Smartphone use during forward ambulation causes generalized alterations to sagittal axis and gait pattern – A 4D-motion lab analysis

Abstract text (incl. references and figure legends)

Purpose: Excessive smartphone usage has been shown to cause substantial strain on the C-Spine, coining the term "text-neck syndrome". Previous studies have shown that this effect extends to alter sagittal axis as a whole. The impact of smartphone usage during ambulation on posture and gait patterns remains relatively unexplored. Therefore, we aimed to evaluate the effect of smartphone usage on posture and gait in a dynamic experimental setting.

Methods: Healthy volunteers were evaluated using the "DIERS 4D-motion-lab" during regular gait (control) and during "texting while walking" (TWW). Measurements included dynamic surface topography of the back, and foot pressure reaction force analysis. A within-subject design was used. Results were compared using paired student t-tests. An alpha of 0.05 was set as threshold for significance.

Results: We included 20 participants (50 % female), with a mean age of 31,4 years. Mean cervical flexion during TWW was 29.6°. We observed a significant increase of thoracic kyphosis (p<0.001), lumbar lordosis (p=0.05), cadence (0.001), and track width (p<0.001) during TWW compared to control, while step length was significantly decreased (p = 0.02). Trunk inclination, as measure of the sagittal balance, remained unaltered.

Conclusion: TWW causes multisegmental changes of the spinal axis, while sagittal balance is sustained. Besides postural changes, TWW also causes relevant alterations to the gait pattern by shortening step length and increasing track width.

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