Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
권호 표지
DOI QR코드

DOI QR Code

The Effect of Smartphone Addiction on Scapular Position and Muscle Activation During Shoulder Abduction in Asymptomatic Subjects

  • Sung-Hyun Kim (Department of Physical Therapy, College of Health and Welfare, Silla University) ;
  • Bo-ram Choi (Department of Physical Therapy, College of Health and Welfare, Silla University)
  • Received : 2025.01.19
  • Accepted : 2025.02.27
  • Published : 2025.04.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Portable, small computers and smartphones are now considered essential tools in modern society and smartphone ownership and usage rates are rising every year. However, excessive smartphone use can have musculoskeletal and postural implications, leading to "smartphone addiction" and related dysfunctions. Objects: This study aimed to investigate the effects of smartphone addiction on scapular position and muscle activity during shoulder abduction in asymptomatic individuals. Methods: A total of 45 participants were classified into high-risk, middle-risk, and low-risk groups based on their smartphone addiction levels. Scapular position was measured using the scapular index, round shoulder posture (RSP), lateral scapular slide test, and scapulohumeral rhythm spine angle. Muscle activity was assessed using electromyography of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and anterior deltoid (AD) muscles during shoulder abduction. Results: Smartphone addiction was significantly associated with altered scapular position and muscle activity. The high-risk group exhibited greater forward head posture and more pronounced RSP. Additionally, the high-risk group had lower SA activation and higher UT, LT, and AD muscle activity, indicating compensatory mechanisms due to altered scapular positioning. Conclusion: These findings suggest that excessive smartphone use contributes to postural deviations and altered muscle activation patterns, which may lead to musculoskeletal dysfunction over time. Clinicians should consider smartphone use when assessing patients with scapular dysfunction, and future studies should explore interventions to mitigate these effects.

Keywords

References

  1. Lee HG. The comparison of posture in the use of smartphone on muscle fatigue of cervical erector spinae and upper trapezius in healthy adults. Incheon, Gachon University, Master thesis. 2014.
  2. Demirci K, Akgönül M, Akpinar A. Relationship of smartphone use severity with sleep quality, depression, and anxiety in university students. J Behav Addict 2015;4(2):85-92. https://doi.org/10.1556/2006.4.2015.010
  3. Korea Communications Commission. 2023 Broadcasting media usage survey. Gwacheon; 2023.
  4. Yoon DK. A Study for the change of workload at varying positions of computer monitor and mouse in computer work. Incheon, Incheon University, Master thesis. 2002.
  5. Park J. The variables in influencing on smart phone addiction in adolescents and college students. Yongin, Dankook University, Master thesis. 2012.
  6. Kim DH, Han JD, Park KJ. The relationships of smartphone addiction and mental health according to exercise hours of the after-school exercise in elementary school students. Korean J Elem Phys Educ 2014;20(2):51-64.
  7. Goodman A. Addiction: definition and implications. Br J Addict 1990;85(11):1403-8. https://doi.org/10.1111/j.1360-0443.1990.tb01620.x
  8. Kim D, Chung YJ, Lee JY, Kim MC, Lee YH, Kang EB, et al. Development of smartphone addiction proneness scale for adults: self-report. Korean J Couns 2012;13(2):629-44. https://doi.org/10.15703/kjc.13.2.201204.629
  9. Haughie LJ, Fiebert IM, Roach KE. Relationship of forward head posture and cervical backward bending to neck pain. J Man Manip Ther 1995;3(3):91-7. https://doi.org/10.1179/jmt.1995.3.3.91
  10. Lee H, Nicholson LL, Adams RD, Maher CG, Halaki M, Bae SS. Development and psychometric testing of Korean language versions of 4 neck pain and disability questionnaires. Spine (Phila Pa 1976) 2006;31(16):1841-5. https://doi.org/10.1097/01.brs.0000227268.35035.a5
  11. Kang JH, Park RY, Lee SJ, Kim JY, Yoon SR, Jung KI. The effect of the forward head posture on postural balance in long time computer based worker. Ann Rehabil Med 2012;36(1):98-104. https://doi.org/10.5535/arm.2012.36.1.98
  12. Mekhora K, Liston CB, Nanthavanij S, Cole JH. The effect of ergonomic intervention on discomfort in computer users with tension neck syndrome. Int J Ind Ergon 2000;26(3):367-79. https://doi.org/10.1016/S0169-8141(00)00012-3
  13. Gupta VK, Arora S, Gupta M. Computer-related illnesses and Facebook syndrome: what are they and how do we tackle them. Med Update 2013;23:676-9.
  14. Ebaugh DD, McClure PW, Karduna AR. Three-dimensional scapulothoracic motion during active and passive arm elevation. Clin Biomech (Bristol) 2005;20(7):700-9. https://doi.org/10.1016/j.clinbiomech.2005.03.008
  15. Gumina S, Carbone S, Postacchini F. Scapular dyskinesis and SICK scapula syndrome in patients with chronic type III acromioclavicular dislocation. Arthroscopy 2009;25(1):40-5. https://doi.org/10.1016/j.arthro.2008.08.019
  16. Belling Sørensen AK, Jørgensen U. Secondary impingement in the shoulder. An improved terminology in impingement. Scand J Med Sci Sports 2000;10(5):266-78. https://doi.org/10.1034/j.1600-0838.2000.010005266.x
  17. Kim T, Kang M. Type analysis and countermeasures of side effects of using smart phone. J Korean Inst Inf Commun Eng 2013;17(12):2984-94.
  18. Kendall FP, McCreary EK. Muscles, testing and function. Williams & Wilkins; 1983.
  19. Sahrmann SA. Does postural assessment contribute to patient care? J Orthop Sports Phys Ther 2002;32(8):376-9. https://doi.org/10.2519/jospt.2002.32.8.376
  20. Borstad JD. Resting position variables at the shoulder: evidence to support a posture-impairment association. Phys Ther 2006;86(4):549-57. https://doi.org/10.1093/ptj/86.4.549
  21. Lee S, Lee D, Park J. Effect of the cervical flexion angle during smart phone use on muscle fatigue of the cervical erector spinae and upper trapezius. J Phys Ther Sci 2015;27(6):1847-9. https://doi.org/10.1589/jpts.27.1847
  22. Watson DH, Trott PH. Cervical headache: an investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia 1993;13(4):272-84; discussion 232. https://doi.org/10.1046/j.1468-2982.1993.1304272.x
  23. Girish V, Vijayalakshmi A. Affordable image analysis using NIH Image/ImageJ. Indian J Cancer 2004;41(1):47. https://doi.org/10.4103/0019-509X.12345
  24. Carvalho LACM, Aquino CF, Souza TR, Anjos MTS, Lima DBM, Fonseca ST. Clinical measures related to forward shoulder posture: a reliability and correlational study. J Manipulative Physiol Ther 2019;42(2):141-7. https://doi.org/10.1016/j.jmpt.2019.03.006
  25. Nijs J, Roussel N, Vermeulen K, Souvereyns G. Scapular positioning in patients with shoulder pain: a study examining the reliability and clinical importance of 3 clinical tests. Arch Phys Med Rehabil 2005;86(7):1349-55. https://doi.org/10.1016/j.apmr.2005.03.021
  26. Kibler WB. The role of the scapula in athletic shoulder function. Am J Sports Med 1998;26(2):325-37. https://doi.org/10.1177/03635465980260022801
  27. Curtis T, Roush JR. The lateral scapular slide test: a reliability study of males with and without shoulder pathology. N Am J Sports Phys Ther 2006;1(3):140-6.
  28. Ockendon M, Gilbert RE. Validation of a novel smartphone accelerometer-based knee goniometer. J Knee Surg 2012;25(4):341-5. https://doi.org/10.1055/s-0031-1299669
  29. Shin SH, Ro DH, Lee OS, Oh JH, Kim SH. Within-day reliability of shoulder range of motion measurement with a smartphone. Man Ther 2012;17(4):298-304. https://doi.org/10.1016/j.math.2012.02.010
  30. Mullaney MJ, McHugh MP, Johnson CP, Tyler TF. Reliability of shoulder range of motion comparing a goniometer to a digital level. Physiother Theory Pract 2010;26(5):327-33. https://doi.org/10.3109/09593980903094230
  31. Johnson MP, McClure PW, Karduna AR. New method to assess scapular upward rotation in subjects with shoulder pathology. J Orthop Sports Phys Ther 2001;31(2):81-9. https://doi.org/10.2519/jospt.2001.31.2.81
  32. Watson L, Balster SM, Finch C, Dalziel R. Measurement of scapula upward rotation: a reliable clinical procedure. Br J Sports Med 2005;39(9):599-603. https://doi.org/10.1136/bjsm.2004.013243
  33. Akodu AK, Akinbo SR, Young QO. Correlation among smartphone addiction, craniovertebral angle, scapular dyskinesis, and selected anthropometric variables in physiotherapy undergraduates. J Taibah Univ Med Sci 2018;13(6):528-34. https://doi.org/10.1016/j.jtumed.2018.09.001
  34. Masoumi AS, Akoochakian M. The effect of duration of smartphone use on head and shoulders posture of young adults aged 20-35 years. Iran J Ergon 2019;7(2):62-71.
  35. Tanveer F, Shahid S, Hafeez MM. Effect of forward head posture on neck disability and level of stress among undergraduate students. Isra Med J 2018;10(2):78-80. https://doi.org/10.1108/IJIF-11-2017-0048
  36. Silva AG, Johnson MI. Does forward head posture affect postural control in human healthy volunteers? Gait Posture 2013;38(2):352-3. https://doi.org/10.1016/j.gaitpost.2012.11.014
  37. Finley MA, Lee RY. Effect of sitting posture on 3-dimensional scapular kinematics measured by skin-mounted electromagnetic tracking sensors. Arch Phys Med Rehabil 2003;84(4):563-8. https://doi.org/10.1053/apmr.2003.50087
  38. Thigpen CA, Padua DA, Michener LA, Guskiewicz K, Giuliani C, Keener JD, et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. J Electromyogr Kinesiol 2010;20(4):701-9. https://doi.org/10.1016/j.jelekin.2009.12.003
  39. Kim SR, Kang MH, Bahng SY, An JK, Lee JY, Park SY, et al. Correlation among scapular asymmetry, neck pain, and neck disability index (NDI) in young women with slight neck pain. J Phys Ther Sci 2016;28(5):1508-10. https://doi.org/10.1589/jpts.28.1508
  40. Weon JH, Kwon OY, Cynn HS, Lee WH, Kim TH, Yi CH. Realtime visual feedback can be used to activate scapular upward rotators in people with scapular winging: an experimental study. J Physiother 2011;57(2):101-7. https://doi.org/10.1016/S1836-9553(11)70020-0
  41. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Phys Ther 2000;80(3):276-91. https://doi.org/10.1093/ptj/80.3.276
  42. Neumann DA. Kinesiology of the musculoskeletal system. Mosby; 2002.
  43. Phadke V, Camargo P, Ludewig P. Scapular and rotator cuff muscle activity during arm elevation: a review of normal function and alterations with shoulder impingement. Rev Bras Fisioter 2009;13(1):1-9. https://doi.org/10.1590/S1413-35552009005000012
  44. Hallström E, Kärrholm J. Shoulder kinematics in 25 patients with impingement and 12 controls. Clin Orthop Relat Res 2006;448:22-7. https://doi.org/10.1097/01.blo.0000224019.65540.d5
  45. Huang LL, Huang TS, Lin YH, Huang CY, Yang JL, Lin JJ. Effects of upper trapezius myofascial trigger points on scapular kinematics and muscle activation in overhead athletes. J Hum Kinet 2022;84:32-42. https://doi.org/10.2478/hukin-2022-000079
  46. Kang FJ, Ou HL, Lin KY, Lin JJ. Serratus anterior and upper trapezius electromyographic analysis of the push-up plus exercise: a systematic review and meta-analysis. J Athl Train 2019;54(11):1156-64. https://doi.org/10.4085/1062-6050-237-18