The Relationship Between Usage of Personal Electronic Devices and Musculoskeletal Pain in Children and Adolescents: A Systematic Review

Background Over the last decade, the use of personal electronic devices has increased rapidly in both children and adolescents. With this growth comes a need to understand the potential association between personal electronic device usage and musculoskeletal disorders. This systematic review aimed to explore the current research to establish whether there is a relationship between children’s (aged 5-17 years) musculoskeletal pain and their usage of personal electronic devices, and to determine any associated risk factors. Methods Systematic searches were conducted in the following electronic databases: CINAHL, MEDLINE, SPORTDiscus, and PubMed Central. Keywords used related to those to describe personal electronic devices, musculoskeletal pain, and children. The articles were screened using a protocol following a two-phase process, data were extracted, and the quality of the papers assessed. Results 14,624 articles were screened and 24 were deemed eligible for inclusion. Out of these, 20 were cross-sectional studies, three were longitudinal, and one was a test re-test study. The device used in the majority of studies was a desktop computer (n=14), seven studies asked about different types of devices, and two used mobile devices. Nine studies reported on posture and musculoskeletal pain whilst using personal electronic devices, and 16 studies reported on the length of time spent when using a personal electronic device and associated musculoskeletal pain. Results showed limited evidence of a relationship between children’s personal electronic device usage and musculoskeletal pain. Potential risk factors associated with musculoskeletal pain reported in the included studies were: type of device, length of time, and position adopted when using the device. Due to the use of subjective measures and the lack of longitudinal studies, these risk factors could not be conclusively demonstrated. Conclusion The findings of this systematic review suggest that there is a need for further research, which should take the form of cohort and/or longitudinal studies using objective measures and physical examinations as opposed to only subjective measures and questionnaires. This would help to develop a greater understanding of risk factors associated with children developing musculoskeletal pain related to personal electronic device usage.