Text neck syndrome and manual dexterity in university students: a cross-sectional study

Prolonged smartphone use is frequently associated with poor neck posture and the development of Text Neck Syndrome (TNS). This study aimed to compare manual dexterity between university students with and without TNS and to investigate its relationship with neck disability and smartphone use. We hypothesized that university students with TNS would demonstrate significantly lower manual dexterity compared to those without TNS.

This cross-sectional study included 280 university students from a public university. Manual dexterity was assessed using the Purdue Pegboard Test (PPT), while neck disability, smartphone addiction, and pain intensity were evaluated using the Neck Disability Index, Smartphone Addiction Scale-Short Version (SAS-SV), and Visual Analogue Scale (VAS), respectively. Group comparisons, correlation analyses, and multivariate regression were performed to examine the relationships between TNS and manual dexterity.

Participants with TNS demonstrated significantly higher neck disability scores compared to those without TNS (p<0.001). Significant impairments were observed only in non-dominant hand dexterity (p=0.025), whereas no significant differences were found in other dexterity parameters (p>0.05). Smartphone usage duration showed statistically significant weak negative correlations with manual dexterity parameters (p<0.05). After adjusting for age, sex, and smartphone usage duration, TNS was independently associated with reduced non-dominant hand dexterity (β=-0.138, p=0.020).

TNS is independently associated with non-dominant hand dexterity, particularly in non-dominant hand performance. Although the effect size was small (Cohen's d = 0.274), these findings provide preliminary evidence of an association between TNS and reduced non-dominant hand dexterity.