Relationship of Smartphone Addiction with Hand Grip Strength and Upper Limb Disability

1. Abstract 1.1. Background: Due to evolution of technology smart phone has become our necessity. Where on one hand it has made our lifestyle more comfortable in the form of browsing internet, important conversation and source of entertainment now a day. On the other hand, it has negative impacts on our lifestyles too. 1.2. Objective: This study aimed to determine the relationship of smart phone addiction with the hand grip strength and upper limb disability. 1.3. Methodology: After approval from research committee of Superior University, a total of 112 participants aged between 18 and 24 years were taken. Their smart phone addiction levels was determined according to SAS-SV questionnaire. A hand dynamometer was used to measure hand grip strength and function of hand and upper extremity was scored on the basis of quick DASH questionnaire. Pearson's co-relation coefficient and t-test were used to analyze the data. 1.4. Results: The mean score of SAS-SV was found to be 42.2054 whereas mean score of quick DASH was 31.36 showing mild to moderate level of disability. Mean reading from dynamometer was found 34KG with minimum 15KG and maximum 70KG. 1.5. Conclusion: This study concluded that there is high level of smart phone addiction among young adults. Increasing smart phone addiction decreases hand grip strength and increases upper limb disability. Whereas smart phone addiction was found slightly higher among female students. Upper limb disability was found mild to moderate level, which was found slightly higher among male students. Hand grip strength was found very high among male students than female.

Keywords: Smart phone addiction; Young adult; Upper limb disability; Hand strength

2. Introduction 2.1. Literature review In 21st century technology plays an important role in human life. Well among all its gadgets Smartphone is a fine revolution to our modern technology [1]. It has become one of the most ubiquitous communication device for past few years. People are not only using smart phones for communication, texting or browsing internet but it has greatly become a mode to play games of one's own choice, listen to music and watch videos. It would be better to say that it has become an essential part of life [2]. Hence, it has become an ideal device for malicious users [3]. Moreover it is a portable and accessible device that makes it possible to use it anywhere at any time. A research shows that the smart phone usage is estimated to be 2.87 billion users worldwide in 2020 [4]. It is said by youngster that they cannot exist without smart phone as it has become a part of their life. And it is no longer common to see youngsters carrying their smart phone in their hands while driving, eating or walking through a street [5].

3. Methodology 3.1. Study design It was analytical cross sectional study. 3.2. Sampling technique Convenient sampling technique was used to collect the data. 3.3. Study Settings The data was collected from Superior university Lahore. 3.4. Duration 6 month 3.5. Sample Size Sample size was 112. Data was analyzed through SPSS version 23. 3.6. Eligibility Criteria This study was conducted after the approval from ethical review board of the concerned institutes. An informed consent from Superior University Lahore was assigned to confirm the proceeding of the study in institute. 3.7. Inclusion criteria • Students aged between 18-24 years. • who use smart phone at least 4 hours a day were included in the study. 3.8. Exclusion criteria • Students having no history of smart phone use were excluded from the study. Number of students who fulfilled the inclusion criteria were provided with questionnaire form. An informed consent was taken from the subjects. Quick DASH questionnaire, Smartphone addiction-short version(SAS- SV) form and a tool named dynamometer was used for data collection. The data was collected under proper COVID-19 protocol i.e proper social distancing among students, wearing a mask and use of sanitizer after dynamometer tool use. The data collection procedure proceeded once the informed consent form was filled. The particulars of the research were explained to the students prior to the data collection and any query was clarified. Quick DASH questionnaire whose reliability was found to be 0.97 was used to measure the level of disabilities of upper extremity of the subjects. SAS-SV(Smart phone addiction scale -short version) whose validity was 0.967, sensitivity value 0.867 and specificity value 0.893 was used to measure the smart phone addiction level of the subjects. Incomplete Questions were not included in the data entry (Table 1-16).

4. Discussion It is presently common in our young generation to spend numerous hours each day on mobile phones playing games, conversations and browsing internet [4]. As a result of this extensive usage we can assume awkward and poor postures of upper limb. And therefore suffering from musculoskeletal complications [21]. This study examined the effects of smart phone addiction with hand grip strength and upper limb disability in young adults. The results of this study reveals that increasing smart phone addiction decreases the hand grip strength and increases the upper limb disability. The percentage of males and females participants were almost equal. The mean age taken was 20 years with minimum 18 years and maximum 24 years. Mean smart phone addiction score found was 42 out of total 60 with minimum 14 and maximum 57 scores. Another quick DASH questionnaire was used to predict level of upper limb disability. Mean DASH score was found 31.36 out of 100 with minimum score 20 and maximum score 46. So participants were having mild to moderate level of disability. The Independent sample t test between Gender and Smart Phone Addiction Score(P value is 0.231) showed that there is nonsignificant difference of Smart Phone Addiction Score between male and female although female were found having slightly higher Smart Phone Addiction Score than male. Independent sample t test between Gender and Hand Dynamometer Reading (KG) P value showed that there is significant difference of Hand Dynamometer Reading (KG) between male and female and male were found having higher Hand Dynamometer reading(KG) than female. Pearson's corelation test showed there is significant negative correlation between smart phone addiction and hand grip strength. It was also found that there is non-significant positive correlation between smart phone addiction and upper limb disability. A previous observational study was conducted by Nadia L.Radwan in 2020. It consists of two groups with children aged 9 and 15. One group contain high frequency smart phone users and other contain low frequency smart phone users. The aim of study was to determine effect of smart phone usage on hand grip and pinch strength. It was concluded that high level of smart phone use diminished hand and pinch grip strength [1]. Comparing previous study with this study, a total of 112 participants based on inclusion criteria were included. The analysis of this study reveal that level of upper limb disability found by quick DASH was of mild to moderate level. The Smartphone addiction scale(SAS-SV) was found to be maximum. The aim was to determine hand grip strength and upper limb disability due to excessive smart phone usage. The results showed that there is significant co- relation of smart phone addiction with hand grip strength and non significant co- relation with upper limb disability.

5. Conclusion This study concluded that there is remarkably increased level of smart phone addiction among young adults. Smart phone addiction was found slightly higher among females. Upper limb disability was found mild to moderate level, which was found slightly higher among male students. Hand grip strength was found very high among male students than female. It was found that there is significant negative correlation between smart phone overuse and hand grasp strength in young adults. It was also found that there is non-significant positive correlation between smart phone addiction and upper extremity dysfunction.

6. Limitations and Recommendations A cross-sectional survey was conducted. There was no follow-up in this study. Further longitudinal cohort studies are recommended. Due to covid-19 access was limited to get the desired population. The study can be conducted by specifying a certain type of mobile brand. Specific screen size of mobile effects on upper extremity should be studied furthur.

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Saeed Taj. Relationship of Smartphone Addiction with Hand Grip Strength and Upper Limb Disability. Annals of Clinical and Medical Case Reports 2021