Smartphone addiction and motor-cognitive performance among adolescents in Tunisia

Smartphone addiction among adolescents has emerged as a significant public health concern, with potential consequences for motor and cognitive development.

To examine the associations between smartphone addiction and motor-cognitive performance among adolescents in Tunisia, using validated digital tools.

Between December 2023 and March 2024, we examined 270 students in 3 public middle schools in urban Tunisia. We assessed smartphone addiction using the validated Arabic version of the smartphone addiction scale short version; motor function using the Takei Grip‑D dynamometer, MySprint app and the Flamingo balance test; and cognitive function using the Vienna test system. Group comparisons were conducted using nonparametric tests; associations were examined using Spearman's correlations; and predictive effects were assessed using separate linear regression analyses adjusted for age, sex and body mass index (P > 0.05).

Adolescents classified as addicted (n = 120) demonstrated significantly higher daily smartphone use (454.8 ± 104.8 vs 172.1 ± 108.6 minutes, P < 0.001), slower sprint time (6.09 ± 0.70 vs 5.63 ± 0.54 seconds, P < 0.001), reduced grip strength (22.3 ± 3.5 vs 25.7 ± 4.1 kg, P < 0.001), and lower cognitive accuracy despite faster reaction time (P < 0.01). Addiction severity independently predicted slower sprinting (β = 0.32) and poorer postural stability (β = 0.35, both P < 0.001).

Smartphone addiction is linked to significant motor and cognitive impairment among adolescents in Tunisian schools, with addiction severity predicting slower sprinting and poorer postural stability. Early school-based interventions to promote healthy smartphone habits and physical activity may help prevent long-term motor-cognitive decline among adolescents in Tunisia.