Investigation of Spinal Health and Internet Addiction of Individuals Working Remotely

Study Overview
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Brief Summary
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Low back pain and neck pain are common problems that affect people at certain times in their lives. These people constitute a significant part of the disease burden due to their recurrent complaints. People with low back and neck pain often seek medical attention. This situation causes individuals to apply to the hospital frequently and causes a serious cost at the social level. When the risk factors for neck pain are examined, many factors such as genetics, sleep problems, smoking, obesity, sedentary lifestyle, poor posture, previous neck pain, trauma, back pain and poor general health cause neck pain to develop. Similarly, conditions such as age, obesity, and poor general health appear to be risk factors for low back pain. In addition to these risk factors, it has been reported that occupational factors such as long and sedentary working hours and unsuitable workplace conditions may also cause low back and neck pain. Fixed posture and prolonged sitting are thought to be risk factors for low back and neck pain, but opinions on this subject are not clear. The COVID-19 pandemic has created a global crisis since 2019 and caused a change in the lifestyle of all people around the world. The World Health Organization (WHO) stated that social distance should be increased and face-to-face contact should be reduced to prevent the spread of the pandemic. For this reason, many institutions have decided to work remotely and trainings have been carried out remotely. The increasing teleworking style with the COVID-19 pandemic has led to an increase in the average screen time of individuals. It was reported that time spent on the Internet increased by 52% compared to the pre-pandemic period. This study aims to investigate the relationship between increased teleworking hours and internet use during the pandemic period in individuals with low back or neck pain. Researchers think that postural changes that may occur with increased distance working time, increased fixed posture and asymmetrical loading may contribute to the uncertain relationship between low back and neck pain and posture.

Official Title
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Investigation of Spinal Health and Internet Addiction of Individuals Working Remotely

Conditions
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Posture, Spine, Internet Addiction, Neck Pain, Low Back Pain

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Working online during the pandemic process, Have a smart phone, Agree to voluntarily participate in the research. Exclusion Criteria: Have a malignant condition, Loss of function due to neurological or systemic disease, Having had a surgical operation in the last 6 months, Have an unhealed fracture, Withdraw consent at any stage of the study.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Individuals Working Remotely<br>Individuals aged between 18-60 and working remotely, who volunteered to participate in the study, will form the study group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of Craniovertebral Angle | Global Postural System (GPS) will be used for posture evaluation. GPS is a computerized photographic postural assessment system. It consists of a digital camera, a ruler frame, and a stable platform that allows for consistent landmark identification. The craniovertebral angle will be recorded, which provides the most relevant and reproducible data in the assessment of neck posture with GPS. The craniovertebral angle is the angle between a line drawn between the C7 vertebra and the tragus and a horizontal line drawn from C7 | 5 minutes, in one assessment session. | 
| Evaluation of Sternocleidomastoideus Muscle Architecture | Sternocleidomastoideus muscle will be architecturally evaluated by US using a 5-12 MHz linear probe (GE Logiq E5 ultrasound device) at rest and during muscle activation. Muscle thickness and pennation angle will be recorded. | 5 minutes, in one assessment session. | 
| Evaluation of Internet Addiction | This evaluation will be carried out using the Kimberly Young Internet Addiction Questionnaire. The questionnaire consisting of 20 items; evaluate their dependencies in personal, professional and social functions. The questions are scored between 0 and 5 points. A total score between 0 and 30 indicates a normal level of internet use, total scores between 31 and 49 indicate the presence of mild addiction, a total score between 50 and 79 indicates the presence of a moderate level of addiction, and a total score of over 80 indicates the presence of severe internet addiction. | 10 minutes, in one assessment session. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of the Time Spent in Front of the Screen | he time spent in front of the screen will be evaluated by questioning the average time spent by people on three different devices as computer, tablet and phone use. | 2 minutes, in one assessment session. | 
| Evaluation of Body Mass Index | Body Mass Index (BMI), muscular and fat body weights will be assessed with TANITA BC420SMA (Tanita Corp, Tokyo, Japan). TANITA is a medically approved and reliable measuring device. It determines body composition by taking advantage of changes in bioelectrical resistance. | 2 minutes, in one assessment session. | 
| Evaluation of Low Back Disability | It was developed to evaluate the level of functional loss in individuals with low back pain. The scale consists of 10 questions about pain intensity, self-care, lifting-carrying, walking, sitting, standing, sleep, degree of change in pain, travel and social life. Each question is scored between 0-5 points. The total score is evaluated out of 100. A high score means an increased level of disability. | 5 minutes, in one assessment session. | 
| Evaluation of Neck Disability | The Neck Disability Questionnaire includes a total of 10 questions about pain, personal care, concentration, work, driving, and sleeping. Each question is scored between 0-5 points. 0-4 points means no disability, 5-14 points means mild disability, 15-24 points means moderate disability, 25-34 points means severe disability, 35 points and above means complete disability. The total score is evaluated out of 50. | 5 minutes, in one assessment session. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Posture, Spine, Neck pain, Low back pain, Screen time, Internet addiction