{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:37:31Z","timestamp":1793133451716,"version":"4.5.0"},"reference-count":38,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100008323","name":"Zanjan University of Medical Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008323","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Back and Musculoskeletal Rehabilitation"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Play-to-earn (P2E) games are a growing category of smartphone games that require repetitive tapping and prolonged gaming in poor postures, increasing the risk of musculoskeletal disorders (MSDs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to assess the prevalence of MSDs among smartphone P2E gamers and compare it with non-P2E gamers among students and staff at Zanjan University of Medical Sciences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted in 2024 on 938 students and staff. Data were collected using a demographic questionnaire and the standardized Nordic Musculoskeletal Questionnaire. Descriptive statistics, independent sample t-tests, and Chi-square tests were used for data analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The one-year and seven-day prevalence of MSDs among P2E gamers were 80% and 70.3%, respectively, both higher than those observed in non-P2E gamers. The upper back had the highest prevalence of pain, followed by the neck and lower back. The seven-day prevalence of MSDs in the wrists\/hands and upper back was significantly higher in P2E gamers. A history of gaming and the frequency of unlocking the smartphone touchscreen were associated with increased MSD prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>As P2E games may increase the probability of MSDs, developing guidelines for smartphone P2E gamers may help raise awareness and prevent MSDs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10538127251354965","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T03:12:36Z","timestamp":1751944356000},"page":"171-177","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Musculoskeletal disorders in smartphone play to earn gamers: A comparative study"],"prefix":"10.1177","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5731-1614","authenticated-orcid":false,"given":"Milad","family":"Gholami","sequence":"first","affiliation":[{"name":"School of Health, Student Research Committee, Arak University of Medical Sciences, Arak, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2139-0135","authenticated-orcid":false,"given":"Arshia","family":"Ahmadi Shoar","sequence":"additional","affiliation":[{"name":"Department of Occupational Health and Safety Engineering, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8938-2476","authenticated-orcid":false,"given":"Reza","family":"Kalantari","sequence":"additional","affiliation":[{"name":"Department of Occupational Health and Safety Engineering, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"1","article-title":"Prevalence of problematic smartphone usage and associated mental health outcomes amongst children and young people: a systematic review, meta-analysis and GRADE of the evidence","volume":"19","author":"Sohn SY","year":"2019","unstructured":"Sohn SY, Rees P, Wildridge B, et al. 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