Musculoskeletal pain and musculoskeletal syndromes in adolescents are related to electronic devices

Queiroz, Lígia Bruni; Lourenço, Benito; Silva, Luiz Eduardo Vargas; Lourenço, Daniela Mencaroni Rodrigues; Silva, Clovis Artur

doi:10.1016/j.jped.2017.09.006

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Original articles • J. Pediatr. (Rio J.) 94 (6) • Nov-Dec 2018 • https://doi.org/10.1016/j.jped.2017.09.006 copy

Musculoskeletal pain and musculoskeletal syndromes in adolescents are related to electronic devices^☆ ☆ Please cite this article as: Queiroz LB, Lourenço B, Silva LE, Lourenço DM, Silva CA. Musculoskeletal pain and musculoskeletal syndromes in adolescents are related to electronic devices. J Pediatr (Rio J). 2018;94:673-9. , ^☆☆ ☆☆ Study conducted at Universidade de São Paulo (USP), Faculdade de Medicina, Hospital das Clínicas, Instituto da Criança, São Paulo, SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To evaluate television and simultaneous electronic devices use in adolescents with musculoskeletal pain and musculoskeletal pain syndromes.

Methods:

A cross-sectional study was performed in 299 healthy adolescents of a private school. All students completed a self-administered questionnaire, including: demographic data, physical activities, musculoskeletal pain symptoms, and use of simultaneous television/electronic devices (computer, internet, electronic games, and cell phones). Seven musculoskeletal pain syndromes were also evaluated: juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, tendinitis, bursitis, epicondylitis, and complex regional pain syndrome.

Results:

Inter-rater agreement between pretest and retest was 0.83. Musculoskeletal pain and musculoskeletal pain syndrome were found in 183/299 (61%) and 60/183 (33%), respectively. The median age (15 [10-18] vs. 14 [10-18] years, p = 0.032) and years of education (10 [5-12] vs. 9 [5-12] years, p = 0.011) were significantly higher in adolescents with musculoskeletal pain when compared with those without this condition. The frequencies of female gender (59% vs. 47%, p = 0.019), cell phone use (93% vs. 81%, p = 0.003), and simultaneous use of at least two electronic devices (80% vs. 67%, p = 0.011) were significantly higher in the former group. Further comparisons between adolescents with and without musculoskeletal pain syndromes revealed that the frequency of female gender was significantly higher in the former group (75% vs. 25%, p = 0.002), and with a significantly reduced median of weekends/holidays electronic games use (1.5 [0-10] vs. 3 [0-17] h/day, p = 0.006).

Conclusions:

A high prevalence of musculoskeletal pain/syndromes was observed in female adolescents. Musculoskeletal pain was mostly reported at a median age of 15 years, and students used at least two electronic devices. Reduced use of electronic games was associated with musculoskeletal pain syndromes.

KEYWORDS
Adolescent; Musculoskeletal pain; Musculoskeletal pain syndromes; Electronic devices

Variables	With musculoskeletal pain (n = 183)	Without musculoskeletal pain (n = 116)	p
Demographic data
Age, years	15 (10-18)	14 (10-18)	0.032^a a Mann-Whitney test.
Female gender	108 (59)	55 (47)	0.019^b b Chi-squared test.
Upper and upper/middle socioeconomic classes	180/183 (98)	114/115 (99)	0.250^c c Fisher's exact test.
Years of education	10 (5-12)	9 (5-12)	0.010^a a Mann-Whitney test.
Physical activities	150 (81)	102 (87)	0.580^b b Chi-squared test.
Sports modalities, number	2 (0-5)	2 (0-5)	0.710^a a Mann-Whitney test.
Computer
Desktop available at home	111 (60)	86 (74)	0.017^b b Chi-squared test.
Laptop available at home	168 (91)	94 (81)	0.006^b b Chi-squared test.
Tablet available at home	128 (69)	81 (69)	0.983^b b Chi-squared test.
Age at computer use onset, years	7 (0-12)	7 (2-14)	0.514^a a Mann-Whitney test.
Weekends/holidays computer use, h/day	3 (0-16)	2 (0-20)	0.721^a a Mann-Whitney test.
Weekdays computer use, h/day	2.5 (0-20)	2.5 (0-12)	0.752^a a Mann-Whitney test.
Computer use after 10 PM	106 (57)	57 (49)	0.187^b b Chi-squared test.
EG
EG use	121 (66)	87 (75)	0.118^b b Chi-squared test.
EG available at home	103 (56)	78 (67)	0.450^b b Chi-squared test.
Age at onset of EG use, years	7 (3-11)	7 (2-13)	0.251^a a Mann-Whitney test.
Weekends/holidays EG use, h/day	2 (0-17)	2 (0-13)	0.811^a a Mann-Whitney test.
Weekdays EG use, h/day	1.5 (0-7)	2 (0-11)	0.245^a a Mann-Whitney test.
EG use after 10 PM	62 (33)	38 (32)	0.317^b b Chi-squared test.

Variables	With musculoskeletal pain (n = 183)	Without musculoskeletal pain (n = 116)	p
Internet
Internet use	182 (99)	114 (98)	0.562^c c Fisher's exact test.
Internet available at home	156 (85)	100 (86)	0.818^b b Chi-squared test.
Age at Internet use onset, years	7 (3-14)	8 (3-13)	0.451^a a Mann-Whitney test.
Weekends/holidays Internet use, h/day	3 (0-24)	3 (0-24)	0.422^a a Mann-Whitney test.
Weekdays Internet use, h/day	3 (5-24)	3 (0-24)	0.742^a a Mann-Whitney test.
Internet use after 10 PM	133 (72)	72 (62)	0.061^b b Chi-squared test.
Cell phone
Cell phone use	171 (93)	95 (81)	0.003^b b Chi-squared test.
Age at cell phone use onset, years	10 (4-16)	10 (5-14)	0.101^a a Mann-Whitney test.
Weekends/holidays of cell phone use, h/day	2 (0-20)	1.5 (0-15)	0.561^a a Mann-Whitney test.
Weekdays cell phone use, h/day	2 (0-20)	2 (0-15)	0.798^a a Mann-Whitney test.
Cell phone use after 10 PM	117 (63)	55 (47)	0.085^b b Chi-squared test.
TV
Weekends/holidays TV use, h/day	1 (0-12)	1 (0-10)	0.649^a a Mann-Whitney test.
Weekdays TV use, h/day	1 (0-8)	1 (0-5)	0.419^a a Mann-Whitney test.
TV use after 10 PM	76 (41)	46 (39)	0.748^b b Chi-squared test.
Simultaneous use of at least two electronic devices^d d Use of computer, electronic game, Internet, cell phone, and/or TV.	147 (80)	78 (67)	0.011^b b Chi-squared test.

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[1] * Corresponding author. E-mail:ligiabq@usp.br (L.B. Queiroz).