Investigation of the relationship between smartphone usage duration visual attention, neck pain and neck muscle endurance

This study aimed to investigate the association between smartphone usage duration, visual attention, neck pain, and cervical muscle endurance. The target population comprised individuals aged 25–55 years residing in Istanbul who regularly use smartphones. The sample included 40 participants living on the Anatolian side of Istanbul. The study was conducted between January and April 2025. Sociodemographic characteristics were recorded using a Sociodemographic Information Form. The Smartphone Addiction Scale–Short Form (SAS-SF) was employed to assess addiction levels; the Trail Making Test (TMT-A and TMT-B) was used to evaluate visual attention; the Neck Disability Index (NDI) was administered to assess neck pain; and the Deep Cervical Flexor Endurance Test (DCF-Endurance) was performed to measure neck muscle endurance. Data were analyzed using SPSS software, with the significance threshold set at p<0.05. A total of 40 individuals participated, comprising 19 females (47.5%) and 21 males (52.5%), with a mean age of 36.33±9.17 years. Participants were categorized into two groups: the Smartphone Addiction Group (SAG) and the non-addicted Control Group (CG). In the SAG, the mean SAS-SF score was 35.45±3.99, the NDI score was 14.45±5.41, TMT-A performance time was 39.94±14.62 seconds, TMT-B performance time was 74.30±18.98 seconds, and DCF-Endurance duration was 37.13±20.05 seconds. Significant correlations were observed between GAS and SAS-SF (r=0.597, p=0.005) and NDI (r=0.688, p=0.001); daily sitting time and PC usage time (r=-0.468, p=0.037), SAS-SF (r=0.474, p=0.035), and NDI (r=0.473, p=0.035); SAS-SF and NDI (r=0.556, p=0.011) and DCF-Endurance (r=-0.449, p=0.047); and NDI and DCF-Endurance (r=-0.549, p=0.012). In the CG, the mean SAS-SF score was 19.55±3.99, the NDI score was 7.45±4.50, TMT-A performance time was 29.85±6.72 seconds, TMT-B performance time was 57.39±14.94 seconds, and DCF-Endurance duration was 52.12±20.65 seconds. Significant correlations were found between GAS and DCF-Endurance (r=-0.514, p=0.020); daily sitting time and NDI (r=0.466, p=0.038); PC usage time and TMT-B (r=-0.531, p=0.016); TMT-A and TMT-B (r=0.591, p=0.006); and TMT-A and DCF-Endurance (r=-0.465, p=0.039). No other statistically significant associations were detected. Between-group comparisons revealed significant differences in GAS (p=0.015), daily smartphone usage time (p=0.044), SAS-SF (p<0.001), NDI (p<0.001), TMT-A (p=0.001), TMT-B (p=0.010), and DCF-Endurance (p=0.012) scores. In conclusion, increased smartphone addiction and prolonged usage time were associated with adverse effects on psychomotor speed, sustained and complex attention, neck pain, cervical muscle endurance, and overall neck function. These findings suggest that smartphone addiction may represent a potential risk factor for neck pain, visual attention impairment, and reduced cervical muscle endurance. Keywords: smartphone use, neck pain, visual attention, addictive behavior, muscle endurance