Text Neck and Its Association With Cardiac Autonomic Function, Smartphone Addiction, and Psychophysiological Status in Young Adults

Background The increasing use of mobile devices has led to a rise in forward head posture (FHP), or "text neck," contributing to health issues. Additionally, nomophobia, or the fear of being without a mobile phone, has emerged as a growing behavioral concern, particularly among younger users. Methods This cross-sectional study aimed to assess FHP and its association with cardiac autonomic function, smartphone addiction, nomophobia, ergonomic risk, and neck disability in 84 participants aged 19-45 years. FHP was evaluated via craniovertebral (CV) angle measurement and cardiac autonomic status through heart rate variability, alongside smartphone addiction and psychological distress. Results Heart rate variability (HRV) analyses revealed a significant inverse relationship between the CV angle and the LF/HF ratio, indicating heightened sympathetic activity with reduced CV angle. Parasympathetic indicators, root mean square of successive differences between adjacent NN intervals (RMSSD) and pNN50, positively correlated with CV angle, suggesting a link between optimal posture and enhanced parasympathetic function. Psychophysiological assessments showed that smartphone addiction moderately correlated with nomophobia. Conclusion Text neck or forward head posture is associated with increased sympathetic and decreased parasympathetic modulation, as evidenced by HRV indices.