智能手机使用对医学生颈痛影响的调查研究
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摘要
目的探讨智能手机使用对医学生颈痛的影响及相关机制,为医学生颈痛的防治提供参考。方法采用随机抽样的方法,在3 500名青岛大学全日制本科医学生中抽取250名进行问卷调查,问卷内容包括颈痛情况、智能手机使用、电脑使用、运动情况以及智能手机依赖量表(SAS)评分。在参与问卷调查的医学生中按照男女比例进行分层抽样,用全身姿势分析系统(GPS)评估其放松站姿及智能手机使用状态下的头颈部姿势,用数字化肌肉功能评估系统(Myoton Pro系统)测量受试者双侧胸锁乳突肌、头夹肌、肩胛提肌以及上斜方肌的肌张力。应用SPSS 24.0软件分析手机使用与头颈部姿势及相应肌肉肌张力的相关性。结果长时间使用智能手机会导致医学生颈痛发生率升高(χ2=5.318,P<0.05),但对其颈痛的严重程度(VAS评分)无显著影响。医学生的SAS总分与过去6个月中感到颈部疼痛和不适的频率以及VAS评分呈正相关(r=0.284、0.685,P<0.01),与进行规律活动的强度、每周活动频率、每次运动持续时间呈负相关(r=-0.261～-0.202,P<0.01);运动频率与VAS评分呈负相关(r=-0.148,P<0.05);双侧胸锁乳突肌的肌张力与SAS总分呈正相关(r=0.275、0.274,P<0.05)。结论医学生智能手机依赖与颈痛密切相关,手机依赖程度越高,头前倾的姿势越明显,双侧胸锁乳突肌的肌张力越高,而增加运动可以在减轻医学生智能手机依赖的同时缓解其颈痛症状。
Objective To explore the effect of smartphone use on the neck pain of medical students and its relevant mechanism so as to provide a reference for the prevention and treatment of their neck pain. Methods Random sampling was adopted to sample 250 from 3 500 full-time medical students in Qingdao University for a questionnaire survey which included neck pain,smartphone usage,computer usage,exercise status,and smartphone addiction scale(SAS)score.The medical students participating in the questionnaire survey were stratified according to gender ratio,and then were evaluated by aglobal posture analysis(GPS)system for the head and neck positions in both relaxed standing posture and smartphone use posture;meanwhile,a digital muscle function assessment system(Myoton Pro)was used to measure muscle tension of bilateral sternocleidomastoid muscles,splenius of the head,levator scapulae,and superior trapezius.SPSS 24.0 was used to analyze the correlation of smartphone use with head and neck posture and muscle tension. Results Long-time smartphone use resulted in increased incidence of neck pain(χ2=5.318,P<0.05),but had no significant effect on the severity of neck pain(evaluated by Visual Analogue Scale(VAS)score).Total SAS score for the medical students was positively correlated with the frequency of neck pain and discomfort in the past 6 months and VAS score(r=0.284 and 0.685,respectively,both P<0.01),and was negatively correlated with the intensity of regular exercises,weekly exercise frequency,and duration of each exercise(r=-0.261 to-0.202,all P<0.01);exercise frequency was negatively correlated with VAS score(r=-0.148,P<0.05);muscle tension of the bilateral sternocleidomastoid muscles was positively correlated with total SAS score(r=0.275 and 0.274,respectively,P<0.05). Conclusion Smartphone addiction in medical students is closely correlated with neck pain.The higher the degree of smartphone addiction is,the more obvious the posture of head leaning forward becomes and the higher the muscle tension of the bilateral sternocleidomastoid muscles is.Increased exercises can reduce medical students' smartphone addiction and alleviate neck pain.
Objective To explore the effect of smartphone use on the neck pain of medical students and its relevant mechanism so as to provide a reference for the prevention and treatment of their neck pain. Methods Random sampling was adopted to sample 250 from 3 500 full-time medical students in Qingdao University for a questionnaire survey which included neck pain,smartphone usage,computer usage,exercise status,and smartphone addiction scale(SAS)score.The medical students participating in the questionnaire survey were stratified according to gender ratio,and then were evaluated by aglobal posture analysis(GPS)system for the head and neck positions in both relaxed standing posture and smartphone use posture;meanwhile,a digital muscle function assessment system(Myoton Pro)was used to measure muscle tension of bilateral sternocleidomastoid muscles,splenius of the head,levator scapulae,and superior trapezius.SPSS 24.0 was used to analyze the correlation of smartphone use with head and neck posture and muscle tension. Results Long-time smartphone use resulted in increased incidence of neck pain(χ2=5.318,P<0.05),but had no significant effect on the severity of neck pain(evaluated by Visual Analogue Scale(VAS)score).Total SAS score for the medical students was positively correlated with the frequency of neck pain and discomfort in the past 6 months and VAS score(r=0.284 and 0.685,respectively,both P<0.01),and was negatively correlated with the intensity of regular exercises,weekly exercise frequency,and duration of each exercise(r=-0.261 to-0.202,all P<0.01);exercise frequency was negatively correlated with VAS score(r=-0.148,P<0.05);muscle tension of the bilateral sternocleidomastoid muscles was positively correlated with total SAS score(r=0.275 and 0.274,respectively,P<0.05). Conclusion Smartphone addiction in medical students is closely correlated with neck pain.The higher the degree of smartphone addiction is,the more obvious the posture of head leaning forward becomes and the higher the muscle tension of the bilateral sternocleidomastoid muscles is.Increased exercises can reduce medical students' smartphone addiction and alleviate neck pain.
引文
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[14]LEE S P,HSU Y T,BAIR B,et al.Gender and posture are significant risk factors to musculoskeletal symptoms during touchscreen tablet computer use[J].Journal of Physical Therapy Science,2018,30(6):855-861.
[15]KWON M,KIM D J,CHO H,et al.The smartphone addiction scale:development and validation of a short version for adolescents[J].PLoS One,2013,8(12):e83558.
[16]GUAN Xiaofei,FAN Guoxin,CHEN Zhengqi,et al.Gender difference in mobile phone use and the impact of digital device exposure on neck posture[J].Ergonomics,2016,59(11):1453-1461.
[17]SHIN H H,KIM K M.Effects of cervical flexion on the flexion-relaxation ratio during smartphone use[J].Journal of Physical Therapy Science,2014,26(12):1899-1901.
[18]陈荣彬.多地区青少年颈肩痛相关影响因素调查分析[D].广州:广州中医药大学,2016.
[19]YANG Shangyu,CHEN Mingde,HUANG Yuechu,et al.Association between smartphone use and musculoskeletal discomfort in adolescent students[J].Journal of Community Health,2017,42(3):423-430.
[20]LEE H.Neck pain and functioning in daily activities associated with smartphone usage[J].The Journal of Korean Society of Physical Therapy,2016,28(3):183-188.
[21]AKER S,SAHIN M K,SEZGIN S,et al.Psychosocial factors affecting smartphone addiction in university students[J].Journal of Addictions Nursing,2017,28(4):215-219.
[22]欧红霞.慢性疼痛和抑郁症临床及生物学相关研究[J].国际精神病学杂志,2008,35(3):166-169.
[23]马弘,赵志宇.抑郁与疼痛的相关性[J].继续医学教育,2007,40(16):30-31.
[24]O’SULLIVAN K,O’KEEFFE M,O’SULLIVAN L A,et al.Perceptions of sitting posture among members of the community,both with and without non-specific chronic low back pain[J].Manual Therapy,2013,18(6):551-556.
[25]BRINK Y,LOUW Q,GRIMMER K,et al.The spinal posture of computing adolescents in a real-life setting[J].BMCMusculoskeletal Disorders,2014,15:212.
[26]CHEN X Q,TRELEAVEN J.The effect of neck torsion on joint position error in subjects with chronic neck pain[J].Manual Therapy,2013,18(6):562-567.
[27]FRICTON J R,KROENING R,HALEY D,et al.Myofascial pain syndrome of the head and neck:a review of clinical characteristics of 164patients[J].Oral Surgery,Oral Medicine,and Oral Pathology,1985,60(6):615-623.
[28]PARK J,KANG S,LEE S,et al.The effects of smart phone gaming duration on muscle activation and spinal posture:pilot study[J].Physiotherapy Theory and Practice,2017,33(8):661-669.
[29]BONNEY R A,CORLETT E N.Head posture and loading of the cervical spine[J].Applied Ergonomics,2002,33(5):415-417.
[30]XIE Y F,SZETO G,MADELEINE P,et al.Spinal kinematics during smartphone texting-a comparison between young adults with and without chronic neck-shoulder pain[J].Applied Ergonomics,2018,68:160-168.
[31]KIM M.Influence of neck pain on cervical movement in the sagittal plane during smartphone use[J].Journal of Physical Therapy Science,2015,27(1):15-17.
[32]黄晓琳.康复医学[M].北京:人民卫生出版社,2013.
[33]张京,肖娟,杨远滨.肌肉结构参数模型在中枢神经系统所致肌张力异常评价中的作用和分析[J].中国康复医学杂志,2015,30(4):408-411.
[34]SCHNEIDER S,PEIPSI A,STOKES M,et al.Feasibility of monitoring muscle health in microgravity environments using Myoton technology[J].Medical&Biological Engineering&Computing,2015,53(1):57-66.
[35]PRUYN E C,WATSFORD M L,MURPHY A J.Validity and reliability of three methods of stiffness assessment[J].Journal of Sport and Health Science,2016,5(4):476-483.
[36]温红梅,兰月,窦祖林,等.Myoton-3肌肉检测仪在健康成人肌张力测量中的评价者间信度[J].中国康复理论与实践,2013,19(11):1058-1060.
[37]LOHR C,BRAUMANN K M,REER R A,et al.Reliability of tensiomyography and myotonometry in detecting mechanical and contractile characteristics of the lumbar erector spinae in healthy volunteers[J].European Journal of Applied Physiology,2018,118(7):1349-1359.
[2]TOH S H,COENEN P,HOWIE E K,et al.The associations of mobile touch screen device use with musculoskeletal symptoms and exposures:a systematic review[J].PLoS One,2017,12(8):e181220.
[3]KWON M,LEE J Y,WON W Y,et al.Development and validation of a smartphone addiction scale(SAS)[J].PLoS One,2013,8(2):e56936.
[4]KEE I K,BYUN J S,JUNG J K,et al.The presence of altered craniocervical posture and mobility in smartphone-addicted teenagers with temporomandibular disorders[J].Journal of Physical Therapy Science,2016,28(2):339-346.
[5]周挥辉,党波涛,蒋永红.手机对当代大学生发展的影响及其对策研究[J].中国青年研究,2011(6):90-92.
[6]葛续华,祝卓宏,王雅丽.青少年手机依赖与依恋、社会支持的关系[J].中华行为医学与脑科学杂志,2013,22(8):736-738.
[7]祝春兰,丁烜红,卢会志,等.中国青少年手机过度使用及其与心理健康的相关性[J].中国学校卫生,2015,36(11):1618-1620.
[8]吴佳丽,高晓妹,高子雯,等.医学生手机使用现况调查[J].文教资料,2018(4):165-166.
[9]周少钦,罗舒仁,黎泽明,等.南宁市医学生手机使用情况以及手机成瘾影响因素研究[J].中国卫生统计,2017,34(2):200-202,206.
[10]许婷婷,曹永福.医学院校大学生手机依赖症的调查研究[J].医学与哲学(A),2016(6):90-93.
[11]VON ELM E,ALTMAN D G,EGGER M,et al.The strengthening the reporting of observational studies in epidemiology(STROBE)statement:guidelines for reporting of observational studies[J].Notfall&Rettungsmedizin,2008,11(4):260-265.
[12]SHAN Zhi,DENG Guoying,LI Jipeng,et al.Correlational analysis of neck/shoulder pain and low back pain with the use of digital products,physical activity and psychological status among adolescents in Shanghai[J].PLoS One,2013,8(10):e78109.
[13]LOPEZ-FERNANDEZ O.Short version of the Smartphone Addiction Scale adapted to Spanish and French:towards a cross-cultural research in problematic mobile phone use[J].Addictive Behaviors,2017,64:275-280.
[14]LEE S P,HSU Y T,BAIR B,et al.Gender and posture are significant risk factors to musculoskeletal symptoms during touchscreen tablet computer use[J].Journal of Physical Therapy Science,2018,30(6):855-861.
[15]KWON M,KIM D J,CHO H,et al.The smartphone addiction scale:development and validation of a short version for adolescents[J].PLoS One,2013,8(12):e83558.
[16]GUAN Xiaofei,FAN Guoxin,CHEN Zhengqi,et al.Gender difference in mobile phone use and the impact of digital device exposure on neck posture[J].Ergonomics,2016,59(11):1453-1461.
[17]SHIN H H,KIM K M.Effects of cervical flexion on the flexion-relaxation ratio during smartphone use[J].Journal of Physical Therapy Science,2014,26(12):1899-1901.
[18]陈荣彬.多地区青少年颈肩痛相关影响因素调查分析[D].广州:广州中医药大学,2016.
[19]YANG Shangyu,CHEN Mingde,HUANG Yuechu,et al.Association between smartphone use and musculoskeletal discomfort in adolescent students[J].Journal of Community Health,2017,42(3):423-430.
[20]LEE H.Neck pain and functioning in daily activities associated with smartphone usage[J].The Journal of Korean Society of Physical Therapy,2016,28(3):183-188.
[21]AKER S,SAHIN M K,SEZGIN S,et al.Psychosocial factors affecting smartphone addiction in university students[J].Journal of Addictions Nursing,2017,28(4):215-219.
[22]欧红霞.慢性疼痛和抑郁症临床及生物学相关研究[J].国际精神病学杂志,2008,35(3):166-169.
[23]马弘,赵志宇.抑郁与疼痛的相关性[J].继续医学教育,2007,40(16):30-31.
[24]O’SULLIVAN K,O’KEEFFE M,O’SULLIVAN L A,et al.Perceptions of sitting posture among members of the community,both with and without non-specific chronic low back pain[J].Manual Therapy,2013,18(6):551-556.
[25]BRINK Y,LOUW Q,GRIMMER K,et al.The spinal posture of computing adolescents in a real-life setting[J].BMCMusculoskeletal Disorders,2014,15:212.
[26]CHEN X Q,TRELEAVEN J.The effect of neck torsion on joint position error in subjects with chronic neck pain[J].Manual Therapy,2013,18(6):562-567.
[27]FRICTON J R,KROENING R,HALEY D,et al.Myofascial pain syndrome of the head and neck:a review of clinical characteristics of 164patients[J].Oral Surgery,Oral Medicine,and Oral Pathology,1985,60(6):615-623.
[28]PARK J,KANG S,LEE S,et al.The effects of smart phone gaming duration on muscle activation and spinal posture:pilot study[J].Physiotherapy Theory and Practice,2017,33(8):661-669.
[29]BONNEY R A,CORLETT E N.Head posture and loading of the cervical spine[J].Applied Ergonomics,2002,33(5):415-417.
[30]XIE Y F,SZETO G,MADELEINE P,et al.Spinal kinematics during smartphone texting-a comparison between young adults with and without chronic neck-shoulder pain[J].Applied Ergonomics,2018,68:160-168.
[31]KIM M.Influence of neck pain on cervical movement in the sagittal plane during smartphone use[J].Journal of Physical Therapy Science,2015,27(1):15-17.
[32]黄晓琳.康复医学[M].北京:人民卫生出版社,2013.
[33]张京,肖娟,杨远滨.肌肉结构参数模型在中枢神经系统所致肌张力异常评价中的作用和分析[J].中国康复医学杂志,2015,30(4):408-411.
[34]SCHNEIDER S,PEIPSI A,STOKES M,et al.Feasibility of monitoring muscle health in microgravity environments using Myoton technology[J].Medical&Biological Engineering&Computing,2015,53(1):57-66.
[35]PRUYN E C,WATSFORD M L,MURPHY A J.Validity and reliability of three methods of stiffness assessment[J].Journal of Sport and Health Science,2016,5(4):476-483.
[36]温红梅,兰月,窦祖林,等.Myoton-3肌肉检测仪在健康成人肌张力测量中的评价者间信度[J].中国康复理论与实践,2013,19(11):1058-1060.
[37]LOHR C,BRAUMANN K M,REER R A,et al.Reliability of tensiomyography and myotonometry in detecting mechanical and contractile characteristics of the lumbar erector spinae in healthy volunteers[J].European Journal of Applied Physiology,2018,118(7):1349-1359.