The relationship between Musculoskeletal Disorders and Pain, and Smartphone use amongst adolescents: systematic review

Abstract

Introduction: Over the last few years, smartphone usage, particularly amongst adolescents, has risen exponentially. This has led to concern regarding the link between smartphone utilisation and musculoskeletal issues. The latter could have a detrimental impact on the growth, normal development and well-being of adolescents. Currently, there are few reviews which have investigated the influence of using smartphones on the musculoskeletal system, and specifically, in the adolescent population. Aim: The aim of this research was to perform a systematic review with respect to contemporary publications on musculoskeletal pain and disorder related to the usage of smartphones in adolescents. Methods: A literature search was carried out in a number of electronic databases in order to recognise publications that could be identified using keywords relating to the use of smartphone, musculoskeletal symptoms, such as pain or discomfort, and exposures. The identified publications underwent screening, pertinent information was retrieved and an evaluation of the quality of the study methods used was performed. Narrative synthesis was presented of the study findings owing to the lack of uniformity between studies. Results: Eight quantitative studies were included and were rated as moderate (n=7) and high (n=1) quality. The findings of the review indicated that long durations of smartphone utilisation are linked with musculoskeletal system pain and disorder; this was a consensus opinion amongst all the included studies. The greater the number of hours a smartphone was used for; the more anatomical sites were determined to be impacted by musculoskeletal pain. Reviewed studies indicated that the neck was the most frequent source of discomfort, but that the shoulder, back, arm, elbow and wrist were also affected. Discussion: It was determined from this systematic review that there was only limited evidence and low number of studies linking the use of smartphones, together with a number of parameters relating to their utilisation, such as degree of use, length of time used and tasks performed, with symptoms and discomfort in the musculoskeletal system. To some extent, these findings were attributed to the predominantly moderate quality of evidence presented in the single case-control study, and in the seven cross-sectional studies encompassed within the review. The review did not include any longitudinal epidemiological publications. Nevertheless, the results obtained from this systematic review offer an improved comprehension of the relationships between musculoskeletal pain and disorder and the use of smartphones, an activity which has become a component of the daily life of most adolescents. The data presented could be incorporated into recommendations and interventions in order encourage the judicious usage of smartphones within this population, and could be of value to scientists, policy-makers, teachers, parents and the adolescents per se.