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ARTICLE TYPE : RESEARCH ARTICLE

Published on :   15 May 2026, Volume - 2
Journal Title :   WebLog Journal of Physical Therapy and Rehabilitation | WebLog J Phys Ther Rehabil | WJPTR
Journal ISSN:   3071-401X
Source URL:   weblog icon https://weblogoa.com/articles/wjptr.2026.e1501
Permanent Identifier (DOI) :   doi icon https://doi.org/10.5281/zenodo.20230324

Effectiveness of Multimodal Ergonomic Interventions Versus Standard Postural Education for Smartphone Related Postural Dysfunction: A Three-Arm Randomized Controlled Trial

P. Muthukrishnan 1 *
Dr. Rajadurai 2
1Department of Musculoskeletal Physiotherapy, Meenachi Higher Education and Research Centre, Chennai, Tamil Nadu, India
2Department of Orthopedic and Rehabilitation Medicine, Meenachi Higher Education and Research Centre, Nagar, Chennai, Tamil Nadu, India

Abstract

Background: Smartphone-related postural dysfunction (SRPD), encompassing forward head posture (FHP), thoracic kyphosis, and rounded shoulder deformity, has emerged as a significant musculoskeletal public health concern. While postural education is widely used, it lacks the environmental and behavioral specificity required for durable correction in habitual smartphone users.

Objective: To evaluate and compare the effectiveness of three interventions — Multimodal Ergonomic Intervention (MEI), Wearable Posture Biofeedback Training (WPBT), and Standard Postural Education (SPE) — on postural parameters, pain, disability, and behavioral smartphone habits in adults with SRPD.

Design: Three-arm, parallel-group, assessor-blinded Randomized Controlled Trial (RCT).

Setting: Physiotherapy Outpatient and Occupational Health Department, Tamil Nadu, India.

Participants: 120 adults aged 18-40 years with clinically confirmed SRPD and habitual smartphone use ≥5 hours/day.

Interventions: Group A (MEI, n=40): workstation/device ergonomic restructuring + targeted exercise + behavioral modification. Group B (WPBT, n=40): real-time posture biofeedback via wearable sensor + corrective exercise. Group C (SPE, n=40): structured postural education sessions (active control). Duration: 8 weeks.

Outcome Measures: Primary — Craniovertebral Angle (CVA) via photogrammetry; Thoracic Kyphosis Index (TKI). Secondary — VAS, NDI, Rounded Shoulder Angle (RSA), Smartphone Addiction Scale-Short Version (SAS-SV), and adherence rates.

Results: Group A (MEI) demonstrated the greatest improvement in CVA (9.4° improvement, p<0.001) and long-term behavioral outcomes (SAS-SV reduction: 34.2%). Group B (WPBT) showed superior short-term postural correction adherence (82.4%) and VAS pain reduction (52.8%). Group C (SPE) showed statistically significant but clinically modest improvements across all domains. No serious adverse events were recorded.

Conclusion: Multimodal ergonomic intervention produces the most comprehensive and durable outcomes for smartphone-related postural dysfunction. Wearable biofeedback adds significant value for real-time compliance monitoring. An integrated MEI-WPBT protocol is recommended for clinical practice and workplace health programs.

Keywords: Smartphone Ergonomics, Postural Correction, Forward Head Posture, Wearable Biofeedback, Text Neck, Thoracic Kyphosis, Randomized Controlled Trial, Physiotherapy, Behavioral Intervention, Craniovertebral Angle

Citation

Muthukrishnan P, Rajadurai. Effectiveness of Multimodal Ergonomic Interventions Versus Standard Postural Education for Smartphone-Related Postural Dysfunction: A Three-Arm Randomized Controlled Trial. WebLog J Phys Ther Rehabil. wjptr.2026.e1501. https://doi.org/10.5281/zenodo.20230324
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