Effect of Extensive use of Smart-phone on Musculoskeletal

Function of Upper Extremity in University Students

Department of Physiotherapy
Guru Nanak Dev University
Amritsar-143005
(2020)
INTRODUCTION
 In today’s world of advancement and automation smart-phones have
a significant role in people’s everyday life as they are being used for
communication, internet browsing, social media, app dependent
automization of appliances of activities of daily life (ADL).
 Though the usages, essentiality and dependency is increasing
exponentially year by year with different benefits of it, in recent
years, “smart-phone addiction” concept has been emerged.
 Postures of using smart-phones in ADL
 handhold positions (such as smart-phone handheld at different
levels, one/two-handed hold or handheld in portrait/landscape
orientation) and workstations (such as smart-phone on desk, lap or
sofa), the use of two hands, with one hand holding and the other
hand operating the smart-phone, is most commonly observed in
sitting postures.
 Smart phone usages have significantly higher head flexion while
using a smart-phone in sitting compared to use in standing (Lee et
al., 2015).
 Neck Pain
NEED OF THE STUDY
In today’s world of advancement and technology
dependence, usage of smart-phone have increased in
all age groups, especially in young adults. Overuse
injuries and postural stress are tend to be associated
with such dependency on smart-phone. Health
professional need to be have better understanding
of, what the type of injuries can occur, its patho-
mechanics and find more effective preventive as well
as rehabilitation measures.
HYPOTHESIS
HYPOTHESIS
There would be considerable effect of the extensive
use of smart-phone and its addiction level on the
upper extremity and neck, range of mobility, pain,
grip strength and their overall function.
NULL HYPOTHESIS
There would not be considerable effect of the
extensive use of smart-phone and its addiction
level on the upper extremity and neck, range of
mobility, pain, grip strength and their overall
function.
AIMS &OBJECTIVES
AIMS
To find the effect of extensive use of smart-phone on the
musculoskeletal function of upper extremity.
OBJECTIVES
 To determine the level of addiction of the smart-phone

usage, in healthy young adults.

 To find the relation of smart-phone addiction with pain at

neck, shoulder, elbow, wrist, thumb in healthy young adults.

 To find the relation of smart-phone addiction with disability

at neck and other upper extremity joints in healthy young

adults.
 To find the relation of smart-phone addiction with hand grip

strength of the dominant hand in healthy young adults.

MATERIALS AND METHOD
 Subject Selection:
 A total of 285 students enrolled in university randomly
selected of age group between 18-26 years (177 girls and108
boys) from Guru Nanak Dev University, Amritsar. Subjects were
divided in to three groups on the basis of their addiction score
on Smart Phone Addiction Scale, Group-A minimally (addicted
score range 33-88) total of 50, Group-B moderately addicted
(score range 89-143) total of 199, Group-C severely addicted
(score range 144-198) total of 34.
 Inclusion criteria
 Enrolled students with the age group of 18-26 years
 Linguistic acceptance in English (speaking, reading and writing)
 Voluntary participation of students
 Exclusion criteria
 Non-student individuals
 Any existing injury of upper limb
 Any existing injury of upper limb
 TOOLS FOR DATA COLLECTION:
 Anthropometric rod
 Weighing machine
 Hand held dynamometer
 Smart phone addiction scale (SAS) questionnaire form
 Vas scale form
 Neck disability index (NDI) questionnaire form
 Data collection performa
 Procedure
 Each and every subject were taken in study after writing
informed consent form. Self reported SAS questionnaire were
given to the subjects to fill. Visual analogue scale score was
taken for their pain of neck, shoulder, elbow, wrist, thumb
separately from the subjects. Neck disability index score was
also taken from subject. Anthropometric measurements like
Height and Weight and dominant Grip strength were
measured.
Statistical analysis
 Data was analysed using SPSS (Statistical Package for Social
Science) version 20.0. Independent t-test was applied for all
the variables between the groups. ANOVA would be applied
for the variables which are taken as outcome measures and
was used for within group comparisons. The Spearman
correlation coefficient was used to assess the relationship
between SAS, VAS of neck and NDI scores. The significance
level was set at p < 0.05.
 RESULTS
Table 1 Descriptive statistics of various anthropometrics variables
in the table in between groups
Variab Group1 Group2 Group3 t- P-
l-es value value
Mean SD Mean SD Mean SD

Age 2.39 20.45 2.01 21.61 2.37 5.622 <0.004

(years) 20.29
Weight 61.85 12.52 58.89 11.70 65.54 9.76 5.106 <0.007
(kg)
Height( 162.85 7.85 161.11 10.59 166.86 7.26 5.965 <0.003
cm)
BMI(k 23.26 4.59 22.56 3.84 23.54 3.33 0.944 0.390
g/m²)
 Chart Title
AGE WEIGHT HEIGHT BMI

166.86
162.85 161.11

65.54
61.85 58.89

20.29 23.26 20.45 22.56 21.61 23.54

GROUP1 GROUP2 GROUP3

Table2. One way analysis of various variables in groups of minimally
addicted, moderately addicted and maximally addicted students

Variables Group 1 Group 2 Group 3 f-value p –value

Mean SD Mean SD Mean SD

NDI (10%) 3.22 8.59 13.37 11.63 37.29 11.46 102.831 < 0.001

VAS. Neck 0.93 2.22 3.51 2.58 6.82 1.11 64.886 < 0.001

VAS. 0.16 0.63 1.35 2.03 3.35 1.29 29.644 < 0.001

Shoulder

VAS. 0.09 o.53 1.26 1.83 3.47 1.65 43.343 < 0.001

Elbow

VAS Wrist 0.32 1.27 2.60 2.35 5.44 1.63 57.421 < 0.001

VAS 0.19 1.07 2.82 2.40 5.47 1.86 58.262 < 0.001

Thumb

HHD. P1 25.61 9.77 23.03 9.62 35.35 10.78 24.774 < 0.001

(kg)

HHD. P2 19.53 9.28 17.37 7.74 26.11 8.85 17.739 < 0.001

(kg)
Table 3 . Descriptive study of various variables listed in table in between
minimally addicted female and minimally addicted male students

variables
Mean SD Mean SD t-value p-value
SAS 75.39 12.58 77.84 7.60 0.660 0.513

NDI (%) 2.36 5.63 4.46 11.78 0.856 0.396

VAS. Neck 0.92 2.04 1.00 2.51 0.113 0.910

VAS. Shoulder 0.42 1.28 0.15 0.55 0.722 0.474

VAS. Elbow 0.15 0.974 0.23 0.83 0.241 0.810

VAS Wrist 0.42 1.50 0.76 1.92 0.672 0.505

VAS Thumb 0.42 1.42 0.46 1.66 0.085 0.933

HHD. P1 (kg) 18.10 4.52 35.08 6.02 10.708 <0.001

HHD. P2 (kg) 14.44 4.30 26.60 10.37 5.958 <0.001

 75.39
80

60

40
18.1 14.44
20
0 2.36 0.92 0.42 0.15 0.42 0.42
0
Table 4. Descriptive statistics of various variables in the table in
between moderately addicted female and male students

SAS 109.14 14.63 116.53 15.56 3.281 <0.001

NDI(10%) 11.98 11.46 16.16 11.55 2.416 <0.017

VAS. Neck 3.31 2.62 3.90 2.47 1.528 0.128

VAS. Shoulder 1.25 2.06 1.56 1.97 0.994 0.321

VAS. Elbow 1.15 1.85 1.50 1.79 1.267 0.207

VAS Wrist 2.18 2.26 3.52 2.27 3.905 <0.001

VAS Thumb 2.51 2.47 3.46 2.13 2.684 <0.008

HHD. P1 (kg) 17.54 4.69 34.09 7.16 19.508 <0.001

HHD. P2 (kg) 13.33 3.88 28.52 7.166 15.572 <0.001

 Chart Title

Column1 Column2 Column3

116.53
109.14

34.09 28.52
16.16
14.63 11.98
11.46 17.54 13.33
3.313.9 1.25
2.62 2.06 1.85
1.561.151.5 2.183.52
2.26 2.513.46
2.47 4.69 3.88

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Table 5. Descriptive study of various variables listed in table in
between maximally addicted female and male students

Variables
SAS 153.14 9.66 162.25 15.68 1.457 0.155

NDI (10%) 31.14 9.15 38.88 11.60 1.633 0.112

VAS. Neck 7.00 0.57 6.77 1.21 0.465 0.645

VAS. Shoulder 3.71 0.75 3.25 1.40 o.821 0.418

VAS. Elbow 3.00 2.30 3.59 1.47 0.840 0.407

VAS Wrist 4.28 1.25 5.74 1.60 2.217 <0.034

VAS Thumb 3.71 2.13 5.92 1.51 3.157 <0.003

HHD. P1 (kg) 20.73 5.97 39.14 8.17 5.554 <0.001

HHD. P2 (kg) 15.94 6.02 28.74 7.48 4.174 <0.001

 Table. 6 correlation of NDI with some other variables in
minimally, moderately and severely addicted students

Variables Minimally addicted Moderately addicted Severely addicted

r p R p r p

SAS -0.092 0.264 0.695 <0.001 0.441 <0.005

VAS neck 0.942 <0.001 .932 <0.001 0.712 <0.001

VAS shoulder 0.517 <0.001 .538 <0.001 0.546 <0.001

VAS elbow 0.718 <0.001 .378 <0.001 0.497 <0.001

VAS wrist 0.389 <0.003 .349 <0.001 0.634 <0.001

VAS thumb 0.512 <0.001 .385 <0.001 0.652 <0.001

HHD P1 0.211 0.070 .214 <0.001 0.260 0.069

HHD P2 0.338 0.008 .202 <0.002 0.197 0.132

Table. 7 Correlation of SAS with other variables in minimally, moderately
and severely addicted students

Variables Minimally addicted Moderately addicted Severely addicted

r p r p r p

NDI -0.092 0.264 0.695 <0.001 0.441 0.005

VAS neck -0.079 0.292 0.623 <0.001 0.313 0.036

VAS shoulder -0.033 0.410 0.419 <0.001 0.308 0.038

VAS elbow -0.151 0.148 0.243 <0.001 0.401 0.009

VAS wrist 0.007 0.480 0.297 <0.001 0.292 0.047

VAS thumb -0.027 0.426 0.333 <0.001 0.295 0.045

HHD P1 0.080 0.290 0.200 <0.002 -0.008 0.483

HHD P2 0.167 0.123 0.168 <0.009 -0.148 0.201

CONCLUSION
 Evidence showed good relation between pain and smart
phone addiction: at neck, shoulder, elbow, wrist and thumb,
which suggested musculoskeletal symptom of upper
extremity and neck, are related to extensive use of smart-
phone. Smart-phone addiction could cause significant neck
disability because of bad posture associated with their use.
 The musculoskeletal problem related to smart-phone usage
could be short term initially but later might lead to long term
disability.
THANK YOU