1.    Introduction
Improper postures maintained during prolonged work and job assignments can result in musculoskeletal Due to the significant increase in the usage of hand-held digital devices and smartphones in society, particularly among individuals aged 20 to 35, a range of issues has emerged. In addition to musculoskeletal problems, there is a rising trend of complications such as smartphone addiction, social relationship damage, social isolation, anxiety, and depression among users (1, 2). These factors have accelerated the progression of physical health problems among users (3). A large portion of individuals using hand-held digital devices, including computers, laptops, digital games, and smartphones, are susceptible to developing musculoskeletal disorders in their upper limbs due to prolonged exposure to incorrect body positions (4). Furthermore, among the contributing factors to skeletal disorders in the upper body among frequent and long-term smartphone users is the pressure exerted on these areas (5).
2.    Methods
This study collected research conducted on the impact of new communication technologies, such as mobile phones, tablets, and personal computers, particularly from 2013 to 2023. Keywords used for the search included: smartphone, tablet, computer, upper limb deformity, children, elementary school children, muscle and skeletal pain, posture, muscle function, skeletal muscle abnormalities, visual balance system, biomechanical methods, and mental capabilities. Searches were conducted in Latin across journals and websites.
3.    Results
A study examining the daily use of mobile phones among students aged 6 to 11 revealed that the sitting position significantly increased neck flexion compared to standing. Additionally, neck flexion was observed to increase when holding a mobile phone with two hands or while typing (6). Another study involving 10-13-year-old female students identified factors influencing skeletal abnormalities within the human skeletal system (7). In a study of 1642 Japanese children aged 6 to 8 in their first year of elementary school, routine and frequent mobile phone use was found to be associated with childhood behavioral problems (8). A review article systematically investigating musculoskeletal disorders, abnormalities, and pain among primary school dancers in Hong Kong found increased activity in the upper trapezius muscles, erector spinae, and neck extensor muscles, as well as increased head bending angle, head tilt angle, and forward head movement during smartphone use (9). Research conducted in Thailand highlighted that prolonged smartphone use exceeding 60 minutes, particularly among children aged 6 to 9, was a significant factor in musculoskeletal pain (10).

4.    Conclusion
The results indicate that excessive use of virtual space by students in educational and recreational activities may have several detrimental effects on skeletal health. Notably, it significantly increases neck flexion compared to the standing position. Furthermore, neck flexion is observed to increase when holding a mobile phone with two hands or while typing. Additionally, significant differences were found in the upper limb position between short-term and long-term users of smartphones, as well as between men and women regarding shoulder position. It appears that smartphone usage in a seated position alters the angle of the head and neck more than when standing, potentially contributing to musculoskeletal disorders. Prolonged smartphone use, particularly exceeding 60 minutes, emerges as a significant factor in the development of musculoskeletal pain, especially among children aged 6 to 9 years. Approximately 53% of students reported using their smartphones while lying down, with prone positioning during smartphone use being 7.37 times more hazardous than sitting (6, 12-14).

Ethical Considerations
Compliance with ethical guidelines
There were no ethical considerations to be addressed in this research.
Funding
This research did not receive any grants from funding agencies in the public, commercial, or non-profit sectors.
Authors' contributions
All authors contributed equally to preparing the article.
Conflicts of interest
The authors declared no conflict of interest.