The impact of excessive smartphone use on imbalance symptoms: The role of craniovertebral angle and cervical proprioception

Background The increase in smartphone use can potentially have negative effects on individuals, affecting musculoskeletal, posture, and sensory functions. However, the impact of this increase on proprioception and dizziness/imbalance have not been sufficiently studied. Objective This study aims to examine the craniovertebral angle (CVA), cervical proprioception, static postural balance, and psychometric imbalance symptoms in individuals who use excessive smartphones. Methods This cross-sectional study included 105 participants divided into two groups based on their median Smartphone Addiction Scale (SAS) scores: high smartphone use (HSU) group (n = 53) and low smartphone use (LSU) group (n = 52). Participants’ CVA, cervical proprioception, static postural balance, and psychometric imbalance symptoms (Vertigo, Dizziness, Imbalance-Symptom Scale (VDI-SS)) were assessed. Results In the HSU group, CVA (Effect size (ES) = 0.28, p = 0.005) and VDI-SS scores were worse (ES = 0.79, p < 0.01), and flexion, extension, right rotation, left rotation, and right lateral flexion cervical proprioception deviation angles were statistically significantly higher than in the LSU group (p < 0.05). Static postural balance functions of the groups were similar (p > 0.05). Also, there was a negative correlation between SAS and CVA (r = -0.277, p = 0.004) and VDI-SS scores (r = -0.440, p < 0.001). Conclusion HSU is related to decreased CVA and worsening of proprioception and dizziness/imbalance symptoms in individuals. The similarity in static postural balance may indicate that postural changes due to HSU, even if not apparent early, may be associated with dizziness/imbalance symptoms. Consequently, it is thought that HSU may be associated with cervical posture, proprioceptive sensitivity, and balance control in the long term. This study is submitted to ClinicalTrial (no: NCT06968078).