School-age children increasingly use smartphones to conduct their learning activities; increasing reports of disorders related to smartphone use exist, including visual-related symptoms, stress, and musculoskeletal pain. This study aimed to examine risk factors for musculoskeletal pain among primary school students using smartphones. A cross-sectional study was conducted with 233 school-aged children in Nakhon Si Thammarat, Thailand. Data collection used a questionnaire for musculoskeletal symptoms using the Nordic Musculoskeletal Questionnaire with ISO 11,226:2000. Through Chi-square, t-test, and logistic regression analysis, factors independently associated with musculoskeletal pain were determined. An important factor in the development of musculoskeletal pain was the prolonged use of smartphones for longer than 60 min, particularly among children aged 6–9 years old. In regards to musculoskeletal pain, almost 53% of the students used their smartphones while lying down. Posing in a prone position while using a smartphone was 7.37 times more dangerous than sitting. The laying position tilts numerous organs at varying angles, especially the upper arm. The risk of musculoskeletal complaints must be reduced by educating parents, children, and the relevant government organizations about safe smartphone usage. The mentioned factors may be used to anticipate the onset of musculoskeletal pain caused by smartphone use in young children.

The playground is perhaps the one area where school children feel like they can roam free, and public playgrounds provide many learning opportunities through different types of play. A cross-sectional descriptive study is presented with the objective of studying playground safety and the play behavior of primary school children at a park in Nakhon Si Thammarat Province, Thailand. The total number of playground equipment pieces was 22, the sample group of children was 362 children, and the data were collected using a playground safety survey and an observation form on playground play behavior. Data were collected from 2017 to 2018 and were analyzed using descriptive statistics including frequency, average, and standard deviation. The research showed that: (1) the most common defects of playground equipment included the material selection, the distance of the stair steps, and the height of the playground equipment; (2) the lack of awareness of children in terms of using the playground equipment safely; and (3) the three top risks in the play behavior of children were not checking equipment or toys before play, playing on the equipment over-adventurously, and playing on the equipment carelessly with friends. Related government agencies should provide support and management for playground areas and playground equipment by continuously implementing equipment checks, improvements, and repairs.

Background. Lots of children use the smartphone in lying down posture that is unappreciated posture. The postures of children while using a smartphone affect their musculoskeletal pain and can enhance Musculoskeletal Disorders (MSDs). Objective. To study the effect of lying down posture while using smartphone among school children in Nakhon Si Thammarat, Thailand. Materials and methods. This survey study employed a Descriptive Cross-Sectional Design. The population was Grade 1-6 students studying in a primary school in Nakhon Si Thammarat. There were 122 samples selected based on the Volunteer Sampling Technique under the written consent of the students’ guardians. The research instruments employed in this study were: 1) Questionnaire adapted from Nordic Musculoskeletal Questionnaire asking musculoskeletal symptoms, 2) Posture Assessment using Kinovea Software to measure the angles of the muscle and postures during photo and video shooting of the smartphone users. The data were analyzed using descriptive statistics while Chi-square and Mann-Whitney U tests were used to test the mean differences. Results. There is a significant difference at p<0.05 level in mean angles of the neck, trunk, shoulder, and lower arms when using smartphones in supine and prone postures. The correlation between smartphone usage postures and musculoskeletal symptoms at the head/neck, trunk, and upper arm are found significantly different at p<0.05 level. The statistically significant difference at p<0.05 level is also found in the differences of age, length of smartphone ownership, position when using smartphone, and length of a smartphone usage in lying down positions. Conclusion. Smartphone usage in lying down positions of the participants can cause musculoskeletal pain especially in prone posture. It is recommended that guardians or relevant sectors have greater attention to smartphone usage among children to prevent their long-term musculoskeletal problems.

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Background: The posture while using smartphone in school-aged children is at risk on occurring musculoskeletal symptoms. The purpose of this study is to study the postures while using a smartphone and the factors related to the abnormalities of the musculoskeletal symptoms of school-aged children. Method: Experimental study is a method of this research. The samples were 233 school-aged children in Nakhon Si Thammarat, Thailand. Multi-stage sampling and data collection consisted questionnaire for the musculoskeletal symptoms by applying from the Nordic Musculoskeletal Questionnaire, ISO 11226: 2000 Ergonomics-Evaluation of static postures, which was a smartphone using posture evaluation form with data analysis using percentage, mean, standard deviation and Chi square. Result: The smartphone usage posture are mostly a lying position, which is 52.4%. 91.5 % of children has unacceptable risky smartphone usage posture. Mostly, the lying position has various organs tilted at angles, compared to the body's symmetrical axis, rather than the sitting position. The school-aged children had a prevalence of musculoskeletal symptoms of 20.2%, with the lying position having a higher rate of musculoskeletal symptoms, which is 10.7%. The smartphone usage posture is statistically significant correlated with the symptoms occurring in the head area. The risk of ergonomics and the musculoskeletal symptoms are statistically significant. Conclusion: The smartphone usage posture among students is at high risk especially lying position and has a chance of a musculoskeletal symptoms, higher than the sitting position. Educating to provide knowledge about safe use of smartphones to students, parents and relevant government agencies is very important.