Effects of smartphone use on postural control and gait performance in older women with neck pain

Neck pain is associated with altered postural and gait performance in older adults. Smartphone use may further challenge postural and gait control due to additional cognitive and motor demands. This study aimed to investigate the effects of smartphone use on postural control and gait performance in older adults with neck pain.

Sixty-eight older women (34 with neck pain and 34 controls) were recruited. Postural control was assessed using a force plate under three conditions: standing with no smartphone use (S), standing while texting (S-text), and standing while talking (S-talk). Gait performance was assessed using a three-dimensional motion capture system under three conditions: walking with no phone use (W), walking while watching (W-watch), and walking while talking (W-talk). Postural outcomes included sway displacement in antero-posterior (AP) and medio-lateral (ML) directions, sway area, and sway velocity. Gait parameters included speed, cadence, stance and swing times, stride and step lengths, and step width. Absolute dual-task performance cost (abs-DTC) was calculated for all outcomes.

No significant interactions between group and condition were observed for any postural sway and gait outcomes (p > 0.05). Significant main effects of group and condition were found for all outcomes (p < 0.05). Regardless of condition, the neck pain group showed greater sway displacements (AP and ML), sway area, and velocity during standing compared with controls (p < 0.05). The neck pain group demonstrated reduced gait speed, lower cadence, longer stance and swing times, shorter stride and step lengths, and larger step width compared with controls (p < 0.05). Abs-DTC values were higher in the neck pain group than controls for all postural and gait outcomes (p < 0.05). Regardless of group, greater postural sway and gait impairments were generally observed during the talking condition compared with the other conditions (p < 0.05).

Older women with neck pain demonstrated greater impaired postural control and gait across all conditions, including smartphone dual-task conditions, compared with controls. No significant group-by-condition interaction was observed, suggesting comparable effects of smartphone use across groups. Talking on a smartphone resulted in greater impairments than texting or watching across groups. These findings suggest the importance of increasing awareness of smartphone use in older women.