Computer use and adverse health problems – are clinicians concerned?

Abstract

The use of computers is prevalent throughout many societies today, with people from all age groups, both sexes, and in many careers having regular contact with them either in the home or at the workplace. Existing scientific evidence clearly demonstrates that poor posture, greater muscle activity and musculoskeletal pain, as well as psychological problems such as internet addiction and antisocial personality disorder, are widely found among habitual users of computers. It is important that the negative consequences of current technology on physical and psychological wellbeing are not ignored, and therefore prevention and rehabilitation of these health effects, in computer users, must be urgently considered by clinicians. Pain and discomfort in the upper body, particularly the neck and shoulders, has been found to correlate with habitual computer usage. A further study by Harris and Straker of students who regularly used a laptop computer found reports of discomfort from usage (60%) and also from carrying the laptop (63%). Such musculoskeletal complaints were linked to improper ergonomics and poor posture during computer use. Poor adaptive posture was also seen in children and young adults, with a wide variety of postures employed, although these age groups differed markedly from the postures adapted by adults. Poor posture was also clearly associated with tall people who used the type of small screen normally seen on laptop computers, and commonly sat at inappropriate heights for their leg lengths, suggesting that it would be better to place such devices on a raised platform. Computer users typically report various musculoskeletal complaints. Neck, back and shoulder pain has been found in adolescent computer users. The one year prevalence of neck and shoulder pain, the most commonly reported somatic pain syndrome, is 58 cases per 100 persons. Neck pain and clinical abnormality has also been correlated with greater head rotation and inclination. Similarly, upper torso pain and severe stiffness has been reported by computer users who have high head rotation and keyboard height above elbow level. In addition, low back pain was reported at least once during the working day in female computer users, and the risk factor for low back pain, and pain exacerbation from prolonged sitting during computer use, was calculated as an odds ratio of 1.1–1.5. Back discomfort has been shown, with statistical significance, to be correlated with a downward viewing angle. However, the highest level of muscular activity was found in erect sitting with forward inclination of the body in visual display technology (VDT) workers, and increased stretching of passive structures in the back was caused by poor posture. Existing evidence suggests that the negative effects on muscular activities were due to the fact that different sitting postures during computer use led to different trunk muscle activation. Thoracic upright sitting increased co-activation of global back muscles, whereas lumbar-pelvic upright sitting increased coactivation of local muscle groups. Similarly, neck and shoulder muscles, particularly the descending aspect of the trapezius muscles, were distressed with additional effects on other muscles such as the longissimus capitis. It is likely that an increase in trapezius muscle activity is found when using a standard desk and workplace board (forearm support) compared to a standard desk, although this may be dependent on the elbow flexion angle. The dynamic and sustained contraction of the small muscles of the forearms and hands, and the shoulder, neck and back muscles, during word processor work may be one of the causative factors in neck and shoulder problems. It has been clearly demonstrated that the trapezius muscles engage in static contraction during keyboard work, and that fatigue of the shoulder muscles occurs rapidly during simple shoulder movement even when there is an application of mass on only one arm. Hand/arm symptoms in computer users were found to be mainly caused by poor non-neutral wrist Correspondence to: Pattariya Intolo, Faculty of Health Sciences, Srinakhawirot University, Origkharak, Nakhonnayoik 26120, Thailand. Email: pattariy@swu.ac.th