Investigating Text Neck Syndrome and Duration of Mobile Phone Use, Muscle Activity, Hand Grip Strength, Posture, and Disability

Abstract

Neck and shoulder musculoskeletal symptoms related to smartphone use are becoming increasingly prevalent, yet the underlying mechanisms including smartphone usage duration, muscle activity, hand grip strength, posture, and disability remain incompletely understood. This study examined the interaction between text-neck syndrome and factors such as smartphone usage duration, muscle activity, hand grip strength, posture, and disability. Forty participants (Text Neck group: n = 18; 14 females or Control group: n = 22; 15 females) underwent neuromuscular assessment. Surface electromyography measured bilateral muscle activity in the upper trapezius (UT) and abductor pollicis brevis (APB) muscles during smartphone use. Secondary outcomes included the Visual Analogue Scale (VAS) to assess pain intensity, hand grip strength, New York Posture Rating Scale (NYPRS), Neck Disability Index (NDI), and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. The Text Neck group demonstrated significantly higher smartphone use (p < 0.001), higher texting time (p = 0.006), and lower muscle activation at activity in the dominant APB (p = 0.011), dominant UT (p < 0.001), and non-dominant UT (p = 0.008). These findings provide novel insights into how excessive smartphone use alters muscle function and postural alignment in individuals with text-neck syndrome. Understanding these mechanisms may inform targeted prevention and rehabilitation strategies to mitigate musculoskeletal risk associated with modern technology use. © 2026 Elsevier Ltd