Table 3 Results of individual studies

Burke (2002), USA [41]

3.3 h on Saturday

Not applicable

-Video gaming was a significant predictor for physical complaints (eyestrain, headache, back discomfort, wrist discomfort)

-Non-educational games were a significant risk factor for wrist pain, backache and headache

-Wrist discomfort was significantly influenced by joystick use and computer gameplay

No OR

DiFrancisco-Donoghue (2019), USA [37]

NR

Not applicable

-The most reported complaints from esport players were eye fatigue (52%), followed by neck, back (41%), wrist (36%) and hand pain (30%)

No OR

Hakala (2006), Finland [38]

 ≤ 1 h, 2-3 h, 4-5 h, > 5 h/day

Yes

-Risk of NSP increased only in the first model by playing digital games > 5 h/day

-Digital gaming exceeding 5 h/day was a threshold for LBP in all three models

Not playing digital games at all or

not daily

NSP:

2-3 h: 1.2 (0.9–1.4)

4-5 h: 1.1 (0.7–1.7)

 > 5 h: 1.9 (1.2–3.1)

LBP:

2-3 h: 0.9 (0.7–1.2)

4-5 h: 1.1 (0.7–1.9)

 > 5 h: 2.5 (1.5–4.1)

NSP:

2-3 h: 1.0 (0.8–1.3)

4-5 h: 1.0 (0.6–1.6)

 > 5 h: 1.5 (0.9–2.6)

LBP:

2-3 h: 0.9 (0.6–1.2)

4-5 h: 1.1 (0.7–1.9)

 > 5 h: 2.3 (1.3–3.9)

NSP:

2-3 h: 1.0 (0.8–1.3)

4-5 h: 1.0 (0.6–1.6)

 > 5 h: 1.4 (0.8–2.4)

LBP:

2-3 h: 0.8 (0.6–1.1)

4-5 h: 0.9 (0.5–1.6)

 > 5 h: 2.0 (1.1–3.5)

Hellström (2015), Sweden [39]

NR

Yes

-Online multiplayer games were associated with MSK symptoms, but not in multivariate binary logistic regression

-Gaming time on weekdays elevated the probability of MSK symptoms significantly

Non gamers vs. online gaming time on weekdays

1.3 (1.1–1.3)

Not applicable

Not applicable

Kang (2003), Korea [33]

 < 1 h, 1-2 h, 

> 2 h/day

Yes

-MSD prevalence of the upper limbs in gaming room users was 26.8% Most frequently in neck (16.2%), shoulders (14.4%) and wrist (8.8%)

-In bivariate analysis a non-significant trend between symptom prevalence of MSDs of the upper limbs and game room usage was observed

-In multivariate analysis the duration of game room use was a significant determinant of MSDs in the whole upper limbs and especially in the neck, elbow, wrist and finger areas

Using game rooms < 1 h/day

Neck:

1-2 h: 1.7 (NR)

 > 2 h: 2.8 (NR)

Shoulder

1-2 h: 0.8 (NR)

 > 2 h: 1.2 (NR)

Elbow:

1-2 h: 1.1 (NR)

 > 2 h: 3.5 (NR)

Wrist:

1-2 h: 1.5 (NR)

 > 2 h: 3.4 (NR)

Finger:

1-2 h: 1.9 (NR)

 > 2 h: 4.1 (NR)

Whole upper limbs:

1-2 h: 1.3 (NR)

 > 2 h: 1.9 (NR)

Neck:

1.8 (1.2–2.8)

Shoulder

1.1 (0.7–1.7)

Elbow:

2.2 (1.1–4.7)

Wrist:

2.0 (1.1–3.3)

Finger:

2.3 (1.2–4.6)

Whole upper limbs:

1.5 (1.0–2.1)

Not applicable

Lindberg (2020), Denmark [25]

24.2 ± NR

Not applicable

-MSK pain was prevalent in esports athletes with 42.6%

-The most reported body pain regions were the back (31.3%), neck (11.3%) and shoulders (11.3%)

-MSK pain was significantly associated with less participation in esports-related training

No OR

Ma (2019), China [34]

 < 2 h, 2–3.9 h, 4–5.9 h, 

> 6 h/day

Yes

-Wrist position and smartphone playtime correlated significantly with DD

-Students who spent over 2.25 h/day videogame playing had significantly higher risk of DD

-Wrist positioning while smartphone gaming in dorsiflexion was more associated with DD than in function position

Mobile gaming > 2.25 h/day

3.2 (2.2–4.6)

Not applicable

Not applicable

Meziat-Filho (2017), Brazil [35]

 < 2 h, ≥ 2 h/day

Yes

-The prevalence of acute neck pain while playing videogames < 2 h/day was 33.5%, for chronic neck pain it was 16.7%

-The prevalence of acute neck pain while playing videogames ≥ 2 h/day was 31.0%, for chronic neck pain it was 13.5%

No OR

Sekiguchi (2018a), Japan [42]

 < 1 h, 1-2 h, 2-3 h, ≥ 3 h/day

Yes

-Playing videogames ≥ 3 h/day was significantly associated with MSK pain in crude analysis

-The risk of MSK pain was increased by 39% in the group of high videogame time (≥ 3 h/day) in adjusted analysis

-The group of high videogame time (≥ 3 h/day) was significantly associated with MSK pain in three or more locations

Video gaming

 < 1 h/day

1-2 h:

1.0 (0.9–1.2)

2-3 h:

1.1 (0.9–1.3)

 ≥ 3 h:

1.7 (1.3–2.0)

1-2 h:

1.0 (0.9–1.2)

2-3 h:

1.1 (0.9–1.3)

 ≥ 3 h:

1.4 (1.1–1.7)

Not applicable

Sekiguchi (2018b), Japan [43]

 < 1 h, 1-2 h, 2-3 h, ≥ 3 h/day

Yes

-High videogame time (≥ 3 h/day) was significantly associated with elbow or shoulder pain in young baseball players

-This association was also significant in multivariate analysis

Video gaming < 1 h/day

1-2 h:

1.5 (0.7–3.0)

2-3 h:

1.0 (0.4–2.7)

 ≥ 3 h:

5.2 (1.6–17.0)

1-2 h:

1.4 (0.7–3.0)

2-3 h:

1.0 (0.4–2.6)

 ≥ 3 h:

5.2 (1.5–18.2)

1-2 h:

1.4 (0.7–3.0)

2-3 h:

0.9 (0.3–2.5)

 ≥ 3 h:

4.8 (1.4–16.7)

Silva (2016), Brazil [44]

 < 1 h, > 1 h/day

No

-The use of electronic games was reported by 2.9% of the adolescents as a triggering factor for at least one pain symptom

-The use of electronic games was not associated with pain complaints in any of the surveyed body regions

Electronic gaming

 < 1 h/day

Cervical region:

1.0 (0.8–1.4)

Scapular region:

1.0 (0.8–1.5)

Thoracolumbar column:

0.9 (0.7–1.6)

Upper limb:

1.1 (0.8–1.5)

Not applicable

Not applicable

Tazawa (2001), Japan [36]

0 h, 0.5 h, 1 h/day

Yes

-Excessive console gaming (> 1 h/day) caused greater frequency of MS than non-console playing (25.6% vs. 14.4%)

-Console playing correlated highly significantly with MS

No OR

Torsheim (2010), Norway [40]

9.5^a ± NR

Yes

-Computer gaming in boys was not correlated with either weekly backaches or headaches

-Computer gaming in girls was significantly correlated with weekly backaches and headaches

Per added daily hour of computer gaming

Boys backache:

1.1 (1.0–1.1)

Girls backache:

1.1 (1.0–1.1)

Boys headache:

1.0 (1.0–1.1)

Girls headache:

1.0 (1.0-.1.0)

Boys backache:

1.0 (1.0–1.1)

Girls backache:

1.1 (1.0–1.1)

Boys headache:

1.0 (1.0–1.1)

Girls headache:

1.0 (1.0-.1.0)

Not applicable

Wang (2019), China [26]

NR

Not applicable

-Measured median frequency of thumb muscles were reduced significantly after 30 min of continuously playing smartphone games

-Measured mean power frequency of thumb muscles were reduced significantly after 30 min of continuously playing smartphone games

-VAS scores for discomfort increased significantly after 30 min of playing the smartphone game (score difference: 0 to 2)

No OR

Xavier (2015), Brazil [46]

9.7 ± 15.5

Yes

-Excessive use of electronic devices (> 4 h/day) was associated with the presence of headaches

-Excessive use of electronic games (> 4 h/day) was associated with the presence of headaches

Electronic gaming

 < 1 h/day

1.4 (0.4–5.7)

1.9 (1.0–3.7)

Not applicable

Yabe (2018), Japan [45]

 < 1 h, 1-2 h, 2-3 h, ≥ 3 h/day

Yes

-Videogame-playing time/day was significantly associated with the presence of lower back pain in both crude and adjusted model analyses

-In all three models videogame-play times of ≥ 3 h/day were highly significantly associated with lower back pain

Video gaming < 1 h/day

1-2 h:

1.3 (1.0–1.7)

2-3 h:

1.6 (1.1–2.6)

 ≥ 3 h:

2.8 (2.0–3.9)

1-2 h:

1.3 (1.0–1.8)

2-3 h:

1.4 (1.0–2.0)

 ≥ 3 h:

2.0 (1.4–3.0)

1-2 h:

1.4 (1.0–1.8)

2-3 h:

1.5 (1.0–2.1)

 ≥ 3 h:

2.2 (1.5–3.2)