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P.Y.G. Szeto1, W.S. Wong1, T.T. Tsui1, S.H. Chong1, Y.K. Lau1, S.K. Kwok1, C.Y. Lau1
1Tung Wah College, Physiotherapy Division, School of Medical & Health Sciences, Kowloon, Hong Kong
Background: Chronic neck pain is a common problem among smartphone users due to prolonged static and maladaptive posture. Young people are commonly known as “head-down tribe” due to the observation of people constantly flexing their necks to view their smartphones and tablet computers. This habit of constant neck flexion may be contributing to their pain and spinal stiffness.
The Postural Awareness Scale (PAS) was first developed in Germany and later translated into English to investigate individuals’ self perceptions of their whole body postures, and whether there is any relationship to their musculoskeletal pain (Cramer et al, 2018). Questions in the PAS were modified to match the current objectives of this study, focusing on the neck-shoulder posture in using smartphones.
The Postural Awareness Scale (PAS) was first developed in Germany and later translated into English to investigate individuals’ self perceptions of their whole body postures, and whether there is any relationship to their musculoskeletal pain (Cramer et al, 2018). Questions in the PAS were modified to match the current objectives of this study, focusing on the neck-shoulder posture in using smartphones.
Purpose: This study evaluated the effects of two types of biofeedback interventions on postural awareness and neck pain associated with smartphone use. Postural biofeedback aimed to remind the person to correct the neck flexion posture, while muscle biofeedback aimed to enhance muscle relaxation.
Methods: Twenty-two subjects were randomly assigned into 3 groups namely the control group (n=9), postural biofeedback (n=7) and muscle biofeedback (n=6) groups. All subjects had more than 3 months of neck pain and were daily use of smartphones (> 2 hours).
Postural biofeedback involved the Upright GO 2TM (Upright Technologies Ltd, USA) attached to the occiput area via a headband. It is activated via a smartphone App with a vibratory signal once the neck flexion exceeded the threshold value for a few seconds. Muscle biofeedback involved the use of Pathway 6750TM (CMT Inc., USA) surface electromyography (EMG) device with 2 channels. Electrodes were placed on bilateral cervical erector spinae muscles and an auditory “beep” sound would be produced if muscle activity exceeded the threshold value. Each participant in the 2 biofeedback groups was instructed to apply the device for 2 hours daily, 5 days a week in 6 weeks. The control group participants would only perform standard exercises for about 10 mins each day. Each participant underwent a pre-intervention assessment and a post-intervention assessment in which their neck pain scores, Neck Disability Index (NDI) and modified PAS scores were recorded.
Postural biofeedback involved the Upright GO 2TM (Upright Technologies Ltd, USA) attached to the occiput area via a headband. It is activated via a smartphone App with a vibratory signal once the neck flexion exceeded the threshold value for a few seconds. Muscle biofeedback involved the use of Pathway 6750TM (CMT Inc., USA) surface electromyography (EMG) device with 2 channels. Electrodes were placed on bilateral cervical erector spinae muscles and an auditory “beep” sound would be produced if muscle activity exceeded the threshold value. Each participant in the 2 biofeedback groups was instructed to apply the device for 2 hours daily, 5 days a week in 6 weeks. The control group participants would only perform standard exercises for about 10 mins each day. Each participant underwent a pre-intervention assessment and a post-intervention assessment in which their neck pain scores, Neck Disability Index (NDI) and modified PAS scores were recorded.
Results: Postural Biofeedback Group showed the highest improvement in PAS total score (+6.3, max score=84), whereas Muscle Biofeedback Group showed highest reduction in NDI (-4.4%) and neck pain score (-2.2), with no statistically significant differences among the 3 groups.
Conclusions: Results showed that use of postural biofeedback device had the most apparent benefit on improving postural awareness in the participants, which may have a long-term benefit on spinal health. However, muscle biofeedback group showed the highest reduction in neck pain and NDI scores confirming the pain-relieving effect of this intervention. Further investigations on a larger sample size may reveal more insight on this issue.
Implications: The present study has provided evidence to show the benefits of biofeedback interventions compared to conventional exercises. During pandemic situation, use of wearable biofeedback devices may be a feasible option for self-management of musculoskeletal disorders associated with use of mobile technologies.
Funding acknowledgements: Nil
Keywords:
Neck Pain
Postural awareness
Biofeedback
Neck Pain
Postural awareness
Biofeedback
Topics:
Musculoskeletal: spine
Occupational health & ergonomics
Health promotion & wellbeing/healthy ageing/physical activity
Musculoskeletal: spine
Occupational health & ergonomics
Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? Yes
Institution: Tung Wah College
Committee: Human Ethics Committee
Ethics number: REC22020913
All authors, affiliations and abstracts have been published as submitted.
