Functional Impact of Text Neck Syndrome and Its Relationship with Upper Extremity Function and Sleep Quality Among Physiotherapy and Rehabilitation Students

Abstract

Background: Text Neck Syndrome (TNS) is an increasingly recognized musculoskeletal condition caused by sustained forward head flexion during smartphone and handheld-device use. While its prevalence among students has been widely documented, fewer studies quantify its functional consequences using validated outcome measures or examine how symptom severity relates to upper extremity function and sleep quality. Objectives: This paper (1) assesses the functional impact of TNS among university students using validated tools, namely the Neck Disability Index (NDI) and a numeric pain rating scale, and (2) examines the relationship between the severity of TNS and upper extremity function and sleep quality. Methods: A descriptive cross-sectional study was conducted among 200 Physiotherapy and Rehabilitation students (143 female, 57 male; mean age 22.11 ± 2.07 years) at the European University of Lefke. Functional impact was measured using the NDI and a Numeric Pain Rating Scale (NPRS); upper extremity function was measured using the Upper Extremity Functional Index (UEFI); and sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Descriptive statistics, chi-square tests, and correlation analysis were computed using SPSS. Results: Neck disability was present in 48.5% of participants (33% mild, 13% moderate, 2.5% severe), and neck pain was reported by 45.3% of participants, with a significant association between NDI scores and daily smartphone duration (p = 0.0049) and between neck pain and NDI scores (p < 0.001). Upper extremity dysfunction was less common but still present in 26.5% of participants (16.5% mild, 10% moderate). Poor sleep quality was reported by 18.5% of participants. Conclusion: TNS produces measurable functional disability of the neck and, to a lesser but meaningful extent, of the upper extremities and sleep quality among physiotherapy students, supporting early ergonomic intervention and awareness programs in this population.