A multi-dimensional assessment of internet gaming disorder in children and adolescents: A case-control study

BACKGROUND: Internet gaming disorder (IGD) leads to social disturbances and isolation, neglect of daily responsibilities, behavioral disorders, and physical impairments.

OBJECTIVE: This study aimed to investigate the effect of IGD on spine biomechanics, range of motion in the neck and low back, and lung functions and respiratory muscle strength in children and adolescents.

METHODS: Sixty-four children and adolescents with IGD (Group I) and 41 healthy controls (Group II) were included in the study. The outcomes were assessed with the Visual Analogue Scale (VAS), Internet Addiction Scale, active range of motion (AROM) in the neck and lumbar spine, posture and spinal alignment, lung function tests, and respiratory muscle strength.

RESULTS: There is a significant difference in pain intensity at rest, during activity, and daily sitting time between groups (p < 0.05). Craniovertebral angle, shoulder asymmetry, thoracic kyphosis angle, cervical extension and rotation, and right lumbar rotation significantly decreased in Group I than in Group II (p < 0.05). Besides, the PEF, FEF 25-75%, and respiratory muscle strength were lower in Group I than in Group II (p < 0.05). With a multiple linear regression model, MEP, FEV1, and weekly time spent playing online games were significant predictors of internet addiction intensity (R-2 = 0.28; p = 0.02, p = 0.01, and p < 0.001, respectively).

CONCLUSION: Postural misalignment and increased sedentary time cause physical health deterioration and negatively affect lung functions in children and adolescents with IGD. Consequently, considering both psychological and physical health is necessary to assess the problematic nature of internet gaming. A comprehensive assessment and multidisciplinary team approach is essential to managing the IGD.