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article · BMC Musculoskeletal Disorders

The effect of handwriting versus iPad writing on cervical alignment and pinch muscle strength among female university students: a cross-sectional study

2026Open accessMansoura University

Abstract

OBJECTIVES: This study aimed to examine the impact of handwriting versus iPad writing on cervical alignment and pinch muscle strength among female university students at the Faculty of Physical Therapy, Cairo University. METHODS: Thirty female students were divided into two equal groups: Group A engaged in handwriting, and Group B used iPad writing. The mean body mass index of the participants was 25.12 kg/m². Each participant was instructed to write for 15 min. Cervical range of motion (ROM) devices were used to assess cervical flexion, lateral bending, and rotation, whereas key pinch strength was measured to evaluate the strength of the dominant pinch muscles. RESULTS: Analysis of variance (ANOVA) indicated no significant differences in the pinch strength outcome variables between the handwriting and iPad writing groups, F (1, 28) = 12.54, P = 0.25; η² = 0.05. The handwriting group exhibited lower mean values within their group compared to the iPad group. Furthermore, a repeated-measures ANOVA comparing the groups revealed no significant difference in the mean cervical range of motion (ROM) in flexion between the two groups (P = 0.67). However, the mean values for the handwriting group increased post-writing compared to those for the iPad group. The repeated-measures ANOVA between groups also demonstrated no significant difference in the mean cervical range of motion values for rotation to the right after writing for either group (P = 0.34) or for the cervical range of motion for rotation to the left (P = 0.49); however, an increase in the mean values of cervical rotation to the right was observed for the handwriting group. CONCLUSIONS: Using an iPad increases the degree of lateral bending and rotation to the left and right. In addition, the degree of right rotation increased in the iPad group. However, key-pinch muscle strength was lower in the handwriting group than in the iPad writing group.

Research topics

  • Writing and Handwriting Education
  • Ergonomics and Musculoskeletal Disorders
  • Temporomandibular Joint Disorders

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DOI: 10.1186/s12891-026-09933-4

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