BACKGROUND: In our digital society, the use of smartphones has increased rapidly. Parallel with the growing use of smartphones, musculoskeletal problems associated with intensive smartphone use have also increased. Neck flexion is the most commonly adopted posture by smartphone users while looking at the visual display terminals of smartphones for extended periods; this posture may lead to neck disorders. OBJECTIVE: The purpose of the current study was to investigate musculoskeletal disorders (MSDs) in smartphone users in Thailand in order to confirm high prevalence of neck pain. The study also aimed to determine all possible factors associated with neck disorders among smartphone users. METHODS: A cross-sectional survey study was conducted with 779 undergraduate smartphone users. A self-administered questionnaire was used to collect self-report measures of smartphone use and musculoskeletal disorders. Descriptive statistics were used to analyze participant characteristics and the prevalence of musculoskeletal disorders. Logistic regression analysis was used to identify associated factors. RESULTS: The most painful body region after the use of smartphones over a 12-month period was found to be the neck (32.50%). Factors associated with neck disorders were a flexed neck posture (Odds Ratio (OR): = 2.44, 95% Confidence Interval (CI) = 1.21-4.90) and smoking (OR 8.99, 95% CI 1.88-42.87). CONCLUSIONS: The results suggest that to address neck disorders in smartphone users preventive initiatives should focus on reducing flexed neck postures and smoking.

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The number of smartphone users globally is rapidly increasing. This study aimed to assess the level of ergonomic risk to smartphone users, and to evaluate the correlation between any self-reported musculoskeletal disorders and the level of ergonomic risk. Thirty participants completed a questionnaire, tailored specifically for smartphone users, to determine any musculoskeletal disorders. Participants were given a seated smartphone texting task and their postures were video recorded during the task. The video scenarios were evaluated by three independent researchers to determine the level of ergonomic risk using the Rapid Upper Limb Assessment (RULA) tool. RULA is an observation-based screening tool which has been widely used to assess the postural risk of IT device users. However, it has not yet been specifically utilized with smartphone users. The RULA tool scores identified ergonomics risks from using smartphones to text. Most smartphone users had a total RULA Grand Score of 6 for both sides (left side: 80.00%, right side: 90.00%), indicating the need for further investigation and changes (Action Level 3). Notably, no participants had acceptable RULA Grand Scores of 1 or 2. The correlation between musculoskeletal disorders and the ergonomic risk among smartphone users was determined using the Chi-Square test and Fisher's exact test; p<0.05 was considered statistically significant. There was a significant correlation between right RULA Grand Score and neck musculoskeletal disorder (χ2 = 9.424 at p value = 0.009) and right RULA Grand Score and upper back musculoskeletal disorder (χ2 = 31.717 at p value <0.001). RULA Score B (combination of neck, trunk and leg postures) and RULA Score D (combination of Score B, muscle use and force scores for group B) were also significantly correlated with neck musculoskeletal disorders (χ2 = 19.286 at p value<0.001 and χ2 = 9.310 at p value = 0.002 respectively). The RULA results identified the high ergonomics risk of smartphone users, this resulted from two key risk factors: posture and muscle use. The neck, trunk and leg postures had a combined effect on neck musculoskeletal disorders. Future investigations should consider these factors when designing ergonomic interventions for smartphone users.

[Purpose] To determine the short-term effects of thoracic manipulation, used alone or in conjunction with the Rungthip massage technique, on pain and neural extensibility in patients with chronic mechanical neck pain. [Participants and Methods] Thirty participants were randomly allocated to the aforementioned two groups. Outcome measures were neck pain at rest assessed using the Visual Analog Scale, and elbow extension range of motion evaluated using Upper Limb Neurodynamic Test 1 prior to treatment and three weeks after it. [Results] A statistically significant reduction in resting neck pain, and an improvement in elbow extension range of motion was reported by both groups shortly after the moment when the pain was first felt (threshold level). However, an improvement in elbow extension range of motion was not observed in either group at the maximum level of pain (tolerance level). A significant reduction in resting neck pain was seen in the thoracic manipulation plus Rungthip massage group, compared to that achieved using thoracic manipulation alone. [Conclusion] The use of thoracic manipulation and Rungthip massage is recommended to reduce resting neck pain and increase pain-free neural tissue extensibility.