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16 June 2025

Effects of Smartphone Use on Posture and Gait: A Narrative Review

and
Motion Science Lab, Graduate School of Sports Medicine, CHA University, Seongnam 13503, Republic of Korea
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Author to whom correspondence should be addressed.
Appl. Sci.2025, 15(12), 6770;https://doi.org/10.3390/app15126770
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Abstract

Advances in information technology and the widespread adoption of smartphones have improved human convenience and quality of life by facilitating extensive information sharing. However, the increasing frequency and duration of smartphone use is linked to a high risk of musculoskeletal disorders, particularly manifesting as changes in posture and gait. These alterations can lead to various physical issues, including spinal deformities, reduced gait stability, and increased muscle fatigue. Furthermore, excessive smartphone use can negatively affect mental health, contributing to depression, anxiety, and cognitive impairment. This narrative review primarily aims to systematically examine the effects of smartphone-related posture and gait alterations on physical function and identify associated problems. This study systematically summarized individual studies published between 2009, when smartphones first became widespread, and 2024 that investigated the effects of smartphone-induced posture and gait alterations. Through identifying issues related to these alterations, we aim to propose preventive strategies to avoid further complications.

1. Introduction

As of late 2022, approximately 6.65 billion people—representing 83% of the global population—own a smartphone The extensive adoption of this technology has sparked international concerns regarding excessive smartphone usage. Studies have shown that students who frequently engage with their smartphones tend to report elevated levels of depression and anxiety [1]. An analysis of studies published between 2010 and 2019 revealed that neck and shoulder regions are the most frequently reported areas of discomfort among users. The reported prevalence of such musculoskeletal complaints varied widely, ranging from 32.5% to 85.6% [2]. Prolonged smartphone use can cause physical (posture and gait), psychological (depression, anxiety, and stress), and social issues (decreased work efficiency and productivity) [3,4]. Since their introduction in 2009, smartphones have significantly enhanced convenience in daily life, enabling social networking and information exchange [5,6] anytime and anywhere [5]. However, prolonged smartphone use induces spinal posture and gait alterations, thereby exacerbating the risk of musculoskeletal disorders [6]. Specifically, smartphone viewing increases cervical spine flexion, intensifying muscle load in the neck and shoulders and leading to elevated muscle fatigue [7]. On average, muscle activation while using a smartphone during walking was elevated by 21.2% compared to sitting and by 41.7% compared to standing [8]. Additionally, using smartphones while walking shifts the head forward, reduces stride length, and decreases gait speed [9,10] while limiting the visibility of obstacles and reducing reaction time, potentially creating hazardous situations [11,12].
Prolonged smartphone use can alter spinal posture across various age groups, significantly elevating the risk of spinal musculoskeletal disorders [5,13]. Particularly, it negatively affects posture throughout the entire spine, including cervical, thoracic, and lumbar regions [5,6,10,14,15,16,17,18,19,20,21]. For instance, text messaging reduces cervical rotation angles by approximately 2–4 degrees on average and increases thoracic and lumbar flexion, potentially causing pain and discomfort in the neck and shoulders [20]. Increased cervical flexion due to smartphone use also leads to the sustained contraction of the upper trapezius, elevating muscle activity and fatigue, which can result in discomfort and pain [14,17,18]. Short-term spinal posture alterations will progressively intensify with the prolonged duration and increased frequency of smartphone use, ultimately leading to diverse spinal joint issues.
Excessive smartphone use also alters gait patterns [9,12,22]. Specifically, biomechanical gait changes, including reduced stride length, decreased cadence, and slower gait speed, are commonly observed [23]. Additionally, smartphone use while walking constitutes a dual-task scenario, temporarily diminishing attention and cognitive function [24,25,26]. Particularly, texting while walking heightens cognitive demands, leading to decreased overall gait speed, reduced text comprehension, and increased gait variability [26].
The primary objective of this study is to systematically review and summarize individual studies investigating the effects of smartphone use on spinal posture and gait alterations. Although reviews published since 2020 have examined either spinal posture [27] or gait alterations [27,28] due to smartphone use in healthy individuals, reviews addressing both simultaneously remain limited [27].

2. Materials and Methods

Individual studies examining the effects of smartphone use on spinal posture and gait were identified through a comprehensive narrative review. PubMed, Web of Science, Google Scholar, and CINAHL databases were systematically searched for studies published in SCIE journals listed in Journal Citation Reports between January 2009 and June 2024. The search strategy employed was as follows: “smartphone OR cellphone AND gait OR walking AND posture OR postural alignment [Title/Abstract]” across PubMed, Google Scholar, Web of science and CINAHL databases. A total of 3259 articles were initially retrieved; among these, 3067 articles unrelated to spinal posture and gait were excluded. Of the remaining 192 studies, 153 studies that did not include healthy participants were excluded, along with an additional 12 studies lacking gender specification. This process resulted in the final inclusion of 27 studies in this review.

3. Results

The abstracts and titles of the 3259 articles retrieved through the initial database search were reviewed. Of 39 studies investigating smartphone use-related spinal posture and gait alterations, 12 lacking gender specification were excluded, yielding 27 studies included in this review (Figure 1). The authors, study designs, participants, outcomes, and discussions of each selected study were thoroughly reviewed. A total of 27 studies, comprising 14 investigating the impact of smartphone use on spinal posture and 13 examining gait alterations, were selected, with their dependent variable outcomes summarized in Table 1 and Table 2. Figure 2 and Figure 3 conveniently illustrate the overall impact of smartphone use on posture and gait, providing a comprehensive overview at a glance.
Figure 1. A PRISMA diagram showing the selection process for the systematic review.
Table 1. Extracting relevant data from studies examining the effects of smartphone use on posture.
Table 2. Extracting relevant data from studies examining the effects of smartphone use on gait.
Figure 2. Alterations in cervical, thoracic, and lumbar spine biomechanics during and after smartphone use.
Figure 3. Alterations in cognitive function and gait biomechanics during smartphone use.

4. Discussion

Since the widespread adoption of smartphones in 2009, numerous studies over the past 15 y have explored their effects on human posture and gait. However, recent systematic reviews directly aligned with this study’s objectives—specifically, those examining smartphone-induced spinal posture and gait changes among healthy individuals—remain limited to reviews published in 2020 and 2023 [27,37]. Bruyneel’s 2020 review comprehensively assessed 46 individual studies related to smartphone-induced changes in posture and gait [27]. The current review builds on this by incorporating recent individual studies published after October 2020, which were not included in earlier reviews [5,9,10,15,18,26,30,33,34,36,38]. Bruyneel’s more recent 2023 review focused on smartphone-related gait alterations and included data from healthy participants, older adults, and individuals with cognitive impairments [27]. The current review extends this work [25] by incorporating additional studies on smartphone-induced gait alterations [27,34,35,36,38,39,40,41,42,43] and exclusively includes research involving healthy individuals, excluding studies on populations with specific clinical disorders. Smartphones have become indispensable in modern life; yet, while offering convenience, they also negatively affect physical functioning, underscoring their dual impact. Therefore, this study aims to provide a comprehensive synthesis of the literature on the effects of smartphone use on posture and gait. Through a narrative analysis, this review systematically evaluates how increased smartphone usage—both in frequency and duration—affects spinal postural alignment and key gait parameters, including walking speed [5,14,15,20,25].

4.1. Effect of Smartphone Use on Static Posture

4.1.1. Effect of Smartphone Use on Cervical Spine Posture

Seven studies have investigated the effects of smartphone use on cervical spine posture [5,11,12,13,14,15,16,17]. Prolonged smartphone use has been shown to significantly increase cervical flexion angles, thereby elevating the risk of posture-related cervical issues [15,17]. For example, using a smartphone while seated without backrest support increased cervical head flexion by approximately 2° [5]. Similarly, individuals who used smartphones for more than 4 h per day exhibited forward head posture angles that were, on average, 9° greater than those who used them for less than 4 h [14]. Collectively, these findings indicate that smartphone use shifts the head position anteriorly, increases cervical flexion, raises muscular loading around the cervical spine, and slows cervical nerve conduction velocity [14]. Additional studies have shown that smartphone usage exceeding 3 h daily contributes to greater cervical flexion angles, increasing biomechanical load and elevating the risk of cervical intervertebral disk herniation and degeneration [44,45].

4.1.2. Effect of Smartphone Use on Thoracic Spine Posture

Four studies have assessed the impact of smartphone use on thoracic spine posture [10,15,30,31]. The results indicate that thoracic flexion angles increase by approximately 5° with every additional 5 min of smartphone use, particularly during durations of 5, 10, and 15 min. These findings have been consistently supported across multiple studies examining thoracic posture during smartphone use [10,15,30,31].

4.1.3. Effect of Smartphone Use on Lumbar Spine Posture

Four studies have examined lumbar spine posture in relation to smartphone use [15,30,32,33]. Prolonged smartphone use has been associated with alterations in lumbar lordosis [15] and an increased prevalence of lumbar musculoskeletal disorders, including lumbar disk herniation, spinal stenosis, and chronic lower back pain [30,32]. The prolonged maintenance of static postures during work has been identified as a significant risk factor contributing to the increased prevalence of lumbar disorders [30]. Office workers who sit for prolonged periods may face a heightened risk of lumbar disorders due to the increased frequency and duration of smartphone use [30]. Forward trunk flexion during smartphone use increases posterior displacement forces on lumbar intervertebral disks, heightening the risk of herniation and joint stress [15]. Additionally, treadmill-based studies have shown that smartphone use can increase lumbar repositioning errors by approximately 3°, likely due to proprioceptive deficits [32]. These findings were attributed to deficits in the proprioceptive sense associated with lumbar repositioning errors [32]. Considering these results, smartphone use may pose risks by potentially causing lumbar dysfunction through proprioceptive deficits and increased joint stress. A study examining the association between spinal curvature and smartphone use found that using a smartphone with one arm restrained reduced lumbar lordosis angles by approximately 0.07 degrees. This reduction in the lumbar lordosis angle led to increased erector spinae muscle activation, potentially causing various lumbar musculoskeletal issues, such as lumbar disk disorders [33].

4.1.4. Effect of Smartphone Use on Muscle Activation and Muscle Fatigue

Four studies have investigated the impact of smartphone use on muscle activation and muscle fatigue [14,17,18,21]. Previous research focusing on cervical muscle activation revealed no statistically significant differences in activity among four muscle groups: the right splenius capitis, right upper trapezius, left splenius capitis, and left upper trapezius during maximal cervical flexion postures associated with smartphone use. However, higher average muscle fatigue values—approximately 0.2—were noted in the right splenius capitis, left splenius capitis, and left upper trapezius muscles. These findings indicate that maintaining a neutral cervical posture may be more effective in reducing muscle fatigue than adopting an excessively flexed cervical position [21]. Moreover, a study assessing the bilateral muscle activation of cervical spinal extensor muscles at four different smartphone viewing angles (0°, 15°, 30°, and 45°) found that maximum voluntary isometric contraction increased by approximately 2% with each 15° increment in the viewing angle [18]. Prolonged smartphone use, particularly at angles around 50°, can lead to the hyperactivation of cervical extensor muscles, potentially resulting in headaches and increased cervical disk pressure. Additionally, the excessive activation of the bilateral upper trapezius muscles may exacerbate neck and shoulder pain, further intensifying forward head posture and kyphosis [14,17].

4.2. Smartphone and Gait

4.2.1. Effect of Smartphone Use on Walking Speed

Six studies have reported decreased walking speeds associated with smartphone use [24,26,29,34,35,39]. Compared to single-task walking without a smartphone, dual-task walking—such as reading text messages—resulted in an approximate reduction of 0.16 m/s in walking speed [26]. Additionally, a study involving 308 participants aged 20 to 60 y indicated an average reduction of 0.31 m/s while sending text messages [24]. These findings underscore smartphone use as a significant factor contributing to reduced walking speed, highlighting substantial risks associated with texting while walking.
Notably, older adults (aged 60 and older) experienced a more pronounced decrease in walking speed, averaging 0.4 m/s slower while texting. Specifically, among older individuals, walking speed dropped by approximately 1.3 m/s when using smartphones [35]. Such outcomes illustrate that smartphone use leads to cognitive distraction and diminished situational awareness. Activities like sending or reading messages significantly impair walking speed due to diverted visual attention and cognitive overload. Therefore, it is recommended to perform these tasks while stationary. Research has also shown that smartphone use during obstacle negotiation alters the center of mass, leading to gait imbalance, increased visual distraction, and heightened pelvic movement, all of which contribute to gait instability [29]. Increased smartphone addiction further diminishes gait attention and significantly raises the risk of accidents [40]. Reduced walking speed poses safety concerns, particularly at crosswalks where focused attention is critical [34].

4.2.2. Effect of Smartphone Use on Gait Biomechanics

Four studies have examined gait biomechanics, specifically kinematic, kinetic, and electromyographic variables, in relation to smartphone use [25,33,37,38]. In a gait kinematics study, texting while walking resulted in a 4.4-degree reduction in pelvic rotation and a 1.82-degree increase in head rotation [25]. Another study comparing single-task walking with a walk-and-converse task observed a reduction in ankle dorsiflexion by 0.15 degrees and hip flexion by 0.14 degrees [37]. These findings suggest that gait kinematics can vary depending on specific smartphone use tasks. Regarding kinetics, the texting group exhibited an increased center-of-pressure sway area by approximately 1.4 cm compared to the no-cell-phone group during walking [38]. Another study demonstrated a 28.8% reduction in thoracic rotation when participants walked while using smartphones compared to normal walking conditions. This reduction in thoracic rotation increased thoracic muscle fatigue, exaggerated thoracic kyphosis, and consequently heightened pain in the thoracolumbar region [27]. Since dual tasks can induce kinematic and kinetic changes, additional studies are required to further investigate other biomechanical variables affecting gait alterations.

4.2.3. Effect of Smartphone Use on Gait Parameters

Four studies have explored the effects of smartphone use on gait parameters, specifically focusing on step length and width [7,25,34,43]. Notably, a comparison of two trials—walking without a phone at a comfortable velocity and walking with a phone at a similar velocity—demonstrated a reduction of approximately 4 cm in both right and left step lengths, alongside an increase in step width of approximately 0.93 cm [34]. Furthermore, participants who engaged in texting while walking exhibited a 0.2 m decrease in step length relative to those walking without smartphone use [25]. These findings indicate that alterations in gait kinematics, exacerbated by reduced arm swing due to screen focus, likely contribute to modifications in step length and width.
Research on diminished gait parameters has shown that changes in stride length, cadence, and double support time culminated in an approximate 33.9% reduction in walking speed compared to conditions without smartphone use. This decline in speed and stability is associated with decreased attentiveness, thereby potentially heightening fall risk [43]. Prior studies have similarly reported reduced foot clearance and compromised gait stability during smartphone use while walking [7]. Collectively, these findings suggest that negative alterations in gait parameters may decrease stability, mimic patterns observed in older populations, slow movement, impair attention, and subsequently elevate fall risks. Accordingly, exercising caution while using smartphones during ambulation is strongly recommended.

4.2.4. Effect of Smartphone Use on Cognitive Function

Three studies have investigated the impact of smartphone use on cognitive function [25,26,41]. One such study evaluated text comprehension and cognitive flexibility among 30 participants engaged in various tasks, including sending text messages, reading texts on smartphones, and writing tasks [26]. The results indicated that engaging in dual tasks involving texting while walking resulted in a reduction of approximately 23% in text comprehension compared to single-task writing or dual-task conditions involving simultaneous writing and texting with a smartphone [26]. The resultant decrease in gait stability during dual-task performance may contribute to diminished text comprehension, thereby impairing executive function and reflecting an overall decline in cognitive performance.
Moreover, additional research has shown that continuous smartphone use adversely affects cognitive function, correlating with decreased ability to walk in a straight line, attention deficits, heightened collision risk, and an increased likelihood of traffic accidents [25]. These findings suggest that activities such as reading or sending text messages may exacerbate gait variability, indicating a reduction in cognitive flexibility. Other studies have similarly reported a heightened risk of falls associated with cognitive impairment, particularly noting challenges in executing motor tasks, such as ascending and descending stairs [41].

4.3. Limitations of the Study

This study has some limitations that should be carefully considered. First, future research should include a greater number of studies capable of providing detailed evaluations of joint function. Prior investigations into posture and gait alterations have revealed three key limitations. Firstly, data collection regarding participants’ educational levels and cognitive status according to age groups was insufficient [20]. Secondly, certain studies failed to adequately reflect the unique characteristics of participants [42]. Thirdly, many studies have been limited to specific age groups or genders [7]. A specific limitation of the current study is the relatively small sample size, highlighting the need for larger cohorts in future longitudinal research. Additionally, while it is clear that smartphone use affects posture and gait, these changes may progressively impact spinal kinematics and overall physical function. Thus, follow-up studies are needed to investigate the long-term consequences of these alterations.
Beyond musculoskeletal concerns, future research should aim to collect standardized, comprehensive data using advanced technologies that incorporate neuromuscular and anatomical modeling. For instance, AI-based systems capable of visually displaying individualized neuromuscular and anatomical dysfunction metrics could offer targeted recommendations for correcting posture and gait.
Furthermore, the clinical applicability of findings should be expanded by incorporating diverse age groups—from children to older adults—into research protocols. Additional research is needed to determine which age groups are most vulnerable to posture- and gait-related musculoskeletal changes due to smartphone use and delineate how the duration of use influences these outcomes across different ages.

5. Conclusions

This narrative review primarily aimed to systematically examine the biomechanical and functional consequences of smartphone-induced posture and gait alterations on physical function. Based on the synthesis of 27 selected studies, this review identified that excessive smartphone use contributes to significant postural deviations across the cervical, thoracic, and lumbar spine, increased muscle fatigue, and impaired neuromuscular efficiency. Gait parameters—including walking speed, stride length, and joint kinematics—were also negatively affected, particularly under dual-task conditions such as texting while walking. These findings suggest that smartphone overuse poses substantial risks to musculoskeletal health, functional mobility, and overall safety. The evidence emphasizes the need for comprehensive research into the cumulative effects of posture and gait disturbances and their long-term implications for physical functioning. Additionally, this review highlights the importance of incorporating both postural and gait assessments in future studies to inform clinical practices and public health policies. Further longitudinal and interventional research is needed to better understand the progression and impact of these biomechanical changes over time.

Author Contributions

Conceptualization, I.G.L. and S.J.S.; writing—original draft preparation, I.G.L.; writing—review and editing, I.G.L. and S.J.S. All authors have read and agreed to the published version of the manuscript.

Funding

This research received no external funding.

Institutional Review Board Statement

Not applicable.

Data Availability Statement

Not applicable.

Conflicts of Interest

The authors declare no conflicts of interest.

Abbreviations

The following abbreviations are used in this manuscript:
FHPForward head posture
EMGElectromyography
VASVisual analog scale
VPVertebra prominens
GNGaze neutral
S1HSmartphone one-handed
S2HSmartphone two-handed
CESCervical erector spinae
UTUpper trapezius
BBimanual
AFAsymmetric finger
SSingle-handed
ATAsymmetric thumb
NFNeck flexion
HFHead flexion
GAGaze angle
VDViewing distance
TESThoracic erector spinae
LTLower trapezius
APDFAmplitude probability distribution function
ROMRange of motion
PPTPressure pain threshold
VTVertical
APAnteroposterior
MLMediolateral
NWNormal walking
WLPWalking while looking at the phone
WLLLPWhile looking at the phone using one hand
WTPWalking while talking on phone
WMWalking while listening to music
RFRectus femoris
VMVastus medialis
TATibialis anterior
GAGastrocnemius
BFBiceps femoris
GMGluteus medius
TUGTimed up and go
BMIBody mass index
TEXTTexting
TALKTalking
OCObstacle crossing
COMCenter of mass
CCControl
ICCIndividual conversation
GCGaming
GCCGroup conversation

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