Internet Usage Profile of Medical Students and Effects of Internet Addiction on Sagittal Balance

Öz

Objective: The risk of internet addiction increases as the time of internet usage increases. Long-term internet usage may effect the posture of the person. This may cause the change of the gravity center and may effect the segmental degeneration.

Methods: In Suleyman Demirel University, 168 medical students had internet addiction scale. The scores ≥81 accepted as internet addicted. Equal number of adolescents who got the diagnosis of internet addicted and not had cervical/lumbar x-ray graphics. Sagittal alignments were evaluated by using Cobb’s method. Probable internet addicted descriptive analysis, TwoStep Cluster Analysis, ANOVA, Independent Samples t-Test, Product-Moment Correlation, Mann-Whitney U analysis were used.

Results: Nine(5,4%) students were internet addicted. There was a significant difference between internet usage habits and internet addiction scores, but the highest difference was found between “intermittent+long time usage” and “total usage in once”. There was only a negative(r = -.341) and significant relation(p= .021) between internet addiction and lumbar Cobb angle. As the score of internet usage increases, value of lumbar Cobb angle decreases. Only lumbar Cobb angle values were significantly different(p= .030) for devices used for internet access. According to the Rank values, students’ lumbar Cobb angle using laptop as  internet access device(13,07) were lower than the students’ using cell phone or pads(21,07).

Conclusion: Being in the same  and unsuited anatomical position while using internet for a long time may cause changes in the sagittal alignment. Loadings and stresses on spinal structures influence the spinal morphology and cause the occurrence of disc degeneration. 

Anahtar Kelimeler

• internet addiction,sagittal alignment,Cobb angle,sagittal vertical axis

Tıp Öğrencilerinin İnternet Kullanım Profili ve İnternet Bağımlılığının Sagital Dengeye Etkisi

Öz

Amaç: İnternet kullanımının artması ile internet bağımlılığı riski de artmaktadır. Uzun süreli internet kullanımı kişinin duruşunu etkileyebilmektedir. Bu durum, ağırlık merkezinin değişmesine ve segmental dejenerasyona neden olabilmektedir.

Metod: Süleyman Demirel Üniversitesi’nde 168 tıp öğrencisine internet bağımlılığı skalası uygulandı. ≥81 skoru olanlar ınternet bağımlı olarak kabul edildi. Internet bağımlılığı tanısı almış ve almamış eşit sayıda adolesandan servikal / lomber dırekt grafiler alındı. Sagital dizilim Cobb metodu ile değerlendirildi. Olası internet bağımlı tanımlayıcı analiz, İkiBasamak Küme analizi, ANOVA, bağımsız örnekleme t-testi,ürün-önem korelasyonu, Mann-Whitney U analizi kullanıldı.

Sonuçlar: Dokuz öğrenci(%5,4)  internet bağımlı idi. İnternet kullanım alışkanlıkları ile internet bağımlılık skoru arasında anlamlı fark tespit edildi, ancak en yüksek fark “aralıklı+uzun sure kullanan”  ve “tek seferde total kullanan” grup arasında bulundu. Sadece internet bağımlılığı ve lomber Cobb açısı arasında negatif (r = -.341) ve belirgin bir ilişki (p= .021) vardı. İnternet kullanım skoru arttıkça, lomber Cobb açı değeri azalmaktaydı. İnternet kullanımındaki farklı cihazlar için lomber Cobb açı değeri belirgin olarak farklıydı(p= .030). Rank değerlerine gore, laptop kullanan öğrencilerin lomber Cobb açı değeri(13,07), cep telefonu veya tablet kullananlardan(21,07) daha düşüktü.

Sonuç: Uzun sureli internet kullanımında aynı ve uygun olmayan anatomik pozisyonda durmak sagittal dizilimde değişikliklere neden olabilir. Spinal yapılar üzerindeki yüklenmeler ve stres spinal morfolojiyi etkiler ve disk dejenerasyonlarının ortaya çıkmasına neden olur. 

Anahtar Kelimeler

• internet bağımlılığı,sagittal dizilim,Cobb Açısı,sagittal vertikal aks

Kaynakça

1. 1. Maroof KA, Parashar P, Bansal R. How are our medical studentsusing the computer and internet? A study from a medical college of north India. Nigerian Medical Journal 2012;53(2):89-93.
2. 2. Keller TS, Colloca CJ, Harrison DE, Harrison DD,Janik TJ. Influence of spine morphology on intervertebral disc loads and stresses in asymptomatic adults: implications for the ideal spine. Spine J 2005;5:297-309.
3. 3. Miyazaki M, Hymanson HJ, Morishita Y, He W, Zhang H, Wu G, Kong MH, Tsumura H, Wang JC. Kinematic analysis of the relationship between sagittal alignment and disc degeneration in the cervical spine. Spine 2008;33(23):E870-876.
4. 4. Gunuc S, Kayri M. The profile of internet dependency in Turkey and development of internet addiction scale: study of validity and reliability. Hacettepe University Journal of Education 2010;39:220-232.
5. 5. Ohara A, Miyamoto K, Naganawa T, Matsumoto K, Shimizu K. Reliabilities of and correlations among five standard methods of assessing the sagittal alignment of the cervical spine. Spine 2006;31(22):2585-2591.
6. 6. Tang JA, Scheer JK, Smith JS, Deviren V, Bess S, Hart RA, Lafage V, Shaffrey CI, Schwab F, Ames CP. The impact of standing regional cervical sagittal alignmneton outcomes in posterior cervical fusion surgery. Neurosurgery-online 2012;71(3):662-669.
7. 7. Ghogawala Z, Magge S, Curran J, Bisson E, Krishnaney A, Steinmetz M, et al. Postoperative cervical sagittal imbalance negatively affects outcome following surgery for cervical spondylotic myelopathy. 41st Annual Meeting, Cervical Spine Research Society, Los Angeles, CA, December, 2013, paper#36.
8. 8. Hong JY, Suh SW, Park JH. Reliability analysis for radiographic measures of lumbar lordosis in adult scoliosis: a case-control comparing 6 methods. Eur Spine J 2010; 19(9):1551-1557.

9. 9. Hardie E, Tee MY. Excessive Internet use: The role of personality, loneliness and social support networks in Internet addiction. Australian Journal of Emerging Technologies and Society 2007;5(1),34-47.
10. 10. Cao F, Su L. Internet Addiction Among Chinese Adolescents: Prevalence And Psychological Features. Child: Care, Health & Development 2007;33(3),275-281.
11. 11. Gunuc S. Cart and Chaid analyses of some variables that predict internet addiction. Turkish Journal of Psychology 2013;28(71),88-101.
12. 12. Lin SSJ, Tsai CC. Sensation seeking and internet dependence of Taiwanese high school adolescents. Computers in Human Behavior 2002;18(4),411–426.
13. 13. Nalwa K, Anand A. Internet Addiction in Students: A Cause of Concern. Cyberpsychology & Behavior 2003;6(6),653-656.
14. 14. Simkova B, Cincera J. Internet addiction disorder and chatting in the Czech Republic. Cyberpsychology & Behavior2004;7(5),536-539.
15. 15. Young K, S. Internet Addiction: A New Clinical Phenomenon and Its Consequences. American Behavioral Scientist 2004;48(4),402-415.
16. 16. Kayri M, Gunuc S. The Adaptation of Internet Addiction Scale into Turkish: The Study of Validity and Reliability. Journal of Faculty of Educational Sciences 2008;42(1),157-175.
17. 17. Poli R, Agrimi E. Internet addiction disorder: Prevalence in an Italian student population. Nordic Journal of Psychiatry 2012;66(1),55–59.
18. 18. Dong G, Wang J, Yang X, Zhou H. Risk personality traits of Internet addiction: A longitudinal study of Internet-addicted Chinese university students. Asia-Pacific Psychiatry, e-pub ahead of print. 2012.
19. 19. Ghamari F, Mohammadbeigi A, Mohammadsalehi N, Hashiani AA. Internet addiction and modeling its risk factors in medical students, Iran. Indian Journal of Psychological Medicine 2011;33(2),158–162.
20. 20. Lin MP, Ko HC, Wu JYW. Prevalence and psychosocial risk factors associated with Internet addiction in a nationally representative sample of college students in Taiwan. CyberPsychology, Behavior and Social Networking 2011;14(12),741–746.
21. 21. Lic´winko J, Krajewska-Kułak E, Łukaszuk C. Internet addiction among academic youth in Białystok.Progress in Health Sciences 2011;1(1),124–130.
22. 22. Kayri M, Gunuc S. The Adaptation of Internet Addiction Scale into Turkish: The Study of Validity and Reliability. Journal of Faculty of Educational Sciences 2008;42(1),157-175.
23. 23. Anderson KJ. Internet usage among college students: An exploratory study. Journal of American College Health 2001;50(1),21-26.
24. 24. Damasceno LHF, Catarin SRG, Campos AD, Defino HLA. Lumbar lordosis: a study of angle values and of vertebral bodies and intervertebral discs role. Acta Ortop Bras 2006;14(4):193-198.
25. 25. Jackson RP, McManus AC. Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size: a prospective controlled clinical study. Spine 1994;19:1611-8.
26. 26. Guigui P, Levassor N, Rillardon L, Wodecki P, Cardine L. Valeur physiologique des parametres pelviens et rachidiens de l’equilibre sagittal du rachis-analyse d’une serie de 250 volontaires. Rev Chir Orthop. 2003;89:496-506.
27. 27. Imagama S, Hasegawa Y, Matsuyama Y, Sakai Y, Ito Z, Hamajia N, Ishiguro N. Influence of sagittal balance and physical ability associated with exercise on quality of life in middle-aged and elderly people. Arch Osteoporos 2011;6:13-20.
28. 28. Simpson AK, Whang PG, Jonisch A, Haims A, Grauer JN. The radiation exposure associated with cervical and lumbar spine radiographs. J Spinal Disord Tech 2008;21(6):409-412.
29. 29. Ghogawala Z, Martin B, Benzel E, Dziura J, Magge SN, Abbed KM, et al. Comparative effectiveness of ventral vs dorsal surgery for cervical spondylotic myelopathy. Neurosurgery-online 2011;68(3);622-630.