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Assessment of stresses in the cervical spine caused by posture and position of the head

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Abstract

Preamble. Billions of people are using cell phone devices on the planet, essentially in poor posture. The purpose of this study is to assess the forces incrementally seen by the cervical spine as the head is tilted forward, into worsening posture. This data is also necessary for cervical spine surgeons to understand in the reconstruction of the neck.

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... [13] Recently, it is purported that text neck is becoming an epidemic that could lead to permanent damage to neck posture, this seems to be a worldwide health effect. [13,16,17] There are also reports on smartphone-derived conditions such as 'Blackberry thumb' which often refers to repetitive strain injury caused by texting, 'iPad hands,' carpal tunnel syndrome, trigger fingers, as well as aches and pains caused by swiping and typing. [13,18,19] More appalling is the sedentary lifestyle and sleeplessness that is coupled with the use of smartphones both of which are capable of leading to serious health consequences. ...
... [21] These chemicals have been purported to be the dominant chemical content found in the brains of hard drug users. [16,22] A recent review shows that smartphone addiction exists. [23] In fact, nomophobia (the fear of being without your mobile device) is now recognised as a serious issue. ...
... This agrees with previous findings that for majority of students there is a lack of knowledge regarding good posture to assume during smartphone use. [16,31,32] Knowledge of ergonomics is required to assist smartphone users to avoid certain risk factors that can contribute to the development of musculoskeletal disorders. Good knowledge of the proper ergonomic posture of smartphone would include knowledge on the best posture to assume in different positions. ...
... Working with SPs in a sitting posture has increased neck forward flexion angle (Lee et al., 2015b;Yoon et al., 2021). Holding SP below the eye height level (Hansraj, 2014) is assumed to result in forwarding head posture, which increases muscle activity and the load imposed on neck extensor muscles (Antona et al., 2018;Factors & Society, 2007;Seghers et al., 2003;Villanueva et al., 1997). Han et al. (2019) demonstrated that an eight-hour continuous recording of head posture in adult SPs users manifested a head-down tilt of more significant than 30° (Han et al., 2019); which imposes a mean force of more than 40lbs on the cervical spine (Hansraj, 2014). ...
... Holding SP below the eye height level (Hansraj, 2014) is assumed to result in forwarding head posture, which increases muscle activity and the load imposed on neck extensor muscles (Antona et al., 2018;Factors & Society, 2007;Seghers et al., 2003;Villanueva et al., 1997). Han et al. (2019) demonstrated that an eight-hour continuous recording of head posture in adult SPs users manifested a head-down tilt of more significant than 30° (Han et al., 2019); which imposes a mean force of more than 40lbs on the cervical spine (Hansraj, 2014). Moreover, task nature has been recognized to be associated with neck angle (Lee et al., 2015b). ...
... This discrepancy may be due to differences in task and posture types. Hansraj (2014) and Syamala et al. (2018) found a significant positive association between neck flexion angle and biomechanical loads imposed on cervical vertebrae. Specifically, it was reported that changes in the neck angle from a neutral posture to a 60-degree flexion add a force equal to 5-27 kg on cervical vertebrae, respectively. ...
Article
Objective The present study aims to evaluate the effects of posture, task, and handgrip style on discomfort, neck kinematics, and concomitant muscular activity when using a smartphone (SP). Background Along with the popularity of smartphones, musculoskeletal disorders have become prevalent among smartphone users. However, comprehensive aspects of discomfort, kinematics, and electromyographic responses across various conditions remain to be investigated. Method Twenty-four young smartphone users performed typing, video watching, and reading tasks while holding the smartphone both with one hand and with two hands while either sitting or standing. Neck kinematics and muscular activities were simultaneously recorded. Results Working with SPs led to higher discomfort in the neck ( p = 0.01), lower back ( p = 0.01), and shoulder ( p = 0.04) while sitting as compared to standing. Sitting was associated with greater neck flexion and more minor lateral bending for all tasks and grip styles ( p < 0.05). Electromyographic analysis indicated significant differences between sitting and standing, with alterations being dependent on the test condition. Moreover, neck kinematics and muscular activities significantly differed based on the task nature, handgrip, and interactions. Conclusion This study highlights the risk of using smartphones in increased neck angle flexion and muscular activities fatigue. Thus, posture and handgrip should be considered while using SPs. As each test condition affects a specific dependent variable, a holistic approach is required to evaluate the responses of SP users’ musculoskeletal systems. Application Results can be applied to develop guidelines for musculoskeletal disorders/discomfort prevention among SP users, especially with the rise of smartphone use during the COVID-19 pandemic.
... Higher NF causes more strain on the cervical spine. For an adult with a neutral head position, 44-53 N of force is applied to the cervical spine, but this force increases to 120 N when the neck is flexed 15 • , to 178 N at 30 • , to 218 N at 45 • , and to 267 N at 60 • [20]. This relationship is approximately linear. ...
... However, NF was similar between genders (46.2 • for men and 46.4 • for women) during supported sitting because a backrest restricts body movement. Although static postures (especially sitting) tend to cause lower UT activation and higher fatigue levels and discomfort scores than dynamic postures [33], our findings revealed that NF was significantly lower among female users in either sitting position and among male users during supported sitting, indicating a lighter load on the neck [20]. ...
... However, NF was similar between genders (46.2° for men and 46.4° for women) during supported sitting because a backrest restricts body movement. Although static postures (especially sitting) tend to cause lower UT activation and higher fatigue levels and discomfort scores than dynamic postures [33], our findings revealed that NF was significantly lower among female users in either sitting position and among male users during supported sitting, indicating a lighter load on the neck [20]. This study has several limitations. ...
Article
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Prior investigations have been primarily conducted in a laboratory to examine the effects of the smartphone use on the neck and head positions, whether these results are pplicable to actual conditions is still unknown. This field survey thus analyzed the neck flexion (NF), head flexion (HF), gaze angle (GA), and viewing distance (VD) of smartphone users in public areas in Taipei, Taiwan. Six hundred smartphone users (300 men and 300 women) were photographed sagittally in standing, supported sitting, or unsupported sitting postures while using a smartphone. Results showed that women had significantly less NF and HF and shorter VDs than male users. Regardless of gender, higher NF was observed for standing than for sitting. Women had similar NF and HF while sitting supported and unsupported, but both were significantly lower than those while standing. By contrast, male users had higher NF and HF during unsupported sitting than during supported itting. The NF (45°–50°) was much greater than the recommended maximum safe NF of 15°. Women may be at higher risk of visual strain because of shorter VD.
... The present study also warns of the importance of adopting an adequate posture by keeping the device at eye level with support from upper limbs to prevent muscle and postural dysfunction in the general population and, in particular, in adolescents 18 . ...
... Cad. Edu Saúde e Fis 2021 8(18):Páge081811 ...
Article
Objective: This study aimed to assess the relationship between smartphone usage time and postural alignment in teenage university students and the associated factors. Methods: We carried out a cross-sectional study with 133 teenage university students (18-19 years old) between April and November 2018 in Fortaleza, Ceará, Brazil. Questionnaires were used to collect information on socioeconomic status, health conditions, smartphone usage time and level of physical activity. The alignment of the cervical region was assessed using photogrammetry in anatomical position and while texting on the smartphone. Horizontal alignment of the head (HAH), horizontal alignment of the acromion (HAA) and vertical alignment of the head (VAH) were measured. Bivariate and multivariate analyses were performed to check for factors associated with smartphone usage time (>6 hours a day). Results: There were higher rates of girls (66.9%; n=89), people in the lower social class (71.4%; n=95), frequent drinkers (66.9%; n=89), people who complained of headache (83.5%; n=111) and people who used smartphones for more than 6 hours a day (72.9%; n=97). The multivariate analysis showed an association of smartphone usage time (>6 hours a day) with cervical anteriorization, estimated by measuring the VAH (OR=1.053; p=0.007 – left side), female gender (OR=2.729; p=0.046), frequent drinking (OR=2.636; p=0.038) and complaint of headache (OR=5.617; p=0.002). Conclusions: There was a high percentage of adolescents who excessively used smartphones for more than 6 hours a day. Prolonged smartphone use was associated with female gender, alcohol consumption, headache and changes in cervical alignment.
... Previous studies (Kietrys et al., 2015;Lee et al., 2014;Ning et al., 2015;Park et al., 2017;Vasavada et al., 2015;Xie et al., 2016) showed that an increased neck flexion angle resulted in increased muscle activity of the cervical erector spinae (CES) during smartphone use, this is a common behavior and increases risks for musculoskeletal disorders. The CES muscles were less active (Thuresson et al., 2003;Yoo CW, 2008) and force applied to the cervical spine was minimal (Hansraj, 2014) when the neck was in the neutral head position (0 • degrees) compared to the flexed position. While recommended neck posture during smartphone use has been described in many previous studies (Hansraj, 2014;Namwongsa et al., 2019;Park et al., 2017), there may be other alterations to body biomechanics, for example in the shoulder region. ...
... The CES muscles were less active (Thuresson et al., 2003;Yoo CW, 2008) and force applied to the cervical spine was minimal (Hansraj, 2014) when the neck was in the neutral head position (0 • degrees) compared to the flexed position. While recommended neck posture during smartphone use has been described in many previous studies (Hansraj, 2014;Namwongsa et al., 2019;Park et al., 2017), there may be other alterations to body biomechanics, for example in the shoulder region. Namwongsa et al. (2019)'s recent study showed that although CES muscle activity was lowest in the neutral shoulder position, upper trapezius (UT) muscle activity increased. ...
Article
While using their smartphone, users tend to adopt awkward neck and shoulder postures for an extended duration. Such postures impose the risk of MSDs on those body parts. Numerous studies have been undertaken to examine neck posture; however, few studies have investigated shoulder postures. This study examined various shoulder postures during smartphone use and their effect on neck and shoulder kinematics, muscle loading, and neck/shoulder discomfort. Thirty-two asymptomatic young adult smartphone users randomly performed texting tasks for 3 min at four different shoulder flexion angles (15°, 30°, 45°, and 60°), while maintained a neck posture in the neutral position (0° neck flexion angle). Measures were taken of neck and shoulder muscle activity of the cervical erector spinae (CES), anterior deltoid (AD), upper trapezius (UT) and lower trapezius (LT), and kinematic data (angle, distance and gravitational moment). Results showed AD and LT muscle activity significantly increased when the shoulder flexion angle increased with an opposite effect on CES and UT. A recommended shoulder posture was identified as 30° flexion, as this yielded the best compromise between activation levels of the four muscles studied. This angle also induced the lowest neck/shoulder discomfort score. The findings suggest smartphone users hold their device at approximately 30° shoulder flexion angle with their neck in a neutral posture to reduce the risk of shoulder and neck musculoskeletal disorders when smartphone texting. Relevance to industry Smartphone use in the manufacturing and service industries is an integral part of work and useful means of communication tool. Awkward postures during extensive smartphone use impose an increased risk of both neck and shoulder musculoskeletal disorders. Shoulder flexion angles need consideration when making recommendations about safe work postures during smartphone use.
... Excluding the effect of trauma, chronic strain is one of the main pathogenesis of cervical spondylosis [6]. The poor posture of the cervical spine leads to the compression of the cervical spine under a large amount of pressure for a long time [7], which is an important cause of chronic strain. In the process of preventing cervical spondylosis, it is very necessary to recognize each abnormal posture. ...
... It is a common cause of cervical spondylosis, which has a direct impact on the follow-up development and treatment of cervical spondylosis. Medical studies have shown that when the head tilts forward to a deteriorating state, the pressure on the cervical spine is different gradually [7], which is necessary for cervical surgeons to diagnose the neck. The researchers created a cervical measurement model that can obtain actual values to calculate the pressure on the cervical spine. ...
Article
Wireless body area networks (WBANs) is a new research hotspot with great development prospects. The non-contact sensing based on radio frequency signal can solve the issues of personal comfort and privacy. Detection of cervical motion range and cervical strain in time are important in diagnosis and prevention of cervical spondylosis. In this paper, channel state information is used to achieve smart perception and monitoring, timely and efficient detection of different postures and abnormal bending of the neck. It provides an efficient way for protecting cervical health, and also some help for doctors to understand the causes of cervical vertebral disease in a timely manner. The classification accuracy of the four activities reached 99.4%, 99.7%, 99.5% and 99.3%, respectively.
... Psychofizyczne konsekwencje nieprawidłowego korzystania z nowych technologii Nadmierne korzystanie z nowych technologii nadwyręża funkcjonowanie układu mięśniowo-szkieletowego. Podczas używania smartfona przyjmujemy pozycję z głową skierowaną ku dołowi, co powoduje ból i wady postawy (Hansraj 2014). Zjawisko to otrzymało już własne nazwy: text neck (Hansraj 2014) czy turtle neck posture (Park et al. 2015). ...
... Psychofizyczne konsekwencje nieprawidłowego korzystania z nowych technologii Nadmierne korzystanie z nowych technologii nadwyręża funkcjonowanie układu mięśniowo-szkieletowego. Podczas używania smartfona przyjmujemy pozycję z głową skierowaną ku dołowi, co powoduje ból i wady postawy (Hansraj 2014). Zjawisko to otrzymało już własne nazwy: text neck (Hansraj 2014) czy turtle neck posture (Park et al. 2015). Nadwyrężenia również innych części ciała mogą prowadzić do poważnych schorzeń, takich jak: TOS, fibromialgia, syndrom de Quervaina (Yang et al. 2017;Sharan, Ajeesh 2012) czy zespół cieśni nadgarstka (Woronowicz 2009), szczególnie w czasie obsługiwania urządzenia jedną dłonią (Park et al. 2015). ...
Article
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W literaturze przedmiotu można odnaleźć szereg negatywnych konsekwencji nieodpowiedniego użytkowania telefonów komórkowych. Z drugiej strony postęp technologiczny otwiera również szerokie możliwości.Celem niniejszej pracy jest zbadanie związku pomiędzy problemowym używaniem telefonu komórkowego przez młodzież a wsparciem społecznym oraz jakością życia, a także próba odpowiedzi na pytanie, czy młodzież trafnie przewiduje czas spędzony przed ekranem telefonu.W badaniu udział wzięły 453 osoby w wieku 16-19 lat. Wykorzystano ankietę fonoholizmu (Dębski, Radziwiłłowicz, Kozłowska) Berlińskie Skale Wsparcia Społecznego, kwestionariusz KIDSCREEN-27 oraz aplikację QualityTime. Wyniki badań wskazują na znaczne przeszacowywanie czasu spędzanego przez młodzież z telefonem, choć silniejszym predyktorem fonoholizmu był jednak czas deklarowany. Widoczny jest również związek nadmiernego korzystania ze smartfona z poszukiwaniem i zapotrzebowaniem na wsparcie społeczne. Telefon okazuje się silnym narzędziem do utrzymywania kontaktów rówieśniczych. Osoby deklarujące większe problemy w zakresie korzystania z telefonu zgłaszają również słabsze wyniki w nauce i gorsze samopoczucie w szkole. Nie zaobserwowano różnic w zakresie samopoczucia fizycznego.
... If a 60 angle is adopted, the weight could be higher than 59.5 pounds. 33 Ideally, the head should be aligned to the spine (with a 0 angle) to avoid extra weight over the neck. However, a study with Brazilian college students showed that only 10.0% of the sample adopted an adequate head position while using mobile devices. ...
... This can be explained by the relaxed and non-ergonomic positions adopted to use mobile devices, such as incorrect sitting or lying down positions. 33,34,36 In contrast, our results showed no relation between the length of computer use and low back pain. Hakala et al. also evaluated this relation and did not find an association as well. ...
Article
Objectives Neck and low back pains are the leading causes of years lived with disability, and using computers or mobile devices in excess could be risk factors for back pain. Our aim was to evaluate the association of the length of time using computers and mobile devices with neck, mid-back and low back pains and the number of regions with pain. Study design Cross-sectional study nested in the 1993 Pelotas birth cohort with young adults aged 22 years. Methods Outcomes analyzed were neck, mid-back and low back pains and the number of regions with pain. Exposures were the number of daily hours using computers and mobile devices. Crude and adjusted analyses were performed to estimate prevalence ratios using Poisson regression. Results Almost half of the sample reported having back pain, the low back pain being the most prevalent. Compared with individuals using mobile devices for less than one hour, the prevalence of neck pain was 1.41 and 1.81 times higher among individuals using mobile devices from three to seven hours and for seven or more hours per day, respectively. Neck pain prevalence was 1.47 times higher among individuals using computers for more than two hours than among those not using computers. Using mobile devices for seven hours or more was associated to 1.19 times higher prevalence of low back pain. Conclusion Using mobile devices in excess was associated to neck and low back pains, while the use of computers in excess was associated only to neck pain. It is important that guidelines are developed to recommend the adequate length of time that computers and mobile devices should be used to prevent back pain.
... FHP geometrically increases the perceived weight of the head. 12,13 Mammalian animal studies help researchers understand neurophysiology that cannot be ethically researched in humans. Occlusal alterations in mammals caused deleterious effects in dogs and rats. ...
... The findings of this study support and corroborate the Solano et al. systemic review, in that a relationship was found between occlusion and posture in the treated subjects. 40 This study's postural sway and forward head posture improvements were also consistent with an observational study (no corrective therapy was administered) by Moustafa et al, 12 who found that subjects with FHP had greater sway, and were less stable than a group of matched controls who had less sway and were more stable. In this study, the occlusion was measured and then corrected with ICAGD, while pre and post therapy observational posture measurements were recorded. ...
Article
Full-text available
Objective: Recently, several studies have reported that occlusion is one of many factors that influence posture. This study’s objective is to metrically evaluate forward head posture and sway in TMD patients, before and after undergoing Disclusion Time Reduction (DTR) with the Immediate Complete Anterior Guidance Coronoplasty (ICAGD), to determine if the occlusal changes altered posture and sway. The null hypothesis is that changing the occlusion will not change posture or sway. Methods: 83 patients suffering from TMD symptomology that were treated with the ICAGD coronoplasty, were assessed for changes in posture and sway from before and after occlusal treatment. 32 consulting untreated control subjects were evaluated for posture and sway twice in the same fashion. The Disclusion Times and posture data pre to post ICAGD or consult from both groups, was analyzed with the Student’s T-test. Results: Prior to ICAGD or Consult, there were no significant Disclusion Times differences between treatment and control subjects. But after ICAGD, the treatment Disclusion Times were significantly less (p < 0.05). Postural sway decreased (p=0.0001), and forward head posture improved (p=0.00001) following the Disclusion Time and bite force corrections. The control group showed no statistically significant posture changes. Conclusion: Long Disclusion Time and bite force imbalances are factors in compromised posture and sway. ICAGD and DTR treatment can positively alter posture and sway, further indicating that an occlusal-posture interrelationship physiologically exists. This study’s findings highlight that tooth-borne trigeminal nerve inputs contribute to whole-body posture and stabilization.
... The posture assessment mobile application was used to measure the neck flexion angle and forward neck translation ( fig 2). The higher the neck flexion angle, the more neutral the head position is, the lower the neck flexion angle the more the subject has a relaxed non-neutral position (Hansraj, 2014). These measurements were taken on two successive occasions, at baseline and at the end of 8 weeks' time. ...
... In addition, some have even shown neurological deficits, and enlarged median nerve accompanied by hand pain (İNal, Demİrcİ, Çetİntürk, Akgönül & Savaş, 2015). Janwantanakul, Sitthipornvorakul & Paksaichol, 2012& Hansraj, 2014 concluded that, loss of normal curvatures of the spine were resulting from increasing the bending of the head in forward position at varying degrees which leads to substantial increase of stress towards the cervical spine. VOLUME 16 | Proc3 | 2021 | S889 ...
... 8 Loss of the cervical curvature may increase stresses on the cervical spine and may lead to early wear, tear and degeneration. 9 The correct use of these muscles exercise before strengthening of the global cervical spine musculature is more effective than just nonspecific strengthening of the neck muscles. For isolation activity of DCFs, Craniocervical Flexion Exercise (CCFE) is found to be a more suitable strategy. ...
Article
Objective: Neck pain is a common cause of disability and costly problem, especially in the working population. However, there is a paucity of studies examining the efficacy of pressure-biofeedback guided craniocervical flexion exercise (CCFE) in neck pain. Therefore, this study aims to find out the efficacy of Pressure-Biofeedback guided CCFE on the treatment of neck pain. Methods: This randomized controlled trial included 60 participants with neck pain who were randomly assigned to the experimental group (n=30) and control group (n=30). The experimental group received pressure-biofeedback guided CCFE for four times per week for four weeks, whereas the control group received physical therapy agents (PTA) (radiant heat and transcutaneous electrical nerve stimulation). Outcome measures included the Visual Analogue Scale (VAS) and Neck Disability Index (NDI). Results: The baseline demographics and outcome measurements were not significantly different between the two groups. More significant reduction in VAS of the experimental group was found in comparison with control group at week 2 and week 4, respectively (p<0.05). Regarding the NDI, there was a more significant reduction in the experimental group than the control group at week 4 (p<0.05). Conclusion: Pressure-biofeedback guided CCFE was useful for improving pain and functional disability of neck for the management of neck pain.
... 6 More than 91% of university students who are smartphone users adopt a flexed neck posture during smartphone use 7 with increased compressive loads on neck structures. 8 Prolonged smartphone use not only increases neck pain 5,6,[9][10][11] and cervical joint position sense (CJPS) error 4,12 but also decreases dynamic balance. 1,13,14 University students are reported as having the highest smartphone addiction rates compared with users of other age groups. ...
Article
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Purpose: University student smartphone users adopt flexed neck postures during smartphone use, creating an increased compressive load on their neck structures. This study was conducted to compare the effects of proprioceptive and craniocervical flexor training with a control group on static balance in a group of university student smartphone users with balance impairment. Methods: A double-blinded, randomized controlled trial was conducted involving 42 university students (19.67±1.68 years old) with balance impairment. Participants were randomized into a proprioceptive training (ProT) group (n=14), a craniocervical flexor training (CCFT) group (n=14), and a control group (CG; n=14) for a 6-week intervention. The balance error scoring system (BESS), cervical joint position sense (CJPS), craniocervical flexion (CCF) test, and visual analog scale (VAS) for neck pain were evaluated using univariate analysis of covariance (ANCOVA). Results: After 6 weeks of intervention, the ProT group showed significantly greater improvement of CJPS than the CG (p=0.000) and the CCFT group significantly improved of CCF test than CG (p=0.002). Findings, at 4 weeks after intervention, were (i) the ProT group had significantly more improvement in BESS than the CCFT group (p=0.014) and CG (p=0.003), (ii) the ProT group had significantly more improvement of CJPS than the CG (right and left rotate) (p=0.001, p=0.016, respectively) and CCFT group (right rotate) (p=0.004), (iii) the CCFT group had significantly more improvement of craniocervical flexor strength than CG (p=0.004), and (iv) the ProT group and CCFT group had significantly more decreased pain than CG (p=0.015, p=0.033, respectively). No adverse effects occurred during or after training in any group. Conclusion: ProT is important for regaining static balance and CJPS, while CCFT improved craniocervical flexor strength. Moreover, both ProT and CCFT can reduce neck pain. We recommend performing ProT to improve static balance, CJPS and to reduce neck pain in smartphone users with static balance impairment. Clinical trail registration number: TCTR20190909003.
... At 15° head flexion, around 12 kg of force is placed on the neck. This force rises to 18 kg at 30°, 22 kg at 45°, and 27 kg at 60°. [6,7] Because children's head/body ratio is larger than adults' , they may be more affected by text neck syndrome. [7] Text neck syndrome is characterized by pain in the cervical spine, upper back, and shoulder regions. ...
Article
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Objectives: Text neck syndrome was first described by Fishman D. It refers to neck pain caused by repetitive stress injury resulting from prolonged neck flexion among smartphone users. The association of neck disability with various behaviors during the use of smartphones is still unclear in the literature. Therefore, we aimed to estimate the frequency of such factors and evaluate whether they contribute to text neck. Methods: A cross-sectional study was conducted at six medical colleges in Jeddah, Saudi Arabia, from July 2020 to January 2021. An electronic, self-administered questionnaire was distributed to medical students online. In addition, participants were asked to complete the smartphone addiction scale-short version (SAS-SV) and the neck disability index (NDI). Results: A total of 428 medical students participated, of which 304 (71.02%) were female, while 124 (28.97%) were male. The mean age was 22.11 ± 2.07 years. The prevalence of text neck syndrome was 68.1%. Among the participants, 49.5% had mild, 16.1% had moderate, and 2.6% had severe neck disabilities. The Spearman correlation coefficient showed a moderate positive correlation between SAS-SV and the NDI (rs = 0.328, P < 0.001). Conclusion: The current study found that most medical students had a neck disability, and there was a significant association between text neck syndrome and smartphone use. In addition, a lack of appropriate neck positioning and prolonged use of smartphones were found in most students. Therefore, more emphasis should be placed on raising awareness of the necessity of maintaining appropriate sitting posture and limiting the duration of mobile phone use.
... It is also indicated that increased neck flexion angle while using electronic devise is one of the risk factors for musculoskeletal pain [16][17][18]. Flexing the head forward at varying degrees increased weight loads on cervical spine dramatically and this increased stress potentially leads to early wear, tear, degeneration, and possibly surgery [19]. ...
Article
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Background Mobile technology has spread rapidly around the globe. In 2018 the numbers of mobile subscribers in Ethiopia hit 66.2 million. Musculoskeletal complaints related to smartphone use in different body parts have been reported ranging from 8.2% to 89.9%. Neck pain has the highest prevalence rate, which ranges from 17.3% to 67.8%. However, there is limited evidence on the burden of neck pain related to Smartphone usage and no research is done in Ethiopia. Therefore, this study was conducted to determine the burden of neck pain and factors associated with smartphone use in Ethiopia. Purpose The objective of this study was to identify the prevalence and factors associated with neck pain among smartphone users at University of Gondar. Methods Institutional based cross-sectional study was conducted from November to December 2019 to determine the prevalence and associated factors of neck pain, with a sample of 845 university student smartphone users at University of Gondar, Ethiopia. A self-administered questionnaire adapted from the Nordic musculoskeletal questionnaire was used to collect data. Independent variables which had a significant association were identified using logistic regression models. Results were reported by using texts and frequency distribution tables. Results Out of 845 questionnaires distributed, 808 students responded; hence, the response rate was 95.6%. The overall prevalence of neck pain among smart phone users in the past 12 months was 47.4% (95% CI, 44.1–50.9%). Attending 5 th year (AOR: 3.907, 95% CI: 1. 952–7.82) and 6 th year (AOR: 2.93,95% CI: 1,304–6.59), regular physical exercise (AOR: 2.405, 95% CI: 1.549–3.734), cigarette smoking (AOR: 5.415, 95% CI: 2.685–10.919), residency (AOR: 1.681, 95% CI: 1.181–2.391), break while using smartphone (AOR: 3.253 95% CI: 2.252–4.699), used smartphone > 6 hour per day (AOR: 2.782 (1.528 95% CI: 1.528–5.063), used other devises (AOR: 3.158 95% CI: 2.128–4.689), number of social media used daily (AOR: 2.007 95% CI: 1.228–3.2788), used devise for playing game (AOR: 1.484 95% CI: 1.024–2.15) were factors significantly associated with neck pain. Conclusion The current study depicted that nearly half of the study participants reported neck pain in the past 12 months. Attending last year of university, personal characteristics, use of smart phone for longer period, playing game, not taking break, other electronic device use, increased number of social media use were associated with neck pain among smartphone users.
... Particularly, persistent flexion of the cervical spine may lead to long-term effects on the musculoskeletal system and compromises the surgical performance [1]. Bending the head 30 degrees off the neutral position results in an up to four times increased load on the cervical spine, with consecutive loss of lordosis and compensational thoracic hyperkyphosis [2,3]. Technical improvements like neuroendoscopes, which decouple the visual from the working axis, particularly in regard of operations at extreme angles, have demonstrated superior ergonomics during surgery [4]. ...
Article
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Exoscopic surgery promises alleviation of physical strain, improved intraoperative visualization and facilitation of the clinical workflow. In this prospective observational study, we investigate the clinical usability of a novel 3D4K-exoscope in routine neurosurgical interventions. Questionnaires on the use of the exoscope were carried out. Exemplary cases were additionally video-documented. All participating neurosurgeons (n = 10) received initial device training. Changing to a conventional microscope was possible at all times. A linear mixed model was used to analyse the impact of time on the switchover rate. For further analysis, we dichotomized the surgeons in a frequent (n = 1) and an infrequent (n = 9) user group. A one-sample Wilcoxon signed rank test was used to evaluate, if the number of surgeries differed between the two groups. Thirty-nine operations were included. No intraoperative complications occurred. In 69.2% of the procedures, the surgeon switched to the conventional microscope. While during the first half of the study the conversion rate was 90%, it decreased to 52.6% in the second half ( p = 0.003). The number of interventions between the frequent and the infrequent user group differed significantly ( p = 0.007). Main reasons for switching to ocular-based surgery were impaired hand–eye coordination and poor depth perception. The exoscope investigated in this study can be easily integrated in established neurosurgical workflows. Surgical ergonomics improved compared to standard microsurgical setups. Excellent image quality and precise control of the camera added to overall user satisfaction. For experienced surgeons, the incentive to switch from ocular-based to exoscopic surgery greatly varies.
... Neck flexion of 15-60 degrees during smartphone use can produce a load of 5-27 kilograms on the cervical spine. 12 Moreover, forward head posture can affect the posterior and anterior neck, shoulder muscles, scapular position, and kinematics. 13 This data indicates that an increased range of cervical flexion and sustain in a period of time would increase the risk of the degenerative cervical spine. ...
Article
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Background: Prolonged smartphone and computer use results in an imbalance of the neck, scapular, and shoulder muscles leading to pain and weakness. However, neck and shoulder exercises are varied and not specific to problems. Objective: To evaluate the effects of modified scapular exercise in participants with neck, scapula, and shoulder pain. Methods: Forty-six participants were randomly allocated to the intervention group and the control group. The allocation sequence was concealed from the researcher enrolling and assessing participants. The intervention group received modified scapular exercise 3 times per week for 6 weeks, and the control group received stretching exercise, 2 times per day for 6 weeks. Neck disability index, pain scale, and muscle contraction force of the upper trapezius, rhomboid, and serratus anterior muscles were evaluated in both groups before and after the intervention. Results: The results showed the statistical significance of the neck disability index (NDI) (p<0.01) and visual analog scale (VAS) (p<0.001) before and after the program but not a significant difference between the groups. As compared between groups, significant differences were found in muscle contraction force of right upper trapezius, rhomboid, and serratus anterior muscle (p<0.05). Conclusion: The modified scapular exercise could decrease neck disability index score, pain and improve the strength of the neck, scapular, and shoulder muscles compared with those of stretching exercises.
... Recurrent and prolonged neck flexion is one of the factors that increase the risk of neck pain and disability 26,27 . A frequent, recurrent neck flexion posture affects natural angle of the cervical spine, increases the stress to which the cervical spine is exposed 28 , leads to proprioception losses in the cervical vertebra 29 and leads to spasm in muscles and ligaments 30 . In some studies, it was reported that in addition to neck flexion angle, the head tilt angle and forward head shifting increased with the use of smartphones 31,32 . ...
... Particularly persistent flexion of the cervical spine may lead to long-term effects on the musculoskeletal system and compromises the surgical performance [3]. Bending the head 30 degrees off the neutral position results in an up to four times increased load on the cervical spine, with consecutive loss of lordosis and compensational thoracic hyperkyphosis [15,5]. Technical improvements like neuroendoscopes, which decouple the visual from the working axis, particular in regard of operations at extreme angles, have demonstrated superior ergonomics during surgery [10]. ...
Preprint
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Background Exoscopic surgery promises alleviation of physical strain, improved intraoperative visualization and facilitation of the clinical workflow. In this prospective observational study we investigate the clinical usability of a novel 3D4K-exoscope in routine neurosurgical interventions. Methods Questionnaires on the use of the exoscope were carried out. Exemplary cases were additionally video-documented. All participating neurosurgeons (n=10) received initial device training. Changing to a conventional microscope was possible at all times. A linear mixed model was used to analyze the impact of time on the switchover rate. For further analysis we dichotomized the surgeons in a frequent (n=1) and an infrequent (n=9) user group. A one-sample Wilcoxon signed rank test was used to evaluate, if the number of surgeries differed between the two groups. Results 39 operations were included. No intraoperative complications occurred. In 69.2% of the procedures, the surgeon switched to the conventional microscope. While during the first half of the study the conversion rate was 90%, it decreased to 52.6% in the second half ( p =0.003). The number of interventions between the frequent and the infrequent user group differed significantly ( p =0.007). Main reasons for switching to ocular-based surgery were impaired hand-eye coordination and poor depth perception. Conclusion The exoscope investigated in this study can be easily integrated in established neurosurgical workflows. Surgical ergonomics improved compared to standard microsurgical setups. Excellent image quality and precise control of the camera added to overall user satisfaction. For experienced surgeons, the incentive to switch from ocular-based to exoscopic surgery greatly varies.
... The loads applied on the cervical spine in neutral head posture was 4.5-5.4 ㎏ and increased up to 27.2 ㎏ as the head tilts forward (Hansraj, 2014). ...
Article
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Purpose : Forward head posture (FHP) is one of the most common postural malalignment of the cranio-cervical region. Previous studies have reported that FHP might affect both temporomandibular joint (TMJ) and cervical muscles, but still remains unclear. The purpose of this study was to compare the changes of craniovertebral angle (CVA) and muscle properties after smartphone use in healthy individuals with and without FHP. Methods : Fifteen healthy individuals aged 18 to 22 years were included. CVA was evaluated using Dartfish motion analysis, and the subjects were divided into two groups according to their CVA: a FHP group (n = 7, CVA less than 48 °) and a control group (n = 8, CVA more than 48 °). MyotonPro was used to measure muscle properties of masseter, digastric and sternocleidomastoid muscles (SCM). Each subject underwent 15-minutes of smartphone task (web browsing or video watching) in relaxed sitting posture. CVA and muscles properties were assessed both before and after the smartphone task. Results : There were significant changes in post measurements of CVA between the groups. Masseter muscle showed significant differences in pre and post measurements of all muscle properties, and digastric muscle showed significance only in muscle tone. Amount of changes (post-pre), however, showed no significant difference in this study. Conclusion : 15-minutes of smartphone task did not affect CVA and muscle properties of masseter, digastric and SCM in both groups, however, there were significant changes in pre and post measurements of CVA and some muscle properties of masseter and digastric muscles. Therefore, CVA, masseter and digastric muscles might be significantly changed in a heavy duration of smartphone usage more than 15-minutes. Further studies are needed regarding duration of smartphone task, assessments in other various TMJ muscle groups, and participants with pathological FHP conditions.
... This might be because the Internet is used in a more relaxed state on weekends, which leads to reducing the use of neck muscles. 42 Musculoskeletal pain has been reported to be associated with not only the length of Internet use, but also poor posture, 43,44 lightning, 45 mental status, 31,46 and other causes, 43 suggesting the complex factors in the development of neck pain. The exact explanation linking neck pain and PIU remains unclear and warrants further research. ...
Article
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Objectives Problematic internet use (PIU) has been suggested in relation to psychological symptoms among schoolteachers, but the relationship with physical symptoms remains unclear. We examined whether PIU or longer Internet usage time is associated with neck pain in schoolteachers. Methods We conducted a cross-sectional study among 2582 teachers aged 20 years or older (35.6% women) in Shimane and Tottori, Japan in 2018. Neck pain was defined as ≥5 points on the Neck Disability Index. The Compulsive Internet Use Scale (CIUS) was used to assess PIU. Internet usage time on weekdays and weekends was divided into five groups: 0, 1–29, 30–59, 60–119, and ≥120 min/day. Logistic regression analysis was conducted to examine the association of the CIUS score and Internet usage time on weekdays or weekends with neck pain, adjusting for sex, age, position at school, insomnia, and psychological distress. Results We observed 800 (31.0%) teachers with neck pain. The median (interquartile range) of their CIUS scores was 7 (2, 14). A higher CIUS score was independently associated with a higher prevalence of neck pain (odds ratio of 4th vs. 1st quartiles, 1.41; 95% confidence interval, 1.06–1.87; trend P = .006). Compared with non-Internet users, Internet users on weekdays had almost double the odds of neck pain although the difference did not reach the customary level for designating statistical significance. Conclusions In conclusion, teachers with higher scores in CIUS were associated with a higher prevalence of neck pain in Japan, suggesting adults with PIU being at risk of physical disorders.
... When the head flexes to 15 degrees, the load on the spine increases to 27 lbs, and at 30 degrees of flexion the head weighs 40 lbs. At 45 degrees of neck flexion, the load of the head increases to 49 lbs, and further increases to 60 lbs when the neck is in 60 degrees of flexion [2,16]. Maintaining a hyper-flexed head and neck position while repetitively using a HHMD can result in excessive loading of spinal structures and produce neck pain, a characteristic of the text neck posture [2]. ...
Article
Background: The excessive use of hand-held mobile devices (HHMD) leads to a postural phenomenon known as text neck. Objective: The aim of this paper is to discuss the anatomical, biomechanical and muscle activation changes within the cervical and thoracic regions associated with the sustained, forward, flexed neck posture, observed with excessive usage of hand-held mobile devices. Additionally, this paper examines the relationship of gender, as well as the effects of carrying backpack loads by youth, on this forward, flexed neck posture. Methods: Multiple aspects of the text neck position that occur when an individual uses a HHMD are described. Results: Prolonged use of hand-held mobile devices results in adverse anatomical and biomechanical changes in the cervical and thoracic spine, muscular imbalances, and postural compensations, all of which contribute to muscular overuse and fatigue resulting in pain. Conclusions: Physical therapists must educate their patients about proper posture while using hand-held mobile devices. Proper posture includes: holding the device close to eye level, using the device while standing or sitting and holding the device with a line of sight perpendicular to the surface of the device, using a larger screen, and texting with both hands. Also, because children are using hand held mobile devices at younger ages, parents and teachers must be educated about the dangers of prolonged use of hand-held devices.
... The text neck (4,5) is a definition used in recent years to describe stress injuries repeated and neck pain resulting (I) from an incorrect interaction with the devices (II) used for an excessive period of time (6). The text neck can be considered a neuromusculoskeletal risk from abuse of smartphone technology (6)(7)(8)(9)(10)(11). The ease of interaction and the enormous potential of the smartphone device can generate the so-called psychocognitive risk of addiction. ...
Article
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Background: The evolution of the Telemedicine and e-Health is strictly related to the evolution of the mobile-technology. If today it is possible to successfully use a wide range of mHealth applications, playing an important role in Telemedicine and e-Health, health care has surely a gratitude debt with the smartphone. However, it is increasingly becoming clear that excessive use of the smartphone has implications for health in terms of risks and it is therefore necessary to tackle the various gaps and/or the role that Telemedicine and e-Health itself has in this field. Methods: Through an overview to literature, Web and App stores the study faced the implications for health from the excessive use of the smartphone and therefore the various gaps and/or the role that Telemedicine and e-Health itself has in this area both in the prevention and in the monitoring with particular regard to the three components: eHealth, mHealth and eLearning. Results: The study found (I) as emerging risks: the text neck, the risk of addiction and the risk in the use of deceptive Apps in mHealth; (II) as Telemedicine and e-Health useful approach: the design of Apps for the text neck prevention and the relevant acceptance and effectiveness assessment; the design and application of electronic surveys for tele-assessment of the addiction risk; the design and application of information and training path on the deceptive Apps in mHealth. Conclusions: The key role of Telemedicine and e-Health in the prevention and monitoring of the risks from smartphone abuse has been clearly identified and the young people has been identified as target population and the relevant need to design specific teaching packages in this field focused on them.
... This leads to loss of curvature, increased stress on the cervical spine, and hastens the process of degeneration of ligaments. [16] Poor posture changes length-tension relationship of cervical spine and shoulder girdle muscles, altering the pattern of muscle activation. There is increased muscle activity observed in the upper trapezius, erector spinae, and neck extensor muscles during smartphone use. ...
Article
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.
... 53-55 A 27 • incline forward of the head has been equated to an increased perceived weight of 18 kg while a 60 • angle looking at a mobile device equates to 27 kg strain. 25,56 In addition, texting using a mobile device has been found to be associated with a non-neutral posture of the cervical spine. 57 Increased sedentary time, overeating, and obesity, and associated higher risk of systemic diseases. ...
Article
Background: The COVID-19 pandemic caused an unprecedented move to emergency remote learning around the world, leading to increased digital screen time for children and adolescents. This review highlights the potential risk of increased screen time to the eye and general health and makes recommendations to mitigate the risks posed. Methods: A narrative review of evidence of increased digital time during the COVID-19 pandemic, the risks linked to increased screen time and offer possible steps to mitigate these in students. Results: Digital screen time was found to have increased for children and adolescents in all the studies examined during the pandemic and data suggests that this has an impact on eye and general health. We discuss the associated risk factors and adverse outcomes associated with increased digital screen time. Conclusions: This review offers evidence of increased digital time, highlights some of the well-known and not so well-known risks linked to increased screen time, and offers possible steps to mitigate these in children and adolescents during the pandemic, as well as offering schools and parents strategies to support the eye health of children and adolescents post-pandemic. We discuss a number of interventions to reduce the risk of eye strain, myopia, obesity, and related diseases that have been shown to be linked to increased digital screen time.
... Epstein et al. [19] reported that the morbidity rate of work-related musculoskeletal disorders among surgeons is quite high; the rate for cervical disorders is 17%, higher than that of 1997, and 12% surgeons retire due to musculoskeletal disorders. When the cervical spine is bent to 60 degrees, the normal 5-kg force on the neck becomes 27 kg [20]. This MMBS was developed to enable surgeons to perform the operation with a heads-up position to view the monitor with seamless various magnification levels and provide the assistants with the same operative fields as the surgeon's (Fig 6). ...
Article
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Objective Microsurgery using conventional optical microscopes or surgical loupes features a limited field of view and imposes a serious strain on surgeons especially during long surgeries. Here we advocate the micro- and macro-borderless surgery (MMBS) using a novel high-resolution (4K) three-dimensional (3D) video system. This study aimed to confirm the applicability of this concept in several surgical procedures. Methods We evaluated the possible use and efficacy of MMBS in the following experiments in porcine subjects. Experiment 1 (non-inferiority test) consisted of dissection and anastomosis of carotid artery, portal vein, proper hepatic artery, and pancreatoduodenectomy with surgical loupe versus MMBS. Experiment 2 (feasibility test) consisted of intra-abdominal and intra-thoracic smaller arteries anastomosed by MMBS as a pre-clinical setting. Experiment 3 (challenge on new surgery) consisted of orthotopic liver transplantation of the graft from a donor after circulatory death maintained by machine perfusion. Circulation of the cardiac sheet with a vascular bed in experiment 2 and liver graft during preservation in experiment 3 was evaluated with indocyanine green fluorescence imaging equipped with this system. Results Every procedure was completed by MMBS. The operator and assistants could share the same field of view in heads-up status. The focal depth was deep enough not to be disturbed by pulsing blood vessels or respiratory movement. The tissue circulation could be evaluated using fluorescence imaging of this system. Conclusions MMBS using the novel system is applicable to various surgeries and valuable for both fine surgical procedures and high-level surgical education.
... Further, CES muscle activity was increased when the neck flexion angle increased during smartphone use (Namwongsa et al., 2019). From these results, the mechanism of neck MSDs is explained by increased cervical muscle activation against head weight and forces acting on the neck from awkward postures during smartphone use (Hansraj, 2014). The greater the neck flexion angle during smartphone use, the greater the risk of neck muscle fatigue and pain. ...
Article
Smartphone use is a risk factor for both neck and shoulder musculoskeletal disorders. The objective of this study was to evaluate an ergonomic arm support prototype device, which may help improve posture while using a smartphone, by determining its effect on muscle activity, muscle fatigue, and neck and shoulder discomfort. Twenty-four healthy young adult smartphone users performed 20 min of smartphone game playing under two different conditions, smartphone use with support prototype device (i.e. intervention condition) and without (i.e. control condition), while neck and shoulder posture were controlled at 0° neck flexion and 30° shoulder flexion. Activity and fatigue of four muscles were measured using surface electromyography (sEMG), these were: anterior deltoid (AD), cervical erector spinae (CES), upper trapezius (UT) and lower trapezius (LT). The intervention condition showed significantly decreased activity of all muscles. Fatigue of all muscles, except LT, significantly increased over time compared to the start point in the control condition. There was no significant difference in muscle fatigue between each time point in the intervention condition. In conclusion, the ergonomic arm support prototype device can be used as ergonomic intervention to reduce neck and shoulder muscle loading and fatigue.
... Remain slouching for long hours on the smart phone, tablet or computer is the most common cause of back pain as demonstrated in medical research [2]. Looking to your phone with bad posture is like placing weights on your neck that stress the vertebrae [3]. ...
Article
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The neck and back pains are the most spread health problems of the century caused by remaining slouching for long hours on the smart phones, the tablets and the computers. Many medical researches prove that the monitoring and the improving of the seating posture can prevent the spinal pains. In this paper we propose a Real-time seating posture monitoring system. The system is composed of a smart belt equipped with inertial sensors. The sensors collect the posture information and send them to a cloud server via Wi-Fi connection. The cloud server processes the collected data, then, sends the result to mobile applications via Wi-Fi connection. The mobile applications allow the user to monitor his posture over time and receive in Real-time a sound and a visual notification in case of a bad posture detection. Two mobile applications Android and iOS are implemented that can be used for different mobile phone OS. In this work we will detail the design and the architecture of the proposed posture monitoring system and the implemented mobile applications. We will present the posture measurements of good and bad posture using the proposed posture monitoring system.
... Maintaining the correct body alignment of body segments affect the function of body organs (Gray et.al., 1966). It is commonly acknowledged among the scientific population that correct posture is worthy of being maintained, taught, and exemplified (Hansraj, 2014;Kritz, 2008;Nair, Sagar, Sollers, Consedine, & Broadbent, 2015). Correct posture has ear, shoulder, hip, knee and ankle in alignment from the side. ...
Article
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The position of a body while performing any of the activity like sitting, standing, laying, writing, walking and sleeping is referred as posture. It helps to hold the body in desired position for certain time. Correct posture is a posture which avoids strain and develops good body carriage while working. Incorrect posture causes body pain. Correct posture reduces excessive strain on the joints and muscles of the body, consequently reduces the pain and minimizes the risk of injury. The purpose of this study is to analyze effect of posture on workplace efficiency along with health benefits and recommend solutions. The results of our statistical analysis indicated that prolonged sitting times among office workers could have an effect on exhaustion during the working day, job satisfaction, hypertension (blood pressure above 140/90 mmHg), and MSD symptoms in the shoulders, lower back, thighs, and knees of office workers.
... Görsel 8.4. Başın Pozisyonuna Göre Boyna Binen Yüklerin Değişimi (Hansraj, 2014) Ayrıca, dokunmatik ekran kullanımında bilek ve parmakların tamamen ekrana dayanamadığından üst trapezius kas aktivitesi artmaktadır. Bu nedenle, farklı cihaz yerleşimlerinin ve bir dokunmatik ekran arayüzünün kullanılmasının kas-iskelet sistemi risklerini etkileyebileceğini ve baş/boyun ve distal üst ekstremitelerde nötral olmayan duruşlara neden olabileceğini ve bunun da semptom riskinin artmasına neden olabileceğini göstermektedir. ...
Chapter
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Günümüzde çocuklar hem geleneksel hem de modern teknolojiyle birlikte büyümektedirler. Televizyon, bilgisayar, cep telefonu ve tablet gibi teknolojik cihazların kullanım sıklığı her geçen gün daha da artmaktadır. Artan kullanım süresi ve sıklığı beraberinde birtakım sağlık sorunlarının ortaya çıkmasına sebep olmaktadır. Fiziksel aktivite düzeyinde azalma, obezite, kas-iskelet sistemi problemleri, uyku bozuklukları ve bağımlılık dijital teknoloji kullanımı ile ilişkili başlıca sağlık riskleridir. Bu bölümde, artan dijital teknoloji kullanımı sonucu karşılaşılabilecek sağlık problemleri özetlenmeye çalışılarak bu problemlerle başa çıkmaya yardımcı olacak bilgiler paylaşılmıştır.
Article
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Background: The evolution of mHealth is strictly related to the evolution of the mobile-technology and in particular of the smartphone. However, it is increasingly becoming clear that excessive use of the smartphone has implications for health in terms of emerging risks and in particular (I) the text neck, (II) the addiction, (III) the use of deceptive Apps in mHealth and today telemedicine and e-Health solutions to face this are strongly needed. What young people need is a package of solutions that allow them to tackle all three of these problems at the same time through dedicated tools and specific material on these topics. However up to now this is lacking. The purpose of the study was the design and application of a teaching package focused in this field and specific for young people, the target population for the emerging risks. Methods: A teaching package was developed in a school-work alternation program for the secondary schools at the Italian National Institute of Health, according the Italian Law. It was available on the basis of proposals offered publically. It provided a two weeks stage on the topics: the risks from smartphone abuse and Telemedicine and e-Health solutions. Results: A specific electronic survey in this field was available at the end of the stage. The survey was submitted to 500 young subjects (50% male; 50% females; mean age 15.9 y; std-dev 1.2 y) at school and/or in meeting initiatives. The outcome demonstrated: (I) that the knowledge on the postural risk (text neck) was very poor, while the desiderata of Apps for correcting the posture was very high; (II) the feasibility to obtain feedback on the risk of addiction through a cyber-psychology approach; (III) a worrying position in relation to non-medical Apps confused with the medical ones. Conclusions: The study demonstrated how the young people mBorn can familiarize with some aspects of telemedicine and e-Health and be at the same time a kind of spreader of a correct vision of the ratio between user and smartphone and the knowledge on both the mTech and the related problems.
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Na infância os alicerces são construídos, baseados num percurso árduo de experiências e emoções com movimentos e sensações, a cada dia novos desafios para alcançar a felicidade e a plenitude e crescimento e desenvolvimento. Este é o desenvolvimento humano no decorrer da vida. Este livro aborda interações entre criança, família, escola, comunidade, gestores e os profissionais de diferentes áreas de conhecimento em especial da saúde e da educação. Ao longo dos capítulos o leitor terá acesso a materiais que perpassam o conhecimento na área do desenvolvimento infantil, desde a fundamentação teórica até dicas práticas e relatos de experiências.
Article
Objective The aim of this study was to evaluate our experience with a high-definition three-dimensional (3D) exoscope (EX) for cervical spine surgery versus a binocular operating microscope (OM). Methods A retrospective review of patients undergoing a single-level anterior cervical discectomy and fusion (ACDF) procedure for the treatment of cervical myelopathy from March 2019 to May 2020 was performed. Demographic, perioperative, and clinical outcomes of 50 patients were included, 23 of whom received assistance from the 3D exoscope (EX group) and 27 of whom received assistance from the OM (OM group). Operative baseline and postoperative outcome parameters were evaluated. Periprocedural handling, visualization, and illumination by the EX, as well as surgeons’ ergonomics, were scored using a questionnaire and rapid upper limb assessment (RULA). Results Baseline characteristics were similar between the two groups. There were no significant differences between groups in mean operative time, blood loss, duration of admission, or postoperative improvement of symptoms. Both groups showed similar clinical improvements after surgery. There were no intraoperative complications in either group. According to the attending surgeons, the intraoperative handling of instruments for the EX was rated to be comparable to that of the OM. Surgeons rated the comfort level of the intraoperative posture for the EX as very high on the subjective questionnaire and equal to the OM on the objective RULA. When compared with the OM, depth perception, image quality, and illumination for the EX were rated as inferior in ACDF procedures with long approaches. The operative education and training function of the EX was rated to be superior to that of the OM. Conclusions Overall, our study showed that the EX appears to be a safe alternative for common ACDF with the unique advantage of excellent comfort and also serves a useful educational tool for the surgical team. However, our investigation revealed several important limitations of this system, including slightly inferior visualization and illumination quality compared with the OM.
Chapter
This chapter presents an overview of occupational health in remote work from the self-care perspective. A literature review regarding remote working conditions and their effects on health and well-being is included, along with an analysis of the most relevant self-care and practices that have been developed for working at the distance. The study focuses on faculty, specifically at a private university in Puebla, Mexico, and the effects of the pandemic-induced remote work schemes on their well-being, along with the most common ailments that emerged from remote working conditions and self-care practices that can be adopted to prevent or reduce them. A survey was conducted among faculty members to understand the health implications of remote work and what people have been doing to deal with them. The concept of health circles is introduced to help explain specific actions taken to promote self-care and group care.
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Technological development of motion and posture analyses is rapidly progressing, especially in rehabilitation settings and sport biomechanics. Consequently, clear discrimination among different measurement systems is required to diversify their use as needed. This review aims to resume the currently used motion and posture analysis systems, clarify and suggest the appropriate approaches suitable for specific cases or contexts. The currently gold standard systems of motion analysis, widely used in clinical settings, present several limitations related to marker placement or long procedure time. Fully automated and markerless systems are overcoming these drawbacks for conducting biomechanical studies, especially outside laboratories. Similarly, new posture analysis techniques are emerging, often driven by the need for fast and non-invasive methods to obtain high-precision results. These new technologies have also become effective for children or adolescents with non-specific back pain and postural insufficiencies. The evolutions of these methods aim to standardize measurements and provide manageable tools in clinical practice for the early diagnosis of musculoskeletal pathologies and to monitor daily improvements of each patient. Herein, these devices and their uses are described, providing researchers, clinicians, orthopedics, physical therapists, and sports coaches an effective guide to use new technologies in their practice as instruments of diagnosis, therapy, and prevention.
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The chocolate is regarded as an indulgent treat and its delicious taste often consuming with all age groups. But all the parents are saying to their kids that, the chocolate is not good for our health and use to blame the chocolates causing for tooth cavities, acne and weight gain. Now, many research studies evidenced the fact and the scientists recommend to consume the dark chocolates with higher cacao mixture. Since, it has loaded with biologically active organic compounds of antioxidants, flavanols and polyphenols are essential for overall healthy and more efficient than many drugs in preventing various diseases.
Children with secondary sexual characteristics who experience considerable physical, psychological, and social development are prone to physical and mental imbalances. The effects of postural intervention on physical and psychological aspects in junior high school students in terms of secondary sexual characteristics were investigated in this study. Of the 30 participants in this study, 21 (10 boys, 11 girls) with complete measurements were included. The postural intervention consisted of 1 month of direct muscle stretching for postural maintenance and breathing as well as activities to orient the spinal curvature. The participants’ body arrangement, spinal curvature, and General Health Questionnaire 30 (GHQ) scores were compared before and after the postural intervention. The intervention improved postural alignment (e.g., head–neck angle t20 = 2.23, p < 0.01, 95%CI [0.30, 5.36]) and GHQ scores (e.g., GHQ total t20 = 3.36, p < 0.01, 95%CI [0.79, 3.40]). The postural intervention improved the posture of the students as well as positively affected their mental health. This study showed that students with secondary sexual characteristics can receive physical and psychological care without the use of special facilities or techniques.
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Purpose: Text-Neck Syndrome is a rising 21st-century syndrome that affects millions of people of all ages all over the world. This study aimed to investigate the effect of Text-Neck Syndrome on Scapular Index and Respiratory Functions in Different Age Groups. Methods: Forty-four subjects aged between (10 and 29 years) who had Text-Neck Syndrome participated in this study. They were distributed into 2 groups according to their age. Group (A) adolescent age group (10-19 years) and group (B) young adult age group (20-29 years). visual analogue scale was used to measure neck pain intensity, Functions of the upper extremity were scored by the Quick questionnaire, Scapular index was measured to assess Rounded shoulder posture, photographing method was used to determine craniovertebral angle to assess forward head posture, Respiratory function was assessed using 6- Minute Walk Distance. Results: Subjects with Text-Neck Syndrome in adolescent age group (A) had significantly worse Quick Disabilities of the Arm, Shoulder, and Hand questionnaire (p<0.05), As well as non-significantly worse measurements of Visual analogue scale, scapular index and craniovertebral angle than those at the young adult age group (B) (p>0.05). But, regarding 6-Minute Walk Distance, group (A) had significantly higher results than group (B). Conclusion: Text-Neck Syndrome co-morbidities such as: neck pain, disabilities of upper extremity, rounded shoulder, forward head posture and decreased respiratory functions are all more present at adolescent compared to young adult age groups excluding the affection of respiratory functions which is worse in older age.
Conference Paper
Maintaining good posture when using a laptop or a smartphone can prevent computer vision syndrome and text neck syndrome. However, it is difficult to remain aware of posture during an activity. Thus, wearable systems with posture feedback can help maintain good posture during daily activities. In this paper, we propose a posture feedback system that uses a commercial wearable speaker, which has been used for music and video conferencing when working from home. To judge a user's posture as good or poor, we focus on estimating the distance between the user's eyes and the screen when using a laptop and the neck tilt when using a smartphone. To estimate the distance, we use an active sensing method with ultrasound sent from a wearable speaker to a microphone on a laptop or a smartphone. The sound pressure of ultrasound changes depending on the distance between the wearable speaker and the microphone. In addition, an active sensing method can be used to estimate neck tilt because the sound pressure changes depending on the angle between the wearable speaker and the microphone. When the system judges the user's posture as poor, it will provide auditory feedback by applying digital audio effects to audible sounds (i.e., audio being listened to). Audio signal processing is implemented as a web application so users can use our system easily and immediately. We conducted three experiments to verify the feasibility of our proposed method. The sound pressure changed depending on the distance and angle between a wearable speaker and a microphone, and the system could judge posture as good or poor at almost 100 % under the experimental conditions.
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Introduction Conventional microscopes have certain limitations in terms of posture and ergonomics. Monitor-based exoscopes could solve this problem and thereby lead to less work-related sick leave for surgeons. Research question The aim of this study was to assess the ergonomics, usability, and neurosurgeon's comfort of a novel three-dimensional head-mounted display-based exoscope in a standardized setting. Material & Methods 34 neurosurgeons participated in a workshop on the exoscope, which features a head-mounted display and a head gesture-triggered control panel. After completion of a custom-made 10-step microsurgical exercise, image quality and comfort were assessed using a questionnaire. The participants' posture during the exercise was analyzed using a video motion analysis software. Results 34 participants (median neurosurgical experience: 6 years) were included. The median time to complete the exercise was 12 min [IqR 9.4, 15.0]. Younger participants (p = 0.005) and those with video game experience (p = 0.03) had a significantly steeper learning curve. The median overall satisfaction was at 80% in general and 82% for image quality. The median upper body as well as the median head coronal displacement from the neutral axis were 0°. Participants with less microsurgical experience showed less head/body displacement during the exercise (p = 0.01). Discussion and conclusion Using the microsurgical training tool, we were able to depict a steep learning curve with a sufficient learnability of the most relevant commands. The exoscope excelled in usability, image quality as well as in ergonomic and favorable posture and could thus become an alternative to conventional microscopes due to the potentially elevated surgeons' comfort.
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Background: Prolonged use of the smartphone causes neck and shoulder pain. However, no study has yet evaluated the effects of sitting upright, combined with frequent breaks, eye rest and self-stretching on pain and EMG during smartphone use. Objectives: The purpose of the study was to compare pain and muscle activity between the control group (rest only) and the intervention group (rest combined with correct posture, eye rest and self-stretching) in smartphone use for 41.30 minutes. Method: Forty-four healthy females aged 18-25 years old were recruited and randomly divided into two groups. The body pain chart and Visual Analog Scale (VAS) were used to evaluate pain. Electromyography (EMG) was used to measure muscle activity of Cervical Erector Spinae (CES) and Upper Trapezius (UT) muscles. Results: The results showed that overall pain and neck pain in the control group increased significantly after smartphone use for 20 min and continually increased to 41.30 minutes (p < 0.05). Overall pain and neck pain in the intervention group was significantly lesser than control group after smartphone use for 41.30 minutes (p < 0.05). In the control group, EMG of CES at 41.30 minute was significantly higher than that of at 0 min (p < 0.05). There was no significant difference in EMG of UT between the two groups. Conclusion: Conclusion smartphone user in the interventional group reported less pain when compared to control group after Smartphone use for 41.30 minutes. Therefore, the user aged 18-25 years should have a rest combined with correct posture, eye rest and self-stretching to prevent neck pain during prolonged smartphone use.
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