Correlation Between Upper Cross Syndrome and Smartphone Addiction in University Students

Abstract

Background: Smartphone addiction is increasingly common among university students and may contribute to sustained forward head posture, rounded shoulders, and postural muscle imbalance associated with Upper Cross Syndrome. Objective: To determine the correlation between smartphone addiction severity and clinical indicators of Upper Cross Syndrome among university students. Methods: This cross-sectional observational study included 167 university students aged 19–24 years from universities in Lahore who used smartphones for at least four hours daily and met predefined Smartphone Addiction Scale–Short Version thresholds. Smartphone addiction was assessed using the SAS-SV, while Upper Cross Syndrome-related findings were evaluated through pectoralis major contracture, middle trapezius weakness, and lower trapezius weakness tests. Descriptive statistics were used for demographic and clinical variables, and correlation analysis was performed between SAS-SV scores and Upper Cross Syndrome-related clinical findings. Results: The sample included 46 males (27.5%) and 121 females (72.5%), with a mean age of 21.51 ± 1.51 years and mean SAS-SV score of 44.37 ± 6.64. Pectoralis major contracture was present in 60 participants (35.9%), middle trapezius weakness in 109 (65.3%), and lower trapezius weakness in 102 (61.1%). SAS-SV score showed weak positive correlations with middle trapezius weakness (r = 0.24), lower trapezius weakness (r = 0.23), and composite Upper Cross Syndrome status (r = 0.22), while correlation with pectoralis major contracture was weaker (r = 0.11). Conclusion: Upper Cross Syndrome-related findings were common among students with elevated smartphone addiction scores, particularly posterior scapular stabilizer weakness. Smartphone addiction severity showed weak positive associations with trapezius weakness and composite Upper Cross Syndrome status