Spinal Posture According to the Severity of Gaming Disorder,

An Investigation of Spinal Posture, Endurance and Fatigue According to the Severity of Gaming Disorder

Background:

Internet Gaming Disorder (IGD) is a behavioral addiction recognized in diagnostic classifications such as DSM-5 and ICD-11. While research historically focuses on psychological and social dimensions, prolonged screen exposure and static sitting postures during gaming may also lead to physical health concerns, including postural alterations, reduced neuromuscular performance, and increased fatigue.

Objective:The purpose of this cross-sectional study is to evaluate and compare spinal posture, trunk and cervical muscle endurance, lumbopelvic stability, and perceived fatigue levels between young adult males with and without Internet Gaming Disorder. Methods & Procedures:A total of 47 young adult male participants aged 18-30 were recruited and divided into two groups: an IGD group (n=24) and a control group (n=23) based on the Internet Gaming Disorder Scale-Short Form (IGDS9-SF). Physical activity level and sitting duration were documented using the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Participants underwent the following evaluations: Spinal Posture: Non-invasive computer-aided sagittal spinal curvature and mobility measurements using the Spinal Mouse device (Baseline/IDIAG). Trunk Endurance: McGill Trunk Endurance Tests (Flexor, Extensor, and Bilateral Lateral Plank tests). Cervical Endurance: Deep Cervical Flexor and Cervical Extensor Endurance Tests. Lumbopelvic Stability: Pressure Biofeedback Unit (PBU) / Cuff test. Fatigue: Fatigue Severity Scale (FSS). Statistical Approach:Data are analyzed using SPSS (version 22.0). Normality distribution is examined visually (histograms) and analytically (Shapiro-Wilk test). Descriptive statistics are reported as mean ± standard deviation for continuous parameters. Group comparisons for parametric data are performed using the Independent Samples t-test, and non-parametric data are compared using the Mann-Whitney U test. Statistical significance is set at p < 0.05

Technological advances have significantly increased screen time among young adults, fostering high rates of sedentary behavior. Prolonged static sitting during video game play places abnormal mechanical stress on the musculoskeletal system, particularly the spine. Maintaining posture depends on spinal muscular endurance and sensorimotor coordination; however, static posture can lead to muscle fatigue, decreased endurance, altered spinal curvatures, and overall physical fatigue. Evidence regarding the specific musculoskeletal impacts of Internet Gaming Disorder (IGD) remains limited. Study Design & Participant Selection:This descriptive, cross-sectional study was approved by the Ethics Committee of Gaziantep Islamic Science and Technology University. Male volunteers aged 18-30 were recruited to eliminate gender-related physical variance. IGD Group Eligibility: Score of 36 or higher on the IGDS9-SF, gaming for at least 2 hours/day, physical activity under 3000 MET-min/week on IPAQ-SF, and no history of spinal surgery, neurological, or orthopedic disorders. Control Group Eligibility: Score below 36 on the IGDS9-SF, aged 18-30, with no neurological, orthopedic, or spinal conditions. Evaluation Protocol:All evaluations were conducted in a single 45-minute face-to-face session per participant by a single physiotherapist: Demographics & Behavior: Age, height, body weight, daily gaming duration, primary gaming hardware (PC, console, mobile), and game genres were documented. Physical Activity & Sedentary Time: Evaluated via IPAQ-SF (MET-min/week calculation for walking, moderate, and vigorous activities, plus daily sitting time in seconds). Spinal Posture Analysis: Measured with the Spinal Mouse device along the spine from C7 to S3. Sagittal parameters (Thoracic Kyphosis, Lumbar Lordosis, Inclination, and Spinal Length) were evaluated in three static positions: Upright Standing, Maximum Flexion, and Maximum Extension, alongside spinal mobility ranges. Trunk Muscle Endurance: Measured in seconds using the McGill Endurance Test Battery (gövde fleksiyon, gövde ekstansiyon, and right/left lateral plank tests). Cervical Muscle Endurance: Measured in seconds using the Cervical Flexor Endurance Test (supine with chin tuck) and Cervical Extensor Endurance Test (prone with head cantilevered over the bed edge). Lumbopelvic Stability: Assessed using the Pressure Biofeedback Unit (PBU) placed under the lumbar spine inflated to 40 mmHg, recording the duration (in seconds) that the participant maintains stability during an abdominal hollowing maneuver. Perceived Fatigue: Total score evaluated via the self-reported Fatigue Severity Scale. Statistical Methodology:All quantitative variables are processed with SPSS version 22.0. Normality testing is performed via the Shapiro-Wilk test and visual inspection of histograms. Continuous variables are summarized using mean ± standard deviation (X ± SD), minimum, and maximum values. Categorical variables (device type, game genre) are summarized as counts and percentages. Between-group comparisons are conducted using: Independent Samples t-test: For normally distributed continuous data. Mann-Whitney U Test: For non-normally distributed continuous data. Two-tailed significance is established at p < 0.05 for all statistical tests.

Inclusion Criteria:

• Aged between 18 and 30,

  • Scoring 36 points or more on the short form of the Internet Gaming Disorder Scale (IGDS9-SF),
  • With a score on the International Physical Activity Questionnaire Short Form (IPAQ-SF) of less than 3,000 METs,
  • who play digital games for at least 2 hours a day,
  • Male participants were included in order to create a more homogeneous group by minimising physical characteristics that might vary by gender.

Exclusion Criteria:

• Those who had undergone any form of spinal surgery, • Individuals with orthopaedic and neurological problems.