Musculoskeletal symptoms among mobile hand-held device users and their relationship to device use: A preliminary study in a Canadian university population
Introduction
The use of mobile hand-held devices to send or receive email, to send or receive instant messages, and to access the internet is on the rise (Rainie, 2010). Along with this rise in device use has come attention in the press and in the clinical literature claiming a link between hand-held device use and upper extremity musculoskeletal symptoms (Storr et al., 2007, Ming et al., 2006, Brasington, 1990). Phrases have been coined such as ‘text messenger’s thumb’, however little evidence exists to support this association.
Although no epidemiological studies have been reported, case reports and laboratory studies indicate potential risks to musculoskeletal health as a result of mobile device use (Jonsson et al., 2007, Sengupta et al., 2007, Storr et al., 2007, Ming et al., 2006). Case reports suggest a link between high keystroke counts and hand disorders, specifically De Quervain’s tenosynovitis and osteoarthritis of the joint at the base of the thumb, the first carpometacarpal (CMC) joint (Storr et al., 2007, Ming et al., 2006). Laboratory work has shown that due to small spacing on the mini-keyboard, greater static strain may be placed on the hand and arm muscles during personal digital assistant (PDA) use as compared to during desktop or laptop use (Sengupta et al., 2007). In addition, laboratory work has demonstrated that as the thumb moves along the interface of the mini-keyboard during a task such as text messaging, it is placed toward the end of its range of motion (Jonsson et al., 2007). Jonsson et al. (2007) described typical thumb postures during text messaging and found that the thumb approaches 79% of its maximum range of motion when abducting in the adduction/abduction plane and 55% of its maximum range of motion when flexing in the flexion/extension plane. Placing the thumb in these static postures likely puts unfavourable static loads on the extrinsic and intrinsic musculature of the thumb. Furthermore, most mobile device tasks require users to look sharply downwards or to hold their arms out in front of them to read the screen; this could lead to fatigue and pain in the neck and shoulders.
Given that the use of mobile hand-held devices is on the rise, that the public has a perception that device use is associated with musculoskeletal symptoms, and that case reports and laboratory studies indicate that this may be an area of concern, an epidemiological study is warranted. The study described herein was therefore designed to: 1) determine the distribution of seven measures of mobile device use among a population of university students, staff, and faculty, 2) determine the distribution of musculoskeletal symptoms of the upper extremity, upper back and neck among a population of university students, staff, and faculty, and 3) assess the relationship between measures of device use and musculoskeletal symptoms among this population. It is hypothesized that measures of higher daily mobile device use are associated with more musculoskeletal symptoms in the upper extremity, upper back and neck within this population of users.
Section snippets
Methods
This preliminary study used a cross-sectional design, with an internet-based questionnaire, to collect self-reported measures of daily mobile hand-held device use and self-reported symptoms of pain in the upper extremity, upper back, and neck in 140 students, staff, and faculty (80 female and 60 male) at a Canadian university, between June 17th and August 12th 2009.
Daily information and communication technology use
137 of 140 participants (98%) reported using a mobile hand-held device. The mean time these individuals spent using their device(s) on a typical day was 4.65 h (SD 5.67). Of those 137 participants, 104 were students and 32 were staff or faculty who spent a mean of 5.05 h (SD 6.15) and 3.01 h (SD 2.92), respectively, using their device(s) (Table 1). Total mobile hand-held device use is broken down into its six measures shown in Table 1. Mean time spent on a typical day for all participants
Discussion
In conjunction with case reports that have made a link between mobile device use and both De Quervain’s tenosynovitis and first CMC joint osteoarthritis (Storr et al., 2007, Ming et al., 2006), information from the occupational epidemiology literature supports a possible association between repetitive thumb movement from mobile device use and hand pain (Fontana et al., 2007, Rossignol et al., 2005, Sakai, 2002, Moore, 1997, Punnett et al., 1985). The aims of this preliminary study were, in a
Conclusion
The associations observed in this study, in combination with case reports, laboratory studies, and information from the occupational epidemiology literature, suggest anatomically feasible relationships between mobile hand-held device use and musculoskeletal symptoms of the upper extremity and neck. Although this research is preliminary, the associations observed, together with the rising use of mobile devices, argue for further research in this field, including a prospective study with more
Acknowledgements
Financial support for this research was provided by the Office Ergonomics Research Committee, USA. The authors would like to acknowledge Philip Kiff for implementing the online version of the questionnaire.
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