Physical Therapy Korea (한국전문물리치료학회지)

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

DOI QR Code

Neck Pain Effects on Head Movement and Tablet Positioning During Tablet PC Writing in College Students

  • Jiwon Moon (Department of Physical Therapy, College of Medical Science, Jeonju University) ;
  • Ye-rin An (Department of Physical Therapy, College of Medical Science, Jeonju University) ;
  • Sujin Kim (Department of Physical Therapy, College of Medical Science, Jeonju University)
  • Received : 2025.07.24
  • Accepted : 2025.08.14
  • Published : 2025.08.20
Download PDF
⟨ Previous Next ⟩

Abstract

Background: With rapid advances in digital technology, tablet PC use among university students has increased significantly. While convenient, prolonged use often causes neck and shoulder discomfort due to poor posture, such as forward head posture and rounded shoulders. Although students commonly use tablets for writing, there is limited research on head movements during these tasks. Objects: To compare frontal plane head movements and tablet tilt angles between college students with and without neck pain during tablet PC use. Methods: Participants were divided into two groups based on neck pain presence (neck pain group and no pain group). Each participant sat at a table, adjusted the tablet stand angle independently, and placed the tablet accordingly. Participants wore earphones and dictated English sentences to ensure focused handwriting and the evaluator recorded all process. These video recordings of handwriting sessions were analyzed for frontal plane head movements using Kinovea software. The Wilcoxon signed-rank test was applied to reveal the group differences in tablet tilt angle, total head movement (THM), horizontal head movement (HHM), and vertical head movement (VHM). Results: There were no significant differences between the neck pain and no neck pain groups in tablet tilt angle or HHM (p > 0.05). In contrast, the neck pain group exhibited significantly greater THM (p < 0.001) and VHM (p < 0.01). Conclusion: The findings of this study indicate no significant relationship between neck pain and tablet tilt angle or HHM, but a significant association with increased VHM and THM. These findings provide basic knowledge for understanding movement patterns in individuals with neck pain.

Keywords

Acknowledgement

ChatGPT was used solely for proofreading and language refinement. All content, analysis, and interpretations were developed by the authors.

References

  1. Zhang Y. Exploring students' increased use of tablets after taking online courses during the COVID-19 lockdown. Contemp Educ Technol 2022;14(4):ep380. https://doi.org/10.30935/cedtech/12283
  2. Shin HS, Kim JH. Survey of dental students' perception of ubiquitous-based test (UBT). J Korean Dent Assoc 2024;62(5):270-81. https://doi.org/10.22974/jkda.2024.62.5.001
  3. Park S. [Market research] the domestic tablet market is expected to grow 6.9% in 2022, reaching 5.01 million units. Digital Economy News [Internet]; 2023 Mar 30 [cited 2025 Feb 21]. Available from: https://www.denews.co.kr/news/articleView.html?idxno=25979
  4. Blair B, Gama M, Toberman M. Prevalence and risk factors for neck and shoulder musculoskeletal symptoms in users of touch-screen tablet computers. Las Vegas, University of Nevada, Doctoral Dissertation. 2015.
  5. Chiang HY, Liu CH. Exploration of the associations of touchscreen tablet computer usage and musculoskeletal discomfort. Work 2016;53(4):917-25.
  6. Lee SP, Hsu YT, Bair B, Toberman M, Chien LC. Gender and posture are significant risk factors to musculoskeletal symptoms during touchscreen tablet computer use. J Phys Ther Sci 2018;30(6):855-61. https://doi.org/10.1589/jpts.30.855
  7. Woo EHC, White P, Lai CWK. Musculoskeletal impact of the use of various types of electronic devices on university students in Hong Kong: an evaluation by means of self-reported questionnaire. Man Ther 2016;26:47-53. https://doi.org/10.1016/j.math.2016.07.004
  8. Yu Z, James C, Edwards S, Snodgrass SJ. Differences in posture kinematics between using a tablet, a laptop, and a desktop computer in sitting and in standing. Work 2018;61(2):257-66. https://doi.org/10.3233/WOR-182796
  9. Lee TH, Lee JH, Lee YS, Kim MK, Kim SG. Changes in the activity of the muscles surrounding the neck according to the angles of movement of the neck in adults in their 20s. J Phys Ther Sci 2015;27(3):973-5. https://doi.org/10.1589/jpts.27.973
  10. Han G, Yi C, Kim S, Kim S. Effect of exercise intervention on craniovertebral angle and neck pain in individuals with forward head posture in South Korea: literature review. Phys Ther Korea 2023;30(4):261-7. https://doi.org/10.12674/ptk.2023.30.4.261
  11. Albin TJ, McLoone HE. The effect of tablet tilt angle on users' preferences, postures, and performance. Work 2014;47(2):207-11.
  12. Young JG, Trudeau M, Odell D, Marinelli K, Dennerlein JT. Touch-screen tablet user configurations and case-supported tilt affect head and neck flexion angles. Work 2012;41(1):81-91. https://doi.org/10.3233/WOR-2012-1337
  13. Chiu HP, Tu CN, Wu SK, Chien Hsiou L. Muscle activity and comfort perception on neck, shoulder, and forearm while using a tablet computer at various tilt angles. Int J Hum-Comput Interact 2015;31(11):769-76. https://doi.org/10.1080/10447318.2015.1064639
  14. Bao D, Xin Y, Ren X. Effect of tilt angle of tablet on pen-based input operation based on Fitts' law. Paper presented at: The 2010 IEEE International Conference on Information and Automation; 2010 Jun 20-23; Harbin, China. New York: IEEE, 2010. pp. 99-104.
  15. Rungkitlertsakul S, Bhuanantanondh P, Buchholz B. The effect of tablet tilt angles and time on posture, muscle activity, and discomfort at the neck and shoulder in healthy young adults. PLoS One 2023;18(3):e0283521. https://doi.org/10.1371/journal.pone.0283521
  16. Gerth S, Festman J. Muscle activity during handwriting on a tablet: an electromyographic analysis of the writing process in children and adults. Children (Basel) 2023;10(4):748. https://doi.org/10.3390/children10040748
  17. Jarque-Bou NJ, Sancho-Bru JL, Vergara M. A systematic review of EMG applications for the characterization of forearm and hand muscle activity during activities of daily living: results, challenges, and open issues. Sensors (Basel) 2021;21(9):3035. https://doi.org/10.3390/s21093035
  18. Kim JC, Yi CH, Kwon OY, Oh DW, Jeon HS. Strength and endurance of the deep neck flexors of industrial workers with and without neck pain. J Ergon Soc Korea 2007;26(4):25-31. https://doi.org/10.5143/JESK.2007.26.4.025
  19. Fejer R, Jordan A, Hartvigsen J. Categorising the severity of neck pain: establishment of cut-points for use in clinical and epidemiological research. Pain 2005;119(1-3):176-82. https://doi.org/10.1016/j.pain.2005.09.033
  20. Elwardany SH, El-Sayed WH, Ali MF. Reliability of Kinovea computer program in measuring cervical range of motion in sagittal plane. Open Access Libr J 2015;2(9):e1916.
  21. Pourahmadi MR, Taghipour M, Jannati E, Mohseni-Bandpei MA, Ebrahimi Takamjani I, Rajabzadeh F. Reliability and validity of an iPhone(®) application for the measurement of lumbar spine flexion and extension range of motion. PeerJ 2016;4:e2355. https://doi.org/10.7717/peerj.2355
  22. Pueo B, Penichet-Tomas A, Jimenez-Olmedo JM. Validity, reliability and usefulness of smartphone and kinovea motion analysis software for direct measurement of vertical jump height. Physiol Behav 2020;227:113144. https://doi.org/10.1016/j.physbeh.2020.113144
  23. Puig-Diví A, Escalona-Marfil C, Padullés-Riu JM, Busquets A, Padullés-Chando X, Marcos-Ruiz D. Validity and reliability of the Kinovea program in obtaining angles and distances using coordinates in 4 perspectives. PLoS One 2019;14(6):e0216448. https://doi.org/10.1371/journal.pone.0216448
  24. Aruin AS, Forrest WR, Latash ML. Anticipatory postural adjustments in conditions of postural instability. Electroencephalogr Clin Neurophysiol 1998;109(4):350-9. https://doi.org/10.1016/S0924-980X(98)00029-0
  25. Nishi Y, Osumi M, Morioka S. Anticipatory postural adjustments mediate the changes in fear-related behaviors in individuals with chronic low back pain. Scand J Pain 2023;23(3):580-7. https://doi.org/10.1515/sjpain-2022-0078
  26. Saadat M, Salehi R, Negahban H, Shaterzadeh MJ, Mehravar M, Hessam M. Postural stability in patients with non-specific chronic neck pain: a comparative study with healthy people. Med J Islam Repub Iran 2018;32(1):196-200. https://doi.org/10.14196/mjiri.32.33
  27. Reddy RS, Tedla JS, Dixit S, Raizah A, Al-Otaibi ML, Gular K, et al. Cervical joint position sense and its correlations with postural stability in subjects with fibromyalgia syndrome. Life (Basel) 2022;12(11):1817. https://doi.org/10.3390/life12111817
  28. Grimmer-Somers K, Milanese S, Louw Q. Measurement of cervical posture in the sagittal plane. J Manipulative Physiol Ther 2008;31(7):509-17. https://doi.org/10.1016/j.jmpt.2008.08.005
  29. Xiong Z, Huang C, Wang H, Liu X, Huang X, Jiang L. Evaluation of writing efficiency when using tablet computers at inclines. IEEE Access 2021;9:144149-56. https://doi.org/10.1109/ACCESS.2021.3121202
  30. Lee WJ, Kim JH, Shin YU, Hwang S, Lim HW. Differences in eye movement range based on age and gaze direction. Eye (Lond) 2019;33(7):1145-51. https://doi.org/10.1038/s41433-019-0376-4
  31. Fang Y, Nakashima R, Matsumiya K, Kuriki I, Shioiri S. Eye-head coordination for visual cognitive processing. PLoS One 2015;10(3):e0121035. https://doi.org/10.1371/journal.pone.0121035