The Analyses of the Relationship between Physical Activity, Musculoskeletal System Problems, Sleep, and Screen Exposure Time in University students during the Distance Learning Process

Abstract

Purpose: To investigate the relationship between physical activity, musculoskeletal system problems, sleep, and screen exposure time in university students during the distance learning process. Methods: Three hundred and one students (183 female, 118 male) participated in the study via online survey. The screen exposure time was recorded. The physical activity using Short Form International Physical Activity Questionnaire and pain using Visual Analog Scale were evaluated. Nordic Musculoskeletal System Questionnaire was used to evaluate musculoskeletal symptoms. The Pittsburg Sleep Quality Index was applied for the details of sleep quality. Results: The students had a low level of physical activity (58.8%) and poor sleep quality (70.8%). Musculoskeletal pain was reported in upper back (85%), lower back (85%), neck (79.4%), shoulder (71.4%). The pain was correlated with total sleep quality (r=0.320, p<0.001), daytime dysfunction (r=0.282, p<0.001), sleep quality (r=0.256, p<0.001), and sleep disturbances (r=0.232, p<0.001). The screen time exposure-education was weakly correlated with PSQI total score (r=0.118, p=0.04) and total activity (r=-0.148, p=0.01). Conclusion: The low-level physical activity, worsened sleep quality, high rate of musculoskeletal problems and increased amount of screen exposure were reported in the distance learning process. We believed that these problems could be the reason for serious health issues later, so approaches targeting to improve physical activity levels, better posture while studying could be beneficial.

Keywords

• Covid-19
• Screen time
• Sleep
• Physical activity.

References

1. 1. Covid-19 Coronavirus Pandemic. Access date: 24 Nisan 2021, https://www.worldometers.info/coronavirus/.
2. 2. World Health Organization. WHO timeline—COVID-19. Access date: 27 Nisan 2021, https://www.who.int/news-room/detail/27-04-2020-who-timeline---COVID-19.
3. 3. Srivastav AK, Sharma N, Samuel AJ. Impact of Coronavirus disease-19 (COVID-19) lockdown on physical activity and energy expenditure among physiotherapy professionals and students using web-based open E-survey sent through WhatsApp, Facebook and Instagram messengers. Clin Epidemiol Glob Health. 2021;9:78-84.
4. 4. Armstrong-Mensah E, Ramsey-White K, Yankey B, Self-Brown S. COVID-19 and Distance Learning: Effects on Georgia State University School of Public Health Students. Front Public Health. 2020;8:576227.
5. 5 Kapasia N, Paul P, Roy A, et al. Impact of lockdown on learning status of undergraduate and postgraduate students during COVID-19 pandemic in West Bengal, India. Child Youth Serv Rev 2020;116:105194.
6. 6 Uddin M, Mustafa F, Rizvi TA, et al. SARS-CoV-2/COVID-19: viral genomics, epidemiology, vaccines, and therapeutic interventions. Viruses. 2020;12(5):526.
7. 7 Todd AI, Bennett AI, Christie CJ. Physical implications of prolonged sitting in a confined posture-a literature review. Ergonomics SA. 2007;19(2):7-21.
8. 8 Ercan Ş, Keklicek H. COVID-19 Pandemisi Nedeniyle Üniversite Öğrencilerinin Fiziksel Aktivite Düzeylerindeki Değişimin İncelenmesi. İKÇÜSBFD. 2020;5(2):69-74.

9. 9 Kim H-J, Kim J-S. The relationship between smartphone use and subjective musculoskeletal symptoms and university students J Phys Ther Sci. 2015;27(3):575-579.
10. 10 Parent J, Sanders W, Forehand R. Youth screen time and behavioral health problems: The role of sleep duration and disturbances. Journal of developmental and behavioral pediatrics: J Dev Behav Pediatr. 2016;37(4):277.
11. 11 Kilani HA, Bataineh MaF, Al-Nawayseh A, et al. Healthy lifestyle behaviors are major predictors of mental wellbeing during COVID-19 pandemic confinement: A study on adult Arabs in higher educational institutions. Plos One. 2020;15(12):e0243524.
12. 12 Christensen MA, Bettencourt L, Kaye L, et al. Direct measurements of smartphone screen-time: relationships with demographics and sleep. Plos One. 2016;11(11):e0165331.
13. 13. Lane HY, Chang CJ, Huang CL, Chang YH. An Investigation into Smartphone Addiction with Personality and Sleep Quality among University Students. Int J Environ Res Public Health. 2021;18(14):7588.
14. 14. Vasantha Raju N, Harinarayana N, editors. Online survey tools: A case study of Google Forms. National Conference on Scientific, Computational & Information Research Trends in Engineering, GSSS-IETW, Mysore; 2016.
15. 15. Craig CL, Marshall AL, Sjöström M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-1395.
16. 16. Saglam M, Arikan H, Savci S, et al. International physical activity questionnaire: reliability and validity of the Turkish version. Percept Mot Ski. 2010;111(1):278-284.
17. 17. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short‐form mcgill pain questionnaire (sf‐mpq), chronic pain grade scale (cpgs), short form‐36 bodily pain scale (sf‐36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthritis Care Res 2011;63(S11):S240-S52.
18. 18. Kuorinka I, Jonsson B, Kilbom A, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233-237.
19. 19. Kahraman T, Genç A, Göz E. The Nordic Musculoskeletal Questionnaire: cross-cultural adaptation into Turkish assessing its psychometric properties. Disabil Rehabil. 2016;38(21):2153-2160.
20. 20. Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
21. 21. Ağargün MY, Kara H, Anlar Ö. The validity and reliability of the Pittsburgh Sleep Quality Index. Turk Psikiyatri Derg. 1996;7(2):107-115 (in Turkish).
22. 22. Warren TY, Barry V, Hooker SP, Sui X, Church TS, Blair SN. Sedentary behaviors increase risk of cardiovascular disease mortality in men. Med Sci Sports Exerc. 2010;42(5):879.
23. 23. Majumdar P, Biswas A, Sahu S. COVID-19 pandemic and lockdown: cause of sleep disruption, depression, somatic pain, and increased screen exposure of office workers and students of India. Chronobiol Int. 2020;37(8):1191-1200.
24. 24. Lis AM, Black KM, Korn H, Nordin M. Association between sitting and occupational LBP. Eur Spine J. 2007;16(2):283-298.
25. 25. Beach TA, Parkinson RJ, Stothart JP, Callaghan JP. Effects of prolonged sitting on the passive flexion stiffness of the in vivo lumbar spine. Spine J. 2005;5(2):145-154.
26. 26. Green A, Dagan Y, Haim A. Exposure to screens of digital media devices, sleep, and concentration abilities in a sample of Israel adults. Sleep Biol Rhythms. 2018;16(3):273-281.
27. 27. Mork PJ, Vik KL, Moe B, Lier R, Bardal EM, Nilsen TIL. Sleep problems, exercise and obesity and risk of chronic musculoskeletal pain: the Norwegian HUNT study. Eur J Public Health. 2014;24(6):924-929.