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

Background 
The use of mobile touch screen devices (MTSDs) has increased rapidly over the last decade, and there are concerns that their use may have negative musculoskeletal consequences; yet evidence on the association of MTSD use with musculoskeletal symptoms and exposures is currently dispersed. The aim of this study was to systematically review available literature on musculoskeletal symptoms and exposures associated with MTSD use. The synthesised information may facilitate wise use of MTSDs and may identify areas in need of further research.


Methods 
EMBASE, Medline, Scopus, PsycINFO and Proquest electronic databases were searched for articles published up to June 2016, using keywords describing MTSD, musculoskeletal symptoms (e.g. pain, discomfort) and musculoskeletal exposures (e.g. posture, muscle activity). Two reviewers independently screened the articles, extracted relevant data and assessed methodological quality of included studies. Due to heterogeneity in the studies, a meta-analysis was not possible and a structured narrative synthesis of the findings was undertaken.


Results 
A total of 9,908 articles were screened for eligibility with 45 articles finally included for review. Included articles were of cross-sectional, case-control or experimental laboratory study designs. No longitudinal studies were identified. Findings were presented and discussed in terms of the amount, features, tasks and positions of MTSD use and its association with musculoskeletal symptoms and musculoskeletal exposures.


Conclusions 
There is limited evidence that MTSD use, and various aspects of its use (i.e. amount of usage, features, tasks and positions) are associated with musculoskeletal symptoms and exposures. This is due to mainly low quality experimental and case-control laboratory studies, with few cross-sectional and no longitudinal studies. Further research is warranted in order to develop guidelines for wise use of MTSDs.

https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0181220&type=printable

The associations of mobile touch screen device use with musculoskeletal symptoms and exposures: A systematic review

Background The lives of many children and adolescents are today increasingly influenced by new technological devices, including smartphones. The coronavirus disease 2019 (COVID-19) pandemic occurred in a time of outstanding scientific progress and global digitalization. Young people had relevant adverse psychological and behavioral effects due to the COVID-19 pandemic, mainly related to infection control measures, which led them to spend more time at home and with major use of technological tools. The goal this study proposes is to evaluate health and social outcomes of smartphone overuse among Italian children and adolescents during the COVID-19 pandemic, analyzing patterns and aims of utilization, as well as the eventual presence and degree of addiction. Methods This study was based on a self-report and anonymous questionnaire, which was administered to 184 Italian school-age (6-18 years) children and adolescents during the second wave of the COVID-19 pandemic. The test was electronically (email, whatsapp) explained and sent by pediatricians either directly to older children (middle and high school), or indirectly, through the help of teachers, to younger ones (primary school). All participants spontaneously and voluntarily joined the present study. The survey was made by 4 sections, and designed to know and outline modalities (frequency, patterns and aims) of smartphone use, adverse outcomes, and related parental behaviors, also in order to reveal the eventual occurrence and degree of addiction. The same information, related to the pre-epidemic period, was also investigated and analyzed. Results The data obtained revealed a significantly greater adhesion to the questionnaire by females, likely reflecting higher attention and interest than boys to initiatives relating to health education. Our study showed more frequent smartphone use among Italian children and adolescents during the COVID-19 pandemic, compared to the pre-epidemic period. This may be related to the social distancing measures adopted during the months under investigation. The present survey also outlined the changing patterns and aims in the use of smartphones among young people, which allowed to limit some effects of the crisis. Indeed, they were used for human connection, learning and entertainment, providing psychological and social support. Finally, it was observed a significant increase of overuse and addiction. This led to many clinical (sleep, ocular and musculoskeletal disorders), psychological (distraction, mood modification, loss of interest) and social (superficial approach to learning, isolation) unfavorable outcomes. Conclusions Pediatricians and health care professionals should be aware of the potential risks related to inappropriate use of smartphones. They should monitor, in cooperation with parents, possible associated adverse effects, in order to early recognize signs and symptoms suggestive, or at high risk, for addiction. They must carry out, as well, the necessary interventions to prevent and/or lower the detrimental impact of smartphone overuse on children and adolescents' health, oriented to sustain adequate physical and psychological development as well as social relationships.

/pdf/smartphone-use-and-addiction-during-the-coronavirus-disease-1m2pl7tdjx.pdf

Smartphone use and addiction during the coronavirus disease 2019 (COVID-19) pandemic: cohort study on 184 Italian children and adolescents.

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.

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

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  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.

Association Between Smartphone Use and Musculoskeletal Discomfort in Adolescent Students

[Purpose] The purpose of this study was to investigate the use of smartphones by university students in selected areas, their musculoskeletal symptoms, and the associated hazard ratio. [Subjects and Methods] This involved the completion of a self-administered questionnaire by dental hygiene students in Seoul, Gyeonggido, and Gyeongsangbukdo. The 292 completed copies of the questionnaire were then analyzed. [Results] The most painful body regions after the use of smartphones were found to be the shoulders and neck. In the musculoskeletal system, back pain was found to have a positive correlation with the size of the smartphone’s liquid crystal display (LCD) screen, and pain in legs and feet were found to have a negative correlation with the length of time that the smartphone was used. As a result, it was revealed that the use of a smartphone was correlated with musculoskeletal symptoms. [Conclusion] Therefore, in today’s environment, where the use of smartphones is on the rise, it is necessary to improve the ways that they are used and to develop a preventive program to alleviate the symptoms of musculoskeletal damage.

Hyo-Jeong Kim

Papers

The relationship between smartphone use and subjective musculoskeletal symptoms and university students.