Reliability of two pragmatic tools for assessing text neck

BACKGROUND: There is a hypothesis that the growing use of mobile phones in an inappropriate posture to text and read (text neck) could be a reason for the increasing prevalence of neck pain in the past decade. Before testing if there is an association between text neck and neck pain, it is necessary to develop reliable pragmatic tools appropriate to epidemiological studies. OBJECTIVES: The primary aim of this study was to assess the reliability of the self-perception of text neck, as well as the reliability of physiotherapists' classification of the text neck. METHODS: The convenience sample was composed of 113 high school students between 18 and 21 years old from a cross-sectional study. As their self-perceived posture, participants had to choose in a questionnaire one of four neck postures of a person texting on a mobile phone. The physiotherapists classified lateral photographs taken with the participants texting on a mobile phone in their habitual posture as 1 (normal), 2 (acceptable), 3 (inappropriate), and 4 (excessively inappropriate). RESULTS: The results showed that the test-retest reliability of the self-perception was substantial (kappa = 0.73, 95% CI 0.54 to 0.86). The reliability of the physiotherapists' responses, according to the photographic analysis considering the three raters, was moderate (kappa = 0.5, 95% CI 0.39 to 0.61). Seventy-six percent of the participants with appropriate posture in the photographic analysis self-reported an inappropriate posture. CONCLUSION: This study showed that the self-perception of the neck posture during mobile phone texting is reliable over time and that the physiotherapists' classification based on photographic analysis was acceptable for epidemiological studies. Participants had a tendency to report that the posture was worse than it actually was in the photographic analysis performed by the physiotherapists.