Excessive screen time on posture, musculoskeletal pain, and quality of life in generation Z adolescents: a cross-sectional study with comparison between the sexes

Int J Adolesc Med Health. 2026 Mar 2. doi: 10.1515/ijamh-2025-0210. Online ahead of print.

ABSTRACT

OBJECTIVES: Excessive use of electronic devices can cause postural changes, pain, and negatively impact generation Z adolescents' quality of life (QoL). The goals of this study were to evaluate and compare between sexes the static posture, postural self-perception, screen time, musculoskeletal pain, and QoL in generation Z adolescents.

METHODS: Cross-sectional study with adolescents. Postural analysis was conducted using the Software SAPo, self-reported posture, back pain, and screen time were assessed with the BackPei-CA, and QoL was evaluated using the Kidscreen-27 questionnaire. Statistical analyses included t-test or Mann-Whitney U test, Spearman's correlation, and adjusted logistic regression, with correction for multiple comparisons (p≤0.05).

RESULTS: 408 adolescents were included (204 of each sex), with a mean age of 14.58 ± 1.98 years (males) and 14.56 ± 1.84 years (females). Postural assessment revealed head anteriorization and pelvic misalignment, with females showing greater head and pelvic angular deviations. No significant associations were found between cell phone use and cervical or pelvic alignment. Cell phones/tablets were the most frequently used devices, with higher daily use among females. Musculoskeletal pain was highly prevalent, particularly in the cervical and lumbar regions, and more frequent in females; however, cell phone use was not independently associated with musculoskeletal pain after adjustment. The total sample of adolescents has a good QoL.

CONCLUSIONS: Adolescents, especially females, showed head anteriorization and pelvic misalignments, high screen time, and self-perceived inadequate postural habits. Musculoskeletal pain was frequent and more prevalent among females, despite good quality of life. Screen time alone was not associated with postural changes or pain, indicating a multifactorial etiology.

PMID:41764664 | DOI:10.1515/ijamh-2025-0210