Computers are now widely used by children. Tablet computers are becoming widely available and promoted for use by school children. The primary objective of this study was to compare the posture and muscle activity of children using a tablet computer to the posture and muscle activity of children using a desktop computer and paper technology. Eighteen children (mean age 5.6 years) performed a colouring-in task in tablet, desktop and paper conditions. 3-D posture and muscle activity around the neck and shoulder was assessed. Tablet computer use was similar to paper use, with less neutral spinal posture, more elevated scapular posture and greater upper trapezius and cervical erector spinae activity. This was offset by greater variability of posture and muscle activity. Tablet computer use clearly results in different musculoskeletal stresses than desktop computer use. Computer use guidelines need to be appropriate to traditional and emerging technologies. Tablet computers are being promoted for use by adults and children. However, the physical impact of using this type of technology is not known. The findings of this study provide the first tablet-specific evidence to inform guidelines on wise use of tablet computers by children.

Posture and adolescent spinal pain may be linked, so adolescent posture measurement is important. Static photographic analysis of posture is practical for large-scale studies of adolescents, but only one adolescent study has investigated its reliability. The aim was therefore to assess the reliability of photographic spinal posture assessment in adolescents. Interrater reliability was measured, as the purpose was to assess the method for large-scale epidemiological studies with multiple raters. Twenty-two healthy adolescent subjects (11 males, 11 females) aged 13Á17 were photographed by four different examiners while standing, sitting and slumped. Eight spinal postural angles and four distance measures were derived. Interrater reliability was quantified by interclass correlation coefficients (ICCs) for consistency, ICCs for absolute agreement between raters and standard errors of measurement (SEMs). Inter-rater reliability was fair (ICC 0.4) to good (ICC 0.75) for all measures in standing except pelvic tilt and sway angle, and for all measures in sitting except head flexion and craniocervical angle. Poorer ICCs for agreement than consistency were observed, reflecting a significant rater effect for most measures. Photographic analysis of adolescent posture has fair reliability, and is appropriate for large-scale adolescent studies. Future studies should observe several precautions to optimize reliability.

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Computer display height and desk design are believed to be important workstation features and are included in international standards and guidelines. However, the evidence base for these guidelines is lacking a comparison of neck/shoulder muscle activity during computer and paper tasks and whether forearm support can be provided by desk design. This study measured the spinal and upper limb muscle activity in 36 young adults whilst they worked in different computer display, book and desk conditions. Display height affected spinal muscle activity with paper tasks resulting in greater mean spinal and upper limb muscle activity. A curved desk resulted in increased proximal muscle activity. There was no substantial interaction between display and desk. Crown