Effect of Smartphone Addiction on Craniovertebral Angle and Muscle Fatigue of Cervical Erector Spinae and Upper Trapezius


  • Krishna Institute of Medical Sciences “Deemed to be” University, Department of Physiotherapy, Karad, Maharashtra, 415110, India
  • Krishna College of Physiotherapy, Krishna Institute of Medical Sciences, Deemed to be University, Department of Physiotherapy, Karad, Maharashtra, 415110, India


India ranks 3rd in number in the smartphone use. Above 50% of worldwide population uses smartphone. The aim of the study is to find the effect of smartphone addiction on craniovertebral angle and muscle fatigue of Cervical Erector Spinae (CES) and Upper Trapezius (UT). Eighty-six healthy students took an interest in the examination. Subjects were chosen for the study with the assistance of SAS-LV form. Lateral postural assessment was done to measure CVA with the assistance of photography method. Electromyography (EMG) was utilized to compute muscle fatigue of cervical erector spinae and upper trapezius. The co-relation coefficient between addiction and CVA is r = -0.2196, that means as SAS-LV score rises, the CVA decreases. Co-relation between addiction score and mean frequencies of UT and CES by r = 0.03679 and r = -0.04472 respectively, this states that as addiction score increases UT shows fatigue however not CES. Co-relation between CVA and muscle fatigue of CES and UT by r = 0.01816 and r = -0.04472 respectively, that means as CVA increases UT shows fatigue but not CES. There is co-relation between smartphone addiction, CVA and UT and CES fatigue but it is not statistically significant (p>0.05). From the statistics, it is concluded that unnecessary utilization of smartphone decreases the CVA and muscle fatigue starts to set in, in the UT however not in CES. As the CVA decreases upper trapezius shows fatigue however not cervical erector spinae.


Cervical Erector Spinae, Craniovertebral Angle, Electromyography, Muscle Fatigue, Smartphone Addiction, Upper Trapezius

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Anjana J, Shinde M, Pawar A, Prasad P, Babu LK. Addiction of smartphone and depression within undergraduate students. Journal of Critical Review. 2020; 7(6):789–95. https://doi.org/10.31838/jcr.07.06.137

Chaffin DB. Localized muscle fatigue-definition and measurement. Journal of Occupational and Environmental Medicine. 1973; 15(4):346–54.

De Luca CJ. Myoelectrical manifestations of localized muscular fatigue in humans. Critical Reviews in Biomedical Engineering. 1984; 11(4):251–79.

Edwards RH. Human muscle function and fatigue. Ciba Foundation symposium. 1981; 82:1–18. https://doi.org/10.1002/9780470715420.ch1

Farina D, Merletti R, Indino B, Nazzaro M, Pozzo M. Surface EMG crosstalk between knee extensor muscles: Experimental and model results. Muscle and Nerve. 2002; 26(5):681–95. https://doi.org/10.1002/mus.10256. PMid:12402291

Greig AM, Straker LM, Briggs AM. Cervical erector spinae and upper trapezius muscle activity in children using different information technologies. Physiotherapy. 2005; 91(2):119–26. https://doi.org/10.1016/j.physio.2004.10.004

Kim YG, Kang MH, Kim JW, et al. Influence of the duration of smartphone usage on flexion angles of the cervical and lumbar spine and on reposition error in the cervical spine. PhysTherKor, 2013; 20:10–17. https://doi.org/10.12674/ptk.2013.20.1.010

Kwon M, Kim DJ, Cho H, Yang S. The smartphone addiction scale: development and validation of a short version for adolescents. PLoS One. 2013; 8(12). https://doi.org/10.1371/journal.pone.0083558. PMid:24391787. PMCid:PMC3877074

Lee S, Lee D, Park J. Effect of the cervical flexion angle during smart phone use on muscle fatigue of the cervical erector spinae and upper trapezius. Journal of Physical Therapy Science. 2015; 27(6):1847–9. https://doi.org/10.1589/jpts.27.1847. PMid:26180333. PMCid:PMC4499996

Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physiotherapy. 2000; 80:276–91. https://doi.org/10.1093/ptj/80.3.276. PMid:10696154

Mekhora K, Liston CB, Nanthavanij S, Cole JH. The effect of ergonomic intervention on discomfort. 2000; 26(3):367–79. https://doi.org/10.1016/S0169-8141(00)00012-3

Mekhora K, Liston CB, Nanthavanij S, Cole JH. The effect of ergonomic intervention on discomfort in computer users with tension neck syndrome. International Journal of Industrial Ergonomics. 2000; 26(3):367–79.

Merletti R, Farina D. Myoelectric manifestations of muscle fatigue. Wiley Encyclopedia of Biomedical Engineering. 2006. https:// doi.org/10.1002/9780471740360.ebs1427. PMCid:PMC2870513

Neumann DA. Kinesiology of the musculoskeletal system: foundations for physical rehabilitation. 1st ed. Mosby: St Louis; 2015. p. 298–304.

Panova T, Carbonell X. Is smartphone addiction really an addiction? Journal of Behavioral Addictions. 2018; 7(2):252– 9. https://doi.org/10.1556/2006.7.2018.49. PMid:29895183. PMCid:PMC6174603

Salahzadeh Z, Maroufi N, Ahmadi A, Behtash H, Razmjoo A, Gohari M, Parnianpour M. Assessment of forward head posture in females: Observational and photogrammetry methods. Journal of back and musculoskeletal rehabilitation. 2014; 27(2):131–9. https://doi.org/10.3233/BMR-130426. PMid:23963268

Schüldt K, Ekholm J, Harms-ringdahl KA, Németh G, Arborelius UP. Effects of changes in sitting work posture on static neck and shoulder muscle activity. Ergonomics. 1986; 29(12):1525–37. https://doi.org/10.1080/00140138608967266. PMid:3816746

Lee J, Lee Y, Kim H, Lee J. The effects of cervical mobilization combined with thoracic mobilization on forward head posture of neck pain patients. Journal of Physical Therapy Science. 2013; 25(1). https://doi.org/10.1589/jpts.25.7

vanNiekerk SM, Louw Q, Vaughan C, Grimmer-Somers K, Schreve K. Photographic measurement of upper-body sitting posture of high school students: a reliability and validity study. BMC Musculoskelet Disord. 2008; 9:113. https://doi.org/10.1186/1471-2474-9-113. PMid:18713477. PMCid:PMC2542508

Vøllestad NK. Measurement of human muscle fatigue. Journal of Neuroscience Methods. 1997 27; 74(2):219–27. https://doi.org/10.1016/S0165-0270(97)02251-6

Watson DH, Trott PH. Cervical headache: An investigation of natural head posture and upper cervical flexor muscle performance. Cephalalgia. 1993; 13(4):272–84. https://doi.org/10.1046/j.14682982.1993.1304272.x. PMid:8374943

Wilmarth MA, Hilliard TS. Measuring head posture via the craniovertebral angle. OrthopPhysTherPract. 2002; 14:13–15.

Yip CH, Chiu TT, Poon AT. The relationship between head posture and severity and disability of patients with neck pain. Manual Therapy. 2008;13(2):148–54. https://doi.org/10.1016/j.math.2006.11.002. PMid:17368075

Zhang FR, He LH, Wu SS, et al. Quantify work load and muscle functional activation patterns in neck-shoulder muscles of female sewing machine operators using surface electromyogram. Chinese Medical Journal. 2011; 124:3731–37.

Eom SH, Choi SY, Park DH: An empirical study on relationship between symptoms of musculoskeletal disorders and amount of smartphone usage. Journal of the Korea Safety Management & Science. 2013; 15:113–20. https://doi.org/10.12812/ksms.2013. 15.2.113


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