Prevalence of musculoskeletal pain in adolescents and association with computer and videogame use

Silva, Georgia Rodrigues Reis; Pitangui, Ana Carolina Rodarti; Xavier, Michele Katherine Andrade; Correia-Júnior, Marco Aurélio Valois; Araújo, Rodrigo Cappato De

doi:10.1016/j.jped.2015.06.006

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Original articles • J. Pediatr. (Rio J.) 92 (2) • Mar-Apr 2016 • https://doi.org/10.1016/j.jped.2015.06.006 copy

Prevalence of musculoskeletal pain in adolescents and association with computer and videogame use^☆ ☆ Please cite this article as: Silva GR, Pitangui AC, Xavier MK, Correia-Júnior MA, Araújo RC. Prevalence of musculoskeletal pain in adolescents and association with computer and videogame use. J Pediatr (Rio J). 2016;92:188-96.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

This study investigated the presence of musculoskeletal symptoms in high school adolescents from public schools and its association with electronic device use.

Methods:

The sample consisted of 961 boys and girls aged 14–19 years who answered a questionnaire regarding the use of computers and electronic games, and questions about pain symptoms and physical activity. Furthermore, anthropometric assessments of all volunteers were performed. The chi-squared test and a multiple logistic regression model were used for the inferential analysis.

Results:

The presence of musculoskeletal pain symptoms was reported by 65.1% of the adolescents, being more prevalent in the thoracolumbar spine (46.9%), followed by pain in the upper limbs, representing 20% of complaints. The mean time of use for computers and electronic games was 1.720 and 583 minutes per week, respectively. The excessive use of electronic devices was demonstrated to be a risk factor for cervical and lumbar pain. Female gender was associated with the presence of pain in different body parts. Presence of a paid job was associated with cervical pain.

Conclusion:

A high prevalence of musculoskeletal pain in adolescents, as well as an increased amount of time using digital devices was observed. However, it was only possible to observe an association between the increased use of these devices and the presence of cervical and low back pain.

Keywords
Musculoskeletal pain; Adolescent; Computer systems; Video games

Variables		Male	Female	Total
Number of volunteers		369	592	961
Age (years)		16.61 ± 1.35	16.40 ± 1.23	16.5 ± 1.3

Schooling
	1st year	146	218	364
	2nd year	106	167	273
	3rd year	112	212	324

Body mass (kg)		64.68 ± 13.60	56.15 ± 10.79	59.45 ± 12.64
Height (m)		1.71 ± 0.07	1.60 ± 0.06	1.64 ± 0.08

Family income
	1–2 minimum wages	235	461	696
	More than 2 minimum wages	134	131	265

Nutritional status
	Normal weight	300	459	759
	Overweight and obesity	75	127	202

Physical activity level
	Active	282	446	728
	Insufficiently active	88	145	233

Has a paid job
	Yes	65	106	171
	No	310	480	790

Computer use
	Yes	332	521	853
	No	37	71	108

Has a computer at home
	Yes	281	434	715
	No	88	158	246

Age at the start of use (years)		11.3 ± 2.8	11.3 ± 2.4	11.3 ± 2.6
Frequency of use (days/week)		5.5 ± 2.1	5.5 ± 2.1	5.5 ± 2.1
Weekly time of use (minutes)		1703.4 ± 1357.4	1731.7 ± 1596.5	1720.8 ± 1508.5

Use of electronic games
	Yes	297	310	607
	No	72	284	354

Frequency of use (days/week)		3.25 ± 2.55	1.82 ± 2.30	2.37 ± 2.50
Weekly time of use (minutes)		949.77 ± 1143.76	354.94 ± 675.39	583.34 ± 930.62
Total time of use of electronic devices (minutes)		2653.21 ± 2125.98	2086.67 ± 1955.69	2304.40 ± 2040.40

Variables		Cervical region					Scapular region
		Presence of pain	Absence of pain	OR	95% CI	p	Presence of pain	Absence of pain	OR	95% CI	p
Gender
	Female	126	466	1.65	1.16–2.35	0.005^a a Statistically significant – p < 0.05.	108	484	1.65	1.13–2.40	0.009^a a Statistically significant – p < 0.05.
	Male	52	317	1			44	325	1

Age
	14–16 years	98	386	1.26	0.91–1.75	0.165	85	399	1.30	0.92–1.85	0.135
	17–19 years	80	397	1			67	410	1

Employment
	Works	44	127	1.70	1.15–2.51	0.007^a a Statistically significant – p < 0.05.	26	145	0.95	0.60–1.50	0.809
	Does not work	134	656	1			126	664	1

Nutritional status
	Overweight and obesity	34	168	0.86	0.57–1.30	0.486	32	170	1.00	0.66–1.53	0.991
	Normal weight	144	615	1			120	639	1

Physical activity level
	Insufficiently active	42	191	0.96	0.66–1.40	0.823	30	203	0.73	0.48–1.13	0.157
	Active	136	592	1			122	606	1

Use of computer
	High (>3 h/day)	100	366	1.42	1.02–1.96	0.035^a a Statistically significant – p < 0.05.	72	394	0.95	0.67–1.34	0.763
	Low (<3 h/day)	80	415	1			80	415	1

Use of electronic games
	High (>1 h/day)	91	388	1.04	0.75–1.43	0.832	78	401	1.07	0.76–1.52	0.692
	Low (<1 h/day)	89	393	1			74	408	1

Total time of use
	High (>4 h/day)	103	375	1.45	1.04–2.01	0.026^a a Statistically significant – p < 0.05.	72	406	0.89	0.63–1.26	0.524
	Low (<4 h/day)	77	406	1			80	403	1

Variables		Upper limb					Thoracolumbar column
		Presence of pain	Absence of pain	OR	95% CI	p	Presence of pain	Absence of pain	OR	95% CI	p
Gender
	Female	134	458	1.56	1.13–2.20	0.010^a a Statistically significant – p < 0.05.	327	265	2.44	1.86–3.19	0.001^a a Statistically significant – p < 0.05.
	Male	58	310	1			124	245	1

Age
	14–16 years	103	380	1.18	0.86–1.62	0.302	224	260	0.95	0.74–1.22	0.685
	17–19 years	89	388	1			227	250	1

Employment
	Works	37	133	1.14	0.76–1.71	0.526	83	88	1.08	0.78–1.51	0.642
	Does not work	155	635	1			368	422	1

Nutritional status
	Overweight and obesity	53	149	1.58	1.10–2.28	0.013^a a Statistically significant – p < 0.05.	85	117	0.78	0.57–1.07	0.120
	Normal weight	139	619	1			366	393	1

Physical activity level
	Insufficiently active	41	191	0.82	0.56–1.20	0.309	92	141	0.93	0.69–1.26	0.697
	Active	151	577	1			300	428	1

Use of computer
	High (>3 h/day)	91	375	0.94	0.69–1.29	0.722	228	238	1.17	0.91–1.51	0.229
	Low (<3 h/day)	101	393	1			223	272	1

Use of electronic games
	High (>1 h/day)	98	380	1.07	0.77–1.46	0.699	218	261	0.89	0.69–1.15	0.380
	Low (<1 h/day)	94	388	1			233	249	1

Total time of use
	High (>4 h/day)	98	380	1.07	0.77–1.46	0.699	278	200	1.65	1.28–2.12	0.001^a a Statistically significant – p < 0.05.
	Low (<4 h/day)	94	388	1			221	262	1

Variables		OR	[95% CI]	p
Cervical column
	Gender (female)	1.93	1.32–2.83	0.001^a a Statistically significant – p < 0.05.
	Has a paid job (works)	1.75	1.17–2.62	0.008^a a Statistically significant – p < 0.05.
	Total time of use of electronic devices (>4 h/day)	1.61	1.13–2.28	0.007^a a Statistically significant – p < 0.05.

Scapular region
	Gender (female)	1.67	1.13–2.49	0.011^a a Statistically significant – p < 0.05.

Upper limbs
	Gender (female)	1.52	1.06–2.17	0.022^a a Statistically significant – p < 0.05.
	Nutritional status (overweight and obesity)	1.47	0.99–2.14	0.059

Thoracolumbar column
	Gender (female)	2.72	2.03–3.65	0.001^a a Statistically significant – p < 0.05.
	Total time of use (>4 h/day)	1.33	1.00–1.75	0.047^a a Statistically significant – p < 0.05.

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[1] *Corresponding author. E-mail:rodrigo.cappato@upe.br (R.C. De Araújo).