Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Apr 26;17(4):e83025.
doi: 10.7759/cureus.83025. eCollection 2025 Apr.

Text Neck and Its Association With Cardiac Autonomic Function, Smartphone Addiction, and Psychophysiological Status in Young Adults

Divyasree Sureshbabu  1 , Rajasegaran Rajalakshmi  1 , Praveen Prakash  1 , Sonit S Vasipalli  1
Affiliations

Text Neck and Its Association With Cardiac Autonomic Function, Smartphone Addiction, and Psychophysiological Status in Young Adults

Divyasree Sureshbabu et al. Cureus. .

Abstract

Background The increasing use of mobile devices has led to a rise in forward head posture (FHP), or "text neck," contributing to health issues. Additionally, nomophobia, or the fear of being without a mobile phone, has emerged as a growing behavioral concern, particularly among younger users. Methods This cross-sectional study aimed to assess FHP and its association with cardiac autonomic function, smartphone addiction, nomophobia, ergonomic risk, and neck disability in 84 participants aged 19-45 years. FHP was evaluated via craniovertebral (CV) angle measurement and cardiac autonomic status through heart rate variability, alongside smartphone addiction and psychological distress. Results Heart rate variability (HRV) analyses revealed a significant inverse relationship between the CV angle and the LF/HF ratio, indicating heightened sympathetic activity with reduced CV angle. Parasympathetic indicators, root mean square of successive differences between adjacent NN intervals (RMSSD) and pNN50, positively correlated with CV angle, suggesting a link between optimal posture and enhanced parasympathetic function. Psychophysiological assessments showed that smartphone addiction moderately correlated with nomophobia. Conclusion Text neck or forward head posture is associated with increased sympathetic and decreased parasympathetic modulation, as evidenced by HRV indices.

Keywords: forward head posture; heart rate variability (hrv); neck disability index (ndi); nomophobia; text neck syndrome.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Institutional Ethics Committee for Observational Studies issued approval #JlP/IEC-OS/2024/92. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

References

    1. Neck pain: global epidemiology, trends and risk factors. Kazeminasab S, Nejadghaderi SA, Amiri P, et al. BMC Musculoskelet Disord. 2022;23 - PMC - PubMed
    1. Prevalence of text neck syndrome, its impact on neck dysfunction, and its associated factors among medical students: a cross-sectional study. Salameh MA, Boyajian SD, Amaireh EA, et al. https://pubmed.ncbi.nlm.nih.gov/38875069/ Work. 2024;79:1111–1119. - PMC - PubMed
    1. Photographic measurement of head and cervical posture when viewing mobile phone: a pilot study. Guan X, Fan G, Wu X, et al. Eur Spine J. 2015;24:2892–2898. - PubMed
    1. The effect of smartphone usage time on posture and respiratory function. Jung SI, Lee NK, Kang KW, Kim K, Lee DY. J Phys Ther Sci. 2016;28:186–189. - PMC - PubMed
    1. Correlation between chronic neck pain and heart rate variability indices at rest: a cross-sectional study. Santos-de-Araújo AD, Dibai-Filho AV, Santos SN, et al. J Manipulative Physiol Ther. 2019;42:219–226. - PubMed

LinkOut - more resources