Effects of the use of mobile phone on postural and locomotor tasks: a scoping review

Highlights

• Conversing or sending messages while walking is often involved in accidental injuries

• Forty-six studies were included in this work

• They compared postural and locomotor tasks with and without the use of a smartphone

• Only 4 studies included pathological subjects

• The use of smartphones slows down movement and induces a systematic imbalance

Abstract

Background

Using a mobile phone while performing a postural and locomotor tasks is a common, daily situation. Conversing or sending messages (SMS) while walking account for a significant share of accidental injuries. Therefore, understanding the consequences of using a mobile phone on balance and walking is important, all the more so when these postural and locomotor tasks are aggravated by a disease.

Research question

Our objective was to conduct a scoping review on the influence of a dual-task situation – generated by the use of mobile phone – on users' postural and/or locomotor tasks.

Methods

The literature search was conducted in English on PubMed/Medline and CINHAL databases, using keywords associated with postural and locomotor tasks and with the use of mobile phone. Study location, population, number of subjects, experimental design, types of phone use, evaluated postural-locomotor tasks and expected effects were then analyzed.

Results and significance

46 studies were included in this work, 24 of which came from North America. All studies compared postural and locomotor tasks with and without the use of a smartphone. Ten studies also compared at least 2 groups with different characteristics. Only 4 studies included pathological subjects. Various modalities were tested, and most studies focused on walking. Results show that the use of smartphones slows down movement and induces a systematic imbalance, except when listening to music. The dual task of "using the smartphone during a postural or locomotor tasks" induces systematic disturbances of balance and movement, which must be taken into account in the rehabilitation approach. Future studies will have to extend the knowledge regarding pathological situations.

Introduction

In 2016, 77% of Americans owned a mobile phone, and this rate rose to 92% for the 18-29-year-olds [1]. Using of mobile phones during postural and locomotor tasks (e.g. balancing, walking) is a daily situation for most individuals at all stages of life and for a variety of environmental and health conditions [2]. Mobile phones are increasingly used in clinical practice by therapists thanks to applications that are being developed either to measure physiological parameters (e.g. range of motion, balance) [3], or to improve the follow-up of individuals (e.g. self-exercise at home, questionnaires) [4]. While many studies have been conducted on these applications, studies on the use of mobile phones during postural and locomotor tasks and the reciprocal interactions are more scarce. Considering the preponderance of these tasks in our daily lives, it is therefore essential to understand the influence of mobile phone use on postural-locomotor tasks, especially for people with motor and/or cognitive impairements that diminish their balance and motor skills during dual tasks [5].

Five to 30% of walking-related falls and accidents are directly attributable to the use of a mobile phone [1,6]. People under 30 – due to their frequency of use – and over 60 are more exposed to risks, particularly when writing a text message [7]. Mobile phone use appears to induce cognitive distraction, reduced visual attention to the environment and impaired musculoskeletal biomechanics through decreasing arm and head mobility – which may be the main factors of risk [8]. However, one study also showed altered walking behavior when crossing a street [9]. Therefore, the use of a mobile phone seems to induce multiple consequences that may explain functional disturbances and associated risks. Nevertheless, the consequences of mobile phone use on the functionality of individuals are still little known. As a result, they are little taken into account in rehabilitation, even though patients under treatment very often use their phone – a crucial social component of their lives – and given that rehabilitation must be a dynamic process that adapts to changing lifestyles.

A scoping review is an alternative to a systematic review. It is used when the main objective is to determine the scope of available studies in order to have an overview of a topic [10]. This methodological choice is appropriate when the evidence is still emerging and does not allow for a systematic review to be conducted because the number of studies with similar methodologies on the same issue is too small. Scoping reviews differ methodologically from systematic reviews in that the authors do not evaluate article quality; it also differs from narrative reviews by its clearly-defined method [11]. Since studying the impact of mobile phone use on postural and locomotor tasks is a recent topic, and since the tasks tested can be varied (balance and walking), a scoping review is appropriate to identify the types of available evidence, to examine how research is conducted in this fields, and to identify knowledge gaps [10]. Moreover, the extremely frequent use of a mobile phone in conjunction with daily activities makes understanding this dual task relevant for patient rehabilitation.

Our objective was to conduct a scoping review on the influence of a dual task situation – generated by the use of mobile phone – on users' postural and locomotor tasks.