Associations between daily smartphone use duration and craniovertebral angle, cervical muscle endurance, and temporomandibular joint proprioception among high smartphone users
Résumé
Background and purpose Smartphones are widely used by adolescents, and prolonged use may be associated with altered cervical posture, reduced neck muscle endurance, and temporomandibular dysfunction. This study aimed to examine the association between daily smartphone use duration and craniovertebral angle, cervical muscle endurance, and temporomandibular joint proprioception in adolescents with high smartphone use. Material and methods This cross-sectional study included 160 adolescents aged 17–19 years who used smartphones for more than 4 hours per day for at least 4 years. The craniovertebral angle was measured using Kinovea, deep neck flexor endurance was assessed with a pressure biofeedback unit, and temporomandibular joint proprioception was evaluated using a vernier caliper. All statistical analyses were performed using SPSS software version 26. Given that all study variables violated the assumption of normality, Spearman's rho correlation coefficient (ρ) was used to examine the associations between daily smartphone use and the measured postural and orofacial outcomes, including the craniovertebral angle (CVA), muscular endurance, and orofacial error variables. Results The results revealed a strong negative correlation between daily smartphone use duration and craniovertebral angle (ρ = -0.774, p < 0.001). In addition, daily smartphone use was strongly negatively correlated with deep neck flexor muscle endurance (ρ = -0.837, p < 0.001), and positively correlated with temporomandibular joint proprioception errors across all measured directions. The mean TMJ error showed a strong positive correlation (ρ = 0.641, p < 0.001). Mouth opening error showed a moderate positive correlation (ρ = 0.527, p < 0.001), protrusion error showed a moderate positive correlation (ρ = 0.449, p < 0.001), right deviation error showed a weak to moderate positive correlation (ρ = 0.303, p < 0.001), and left deviation error showed a weak positive correlation (ρ = 0.293, p < 0.001). Conclusion Among adolescents with high smartphone use, longer daily smartphone use duration was associated with a smaller craniovertebral angle, reduced cervical muscle endurance, and impaired temporomandibular joint proprioception. Because of the cross-sectional design, these findings should be interpreted as associations rather than causal effects.
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