The aim of the current study was to compare the severity of pain and the number of pain locations between 3 sitting positions, which were the preferred sitting position (preferred sitting), sitting upright, and holding a smartphone with two hands at chest height without elbow support (without elbow support). and sitting upright with elbow support and holding the smartphone with both hands at chest level (elbow support) while using the smartphone for 15 minutes in a non-texting video viewing task. A body pain chart and a visual analog scale (VAS) were used to assess pain location and pain severity, respectively. The results showed that 1) pain in the area of the neck, shoulders, upper back and lower back was significantly higher in "preferred sitting" than in the other two positions (p<0.05).
Chavapon Pupapassiri for helping me in the research process and I would also like to thank all the volunteers for participating in this study. Finally, thanks to all the staff of the Faculty of Physiotherapy and Graduate School of Srinakharinwirot University for helping with the paperwork. Side table 1 Severity of pain in the neck, upper back, lower back, shoulder, arm, wrist and hand in 3 positions.
INTRODUCTION
There is a lack of evidence of pain evaluation in the older group during smartphone use, even though it has been clearly established that musculoskeletal pain was induced by smartphone use in the older group. Therefore, the aim of this study is to evaluate pain in the neck, upper back, lower back, shoulder, arm, wrist and hand during smartphone use in elderly people aged 60-69 years after smartphone use for 15 minutes in three sitting positions. The results of this study will be useful to develop a guideline for the use of smartphones for the elderly to prevent the risk of musculoskeletal pain caused by smartphone use.
Which posture will have the least pain and number of pain locations among the 3 sitting positions during smartphone use in the elderly. 1. To compare the intensity of pain between 3 sitting positions, which are the preferred sitting position, sitting upright and holding the smartphone with both hands at chest height, and sitting upright with elbow support and holding the smartphone with both hands at chest height while using the smartphone 15 minutes in the older group from 60 to 69 years old. 2. To determine and compare the number of pain locations between 3 sitting positions, which are the preferred sitting position, sitting upright and holding a smartphone with two hands at chest level, and sitting upright with elbow support and holding a smartphone with both hands at chest level at using a smartphone for 15 minutes in the older group of 60 to 69 years.
LITERATURE REVIEW
Elderly people
- Definition of elderly people
- Elderly people in Thailand
Cervical and Thoracic postural alignments in sitting of elderly people
- Smartphone use in overall
- Smartphone use in elderly people
Musculoskeletal pain caused of Smartphone use
Proper posture during Smartphone use
- Sitting upright
- Neutral or slight neck flexion
- Supporting elbow
- Holding smartphone with both hands
Based on this overview, the present study will evaluate smartphone use among the elderly, which is defined between the ages of 60 and 69 years old from the Study of Smartphone Usage Behavior Related to Data of Internet Users in Thailand (ETDA)(6). The study in the United States showed that in 2019 elderly people used the internet more via smartphones than in 2011.(9) A Swiss study showed that elderly people often use the internet in their daily lives (63%). Therefore, the use of smartphones with mobile internet is seen by the elderly as a means of coping with everyday life (59).
The survey in Thailand also found that Thai people aged 65 years or older used the Internet using smartphones in the duration of 3 hours a day and 49.6% of them had experience in smartphone use for more than a year, but less than five years. The increase of the elderly in the population showed a similar trend in the increase in the use of the Internet in the elderly group. In addition, Electromyography (EMG) of erector spinae and upper trapezius in upright sitting was significantly lower than the preferred sitting posture after smartphone use for 20 minutes (Figure 8).(34) In addition, sitting upright during smartphone use with two elbows supported showed less pain.
Related to Intolo et al, 2016, who studied smartphone use in three positions (putting the smartphone on the lap, holding the smartphone at chest level, and placing the smartphone on a table) for 20 minutes. However, pain while using a smartphone in this posture has not yet been studied in an older group.
Severity of Pain measurement
Location of pain measurement (Body pain chart)
METHODOLOGY
The effect size of the similar study design, procedure and the same measured outcome was used in this study and will examine one parameter:. severity of pain while using smartphone. 89) study as reference with effect size = 3.3 and 95% confidence interval and study parameter is severity of pain after smartphone use (Figure 21). The number of sample size of the present study was 6 using the study of Intolo et al(34) as a reference with an effect size = 1.35 and a 95% confidence interval and the study parameter is the severity of the pain after using a smartphone (Figure 22).
The researcher was explained how to measure the severity of pain using VAS and how to clarify the location of pain using a body pain graph and a hand diagram. Pain severity and pain location were measured immediately after 15 minutes of use in each position. Participants were given their location of pain and severity of pain immediately after using the smartphone for 15 minutes through a body pain graph, hand chart, and VAS.
The current study measures the location of pain in the dominant side and specifies pain in the posterior part of the body. Participants were given a location of pain and a severity of pain indicated on the pain graph, hand diagram, and visual analog scale (VAS), immediately after using the smartphone for 15 minutes (after 15 minutes) in each position. In the present study, the location of pain in the dominant side was measured and pain in the posterior part of the body was specified.
Locations of pain were neck (area next to neck from C1 to C7), upper back (area between midline and medial edge of scapular from T1 to T7), lower back (area below scapular to L5), shoulder (area from midline lateral to acromion process) , arm (area from arm to wrist), wrist and hand (area from wrist to fingers).(83). The normality of pain severity distribution data was analyzed using a Kolmogorov-Smirnov test. Hypothesis tests comparing the severity of pain between three postures were analyzed using a Kruskal-Wallis test.
Comparison of the number of pain locations between the three sitting positions was analyzed using a Kruskal-Wallis test.
RESULTS
However, there was no significant difference in low back pain between "no elbow support" and "elbow support" (Table 1). However, there was no significant difference in shoulder pain between 'preferred sitting' and 'no elbow support' (Table 1). However, there was no significant difference in arm pain between "sitting preferred" and "elbow rest" (Table 1).
The number of pains in the neck area in "preferred sitting position" (18 areas) was significantly higher than in "no elbow support" (2 areas) with p-values 0.001. However, there was no significant difference between "no elbow support" (2 areas) and "elbow support" (0 area) (Table 2). However, there was no significant difference between "no elbow support" (0 range) and "elbow support" (0 range) (Table 2).
The number of low back pain in "preferred sitting" (8 sites) was significantly higher than "no elbow support" (1 site) with p-values of 0.008. However, there was no significant difference between "no elbow support" (1 zone) and "elbow support" (0 zone) (Table 2). The number of shoulder pain in "preferred sitting" (13 sites) was significantly higher than "elbow support" (0 sites) with p-values of 0.001.
The number of pains in the shoulder area in "no elbow support" (11 areas) was significantly higher than in. The number of pains in the arm area in "no elbow support" (10 areas) was significantly higher than in "preferred sitting position" (0 area) with p- values 0.002. The number of pains in the arm area in "no elbow support" (10 areas) was significantly higher than in
However, there was no significant difference between "preferred sitting position" (0 range) and "elbow support" (0 range) (Table 2).
DISCUSSION AND CONCLUSION
A previous study found that an appropriate distance from the eyes to the smartphone was between 30-40 centimeters.(91) Furthermore, the results of this study showed that neck pain in "no elbow support" and "elbow support". Meanwhile, the result of this study showed that shoulder pain in "elbow support" was less than "no elbow support". The pain level in this study in "no elbow support" in elderly group (1.8 out of 10) was close to Intolo et al., 2022(34) which was 2.2 out of ten in sitting in an upright sitting position and holding a smartphone at chest height of university students.
It can be explained that in "elbow support" participants placed their arms on the pillow and did not hold the smartphone at chest level. Upper back and lower back pain in "preferred sitting" was significantly higher than in the "no elbow support" in elderly group. Wrist and hand pain showed no significant difference between "preferred sitting", "no elbow support" and "elbow support".
The results showed that, in general, the number of sites of pain in "preferred sitting" showed the highest number of sites of pain compared to the "no elbow support" and "elbow support" postures. In addition, the number of locations of pain at neck, upper back, lower back and shoulder areas was recorded at the highest in "preferred sitting" compared to "no elbow support" and "elbow support". Interestingly, the number of sites of pain in "no elbow support" was significantly higher than "in elbow support".
The results of this study showed that the number of arm pain locations in "no elbow support" was significantly higher than in "preferred sitting" and "elbow support". It can be explained that in the “no elbow support” participants held their hand to hold the smartphone at chest level for 15 minutes without any elbow support, which caused pain in the arm region. So in “preferred sitting” and “elbow support” participants did not raise both hands to hold the smartphone.
The results of this study clearly showed that the number of participants reporting pain with "preferred sitting" was greatest compared to "no elbow support". This means that using a smartphone in an upright sitting position with or without elbow support is better than in a preferred sitting position. Pain in the shoulders and arms with "no elbow support" was significantly greater than with "elbow support".