of thumb joints in young adults with and without thumb pain associated with text messaging.

METHODS

In this case-control study, 117 students with thumb pain associated with text messaging were evaluated clinically and with ultrasound analysis of the thumb. Age- and sex-matched controls received ultrasound evaluation to note any subclinical changes.

RESULTS

Clinical examination in the cases identified tenderness most commonly in the metacarpophalangeal joints, followed by the carpometacarpal joints, and then the interphalangeal joints. Tenderness was noted in the web space and the anatomic snuff box. Hypermobility on the Beighton scale was recorded as 2. Grind tests were positive in 21% of participants. Grip strength did not differ, but lateral and tip pinch strength were significantly reduced in the cases compared with controls. Fluid was detected in the metacarpal joints by ultrasound but not in the carpometacarpal or interphalangeal joints. No changes were detected in the controls.

CONCLUSION

Clinical examination indicated involvement of all joints of the thumb, but ultrasound evaluation could identify changes only in metacarpal joints, indicating signs of possible subclinical changes taking place in the thumb in these participants as a result of repetitive use.

Association Between Smartphone Use and Musculoskeletal Discomfort in Adolescent Students

Despite the substantial increase in the number of adolescent smartphone users, few studies have investigated the behavioural effects of smartphone use on adolescent students as it relates to musculoskeletal discomfort. The purpose of this study was to explore the association between smartphone use and musculoskeletal discomfort in students at a Taiwanese junior college. We hypothesised that the duration of smartphone use would be associated with increased instances of musculoskeletal discomfort in these students. This cross-sectional study employed a convenience sampling method to recruit students from a junior college in southern Taiwan. All the students (n = 315) were asked to answer questionnaires on smartphone use. A descriptive analysis, stepwise regression, and logistic regression were used to examine specific components of smartphone use and their relationship to musculoskeletal discomfort. Nearly half of the participants experienced neck and shoulder discomfort. The stepwise regression results indicated that the number of body parts with discomfort (F = 6.009, p < 0.05) increased with hours spent using ancillary smartphone functions. The logistic regression analysis showed that the students who talked on the phone >3 h/day had a higher risk of upper back discomfort than did those who talked on the phone <1 h/day [odds ratio (OR) = 4.23, p < 0.05]. This study revealed that the relationship between smartphone use and musculoskeletal discomfort is related to the duration of smartphone ancillary function use. Moreover, hours spent talking on the phone was a predictor of upper back discomfort.

Prevalence and risk factors associated with musculoskeletal complaints among users of mobile handheld devices: A systematic review

This systematic review aimed at evaluating the prevalence and risk factors for musculoskeletal complaints associated with mobile handheld device use. Pubmed, Medline, Web of Science, CINAHL and Embase were searched. The methodological quality of included studies was assessed. Strength of evidence for risk factors was determined based on study designs, methodological quality and consistency of results. Five high-quality, eight acceptable-quality and two low-quality peer-reviewed articles were included. This review demonstrates that the prevalence of musculoskeletal complaints among mobile device users ranges from 1.0% to 67.8% and neck complaints have the highest prevalence rates ranging from 17.3% to 67.8%. This study also finds some evidence for neck flexion, frequency of phone calls, texting and gaming in relation to musculoskeletal complaints among mobile device users. Inconclusive evidence is shown for other risk factors such as duration of use and human-device interaction techniques due to inconsistent results or a limited number of studies.

Exercise training and postural correction improve upper extremity symptoms among touchscreen smartphone users

BACKGROUND

Repetitive movements and poor posture are associated with over-use of smartphones when texting or playing games and significantly contribute to the symptoms of pain and discomfort in the upper extremities.

OBJECTIVE

This study investigated the effect of exercise training and postural correction on disabilities of the arm, shoulder, and hand (DASH), hand grip and key pinch strength among smartphone users.

METHODS

One hundred university students were randomly divided into two groups; the experimental group participated in a 12-week programme of exercise training and postural corrections. The control group were instructed to follow their usual routine for smartphone utilization. Measurements of DASH scores, hand grip strength, and key pinch grip strength were conducted before and after 12 weeks for both groups.

RESULTS

There were no significant differences between the start values of both groups for DASH scores, hand grip strength, and key pinch strength (p > 0.05). However, there was a significant improvement in all outcomes measured in the experimental group (p < 0.05), with significant changes in the outcomes of the control group.

CONCLUSION

Postural correction combined with a selected exercise training programme improved the hand grip, key pinch grip strength, and upper extremity disability and symptoms associated with smartphone use among university students.

Musculoskeletal disorders of the upper extremities due to extensive usage of hand held devices

OBJECTIVE

The use of hand held devices (HHD) such as mobile phones, game controls, tablets, portable media players and personal digital assistants have increased dramatically in past decade. While sending a text message or using the controls of the HHD the users need to use their thumb and other palm muscles extensively. The objective of this study was to describe the risk factors and clinical features of the musculoskeletal disorders (MSDs) arising due to usage of hand held devices and to evaluate the effectiveness of a sequenced rehabilitation protocol.

METHODS

A retrospective report analysis of 70 subjects, who were diagnosed to have a MSD affecting the upper extremities, was conducted. Medical charts from a tertiary level rehabilitation centre from 2005-2013 were analysed. All the subjects reported pain in their upper extremities following extensive usage of HHD and were examined and diagnosed to have a MSD by an orthopaedic and rehabilitation physician. After the assessment and diagnosis, all the patients underwent rehabilitation using a sequenced protocol.

RESULTS

All the subjects reported pain in the thumb and forearm with associated burning, numbness and tingling around the thenar aspect of the hand, and stiffness of wrist and hand. 43 subjects had symptoms on the right side; 9 on left and 18 had bilateral symptoms. Correlation was found between hand dominance and MSD. 33 subjects complained of onset of symptoms following extensive text messaging. All the subjects were diagnosed to have tendinosis of Extensor Pollicis Longus and Myofascial Pain Syndrome affecting the 1st interossei, thenar group of muscles and Extensor Digitorum Communis. 23 of the subjects were senior executives, among these 7 were CEO's of major multinational companies in India. All the subjects recovered completely following the rehabilitation.

CONCLUSIONS

The study concluded that mobile phones and gadgets that promoted the predominant usage of thumb or only one finger while texting or using the controls were associated with a higher prevalence of MSDs. Treatment using a sequenced rehabilitation protocol was found to be effective.