Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 14, 2022
Date Accepted: Jan 29, 2023
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Turning when using a smartphone in persons with and without neurologic conditions: an observational study.
ABSTRACT
Background:
Turning during walking is a relevant and common everyday movement and it depends on a correct top-down intersegmental coordination. This could be reduced in several conditions (en-block turning), and lead to increased risk of falls. Smartphone use has been associated with poorer balance and gait, however its effect on turning-while-walking have not been investigated yet. This study explored turning intersegmental coordination when using a smartphone in different age groups and neurologic conditions.
Objective:
To evaluate the effect of smartphone use on turning behavior in healthy participants of different ages and patients with various neurological diseases.
Methods:
Younger and older healthy participants and patients with Parkinson’s disease (PD), multiple sclerosis, stroke and lower-back pain (LBP) performed turning-while-walking without and with cognitive tasks on a smartphone. General (turn duration and number of steps while turning), segmental (peak angular velocity) and intersegmental turning parameters (intersegmental turning onset latency and maximum intersegmental angle) were extracted for head, sternum and pelvis using a motion capture system.
Results:
One hundred twenty-one participants were enrolled. All participants, irrespective of age and neurologic disease, showed an en-bloc turning behavior when using a smartphone. Concerning change from ST to turning when using a smartphone, PD patients reduced their peak angular velocity the most, which was significant against LBP for head (P<.01). Stroke patients showed an en-block turning already without smartphone use.
Conclusions:
Smartphone use during turning-while-walking may lead to en-block turning and increase fall risk across age and neurologic disease groups. This behavior is probably particularly dangerous for those groups with most pronounced changes of turning parameters during smartphone use and highest fall risk, such as PD patients. Clinical Trial: German Clinical Trials Register (https://www.drks.de/drks_web/) DRKS00022998.
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