{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:55:56Z","timestamp":1781520956660,"version":"3.54.1"},"reference-count":22,"publisher":"FapUNIFESP (SciELO)","issue":"3","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004410","name":"TUBITAK","doi-asserted-by":"crossref","award":["1919B012324064"],"award-info":[{"award-number":["1919B012324064"]}],"id":[{"id":"10.13039\/501100004410","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY  OBJECTIVE: Excessive screen exposure is associated with musculoskeletal discomfort, postural alterations, visual fatigue, and increased anxiety among young adults. This study investigated the effects of a virtually delivered multimodal exercise program integrating sensorimotor, oculomotor, and postural components on postural awareness, musculoskeletal complaints, visual fatigue, and anxiety among screen-exposed university students and staff.  METHODS: Fifty-seven participants (mean age: 23.35\u00b11.2 years) with \u22656 h of daily screen use completed an 8-week program consisting of twice-weekly live virtual sessions and daily video-guided exercises. Outcomes included the Postural Habits and Awareness Scale, Cornell Musculoskeletal Discomfort Questionnaire, Rapid Office Strain Assessment, ASTHENOPIA Eye Fatigue Scale, and State-Trait Anxiety Inventory. Pre\u2013post differences were analyzed using paired-sample t-tests and Wilcoxon signed-rank tests.  RESULTS: Significant improvements were observed in Postural Habits and Awareness Scale Factor 1 and Factor 3 (p&lt;0.05), accompanied by reduced musculoskeletal discomfort across all Cornell Musculoskeletal Discomfort Questionnaire sections (p&lt;0.05). Visual fatigue decreased substantially (z=-4.185; p&lt;0.001), whereas Rapid Office Strain Assessment scores showed no significant change (p&gt;0.05). State anxiety increased slightly (p&lt;0.05), while trait anxiety remained stable.  CONCLUSION: This preliminary single-group study suggests that virtual multimodal exercise programs may be effective, accessible preventive strategies for reducing musculoskeletal symptoms, enhancing posture awareness, and alleviating visual fatigue among individuals with high daily screen exposure. Controlled trials with larger and more diverse populations are recommended to establish causal effectiveness.<\/jats:p>","DOI":"10.1590\/1806-9282.20251229","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:38:49Z","timestamp":1781519929000},"source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of a virtual multimodal exercise program on postural awareness and digital eye strain in university students: a pilot study"],"prefix":"10.1590","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1089-3370","authenticated-orcid":false,"given":"Ay\u00e7a","family":"Arac\u0131","sequence":"first","affiliation":[{"name":"Alanya Alaaddin Keykubat University,  T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2047-8900","authenticated-orcid":false,"given":"Havva Nur","family":"Mutlu","sequence":"additional","affiliation":[{"name":"Alanya Alaaddin Keykubat University,  T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8967-572X","authenticated-orcid":false,"given":"Selenay","family":"Akg\u00fcn","sequence":"additional","affiliation":[{"name":"Alanya Alaaddin Keykubat University,  T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3893-6280","authenticated-orcid":false,"given":"Ali","family":"Kurt","sequence":"additional","affiliation":[{"name":"Alanya Alaaddin Keykubat University,  T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"20","key":"ref1","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.3390\/healthcare12202067","article-title":"Prevalence and interrelationships of screen time, visual disorders, and neck pain among university students: a cross-sectional study at Majmaah University","volume":"12","author":"Almutairi H","year":"2024","journal-title":"Healthcare (Basel)"},{"issue":"22","key":"ref2","doi-asserted-by":"crossref","first-page":"6777","DOI":"10.3390\/jcm13226777","article-title":"Proprioceptive training improves postural stability and reduces pain in cervicogenic headache patients: a randomized clinical trial","volume":"13","author":"Emam MA","year":"2024","journal-title":"J Clin Med"},{"key":"ref3","first-page":"459","article-title":"Examining the impact of the exercise package on eye and neck strain (EPENS) among adolescents: a pre-experimental study at a selected preuniversity college in Mangalore","volume":"13","author":"Kannappan SR","year":"2024","journal-title":"J Educ Health Promot"},{"issue":"5","key":"ref4","doi-asserted-by":"crossref","first-page":"1655","DOI":"10.1007\/s40123-022-00540-9","article-title":"Digital eye strain- a comprehensive review","volume":"11","author":"Kaur K","year":"2022","journal-title":"Ophthalmol Ther"},{"issue":"12","key":"ref5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0314390","article-title":"Digital media use and its effects on digital eye strain and sleep quality in adolescents: a new emerging epidemic?","volume":"19","author":"\u015eambel Aykutlu M","year":"2024","journal-title":"PLoS One"},{"issue":"1","key":"ref6","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1186\/s12891-022-05490-8","article-title":"Usefulness of the rapid office strain assessment (ROSA) tool in detecting differences before and after an ergonomics intervention","volume":"23","author":"Barros FC","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"ref7","doi-asserted-by":"crossref","DOI":"10.2196\/46637","article-title":"Effectiveness of online and remote interventions for mental health in children, adolescents, and young adults after the onset of the COVID-19 pandemic: systematic review and meta-analysis","volume":"11","author":"Fischer-Grote L","year":"2024","journal-title":"JMIR Ment Health"},{"issue":"3","key":"ref8","doi-asserted-by":"crossref","first-page":"407","DOI":"10.18863\/pgy.1032058","article-title":"Zoom yorgunlu\u011fu: bir g\u00f6zden ge\u00e7irme","volume":"14","author":"Bac\u0131k Yaman G","year":"2022","journal-title":"Psikiyatr G\u00fcncel Yakla\u015f\u0131mlar"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"1359594","DOI":"10.3389\/fnins.2024.1359594","article-title":"Interoceptive posture awareness and accuracy: a novel photographic strategy towards making posture actionable","volume":"18","author":"Weiniger SP","year":"2024","journal-title":"Front Neurosci"},{"issue":"6","key":"ref10","first-page":"501","article-title":"Interoception and mental health: a roadmap","volume":"3","author":"Khalsa SS","year":"2018","journal-title":"Biol Psychiatry Cogn Neurosci Neuroimaging"},{"issue":"6","key":"ref11","doi-asserted-by":"crossref","first-page":"103908","DOI":"10.1016\/j.identj.2025.103908","article-title":"Effectiveness of virtual reality-based real-time ergonomics training on dental posture improvement","volume":"75","author":"Eom T","year":"2025","journal-title":"Int Dent J"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"100571","DOI":"10.1016\/j.chbr.2024.100571","article-title":"Zoom fatigue in review: a meta-analytical examination of videoconferencing fatigue's antecedents","volume":"17","author":"Beyea D","year":"2025","journal-title":"Comput Hum Behav Rep"},{"issue":"29","key":"ref13","first-page":"222","article-title":"Online e\u011fitimin g\u00f6z y\u00fczeyine etkisinin de\u011ferlendirilmesi","volume":"4","author":"Koca S","year":"2022","journal-title":"MN Oftalmoloji"},{"issue":"2","key":"ref14","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1080\/10803548.2022.2082694","article-title":"Development of the postural habits and awareness scale: a reliability and validity study","volume":"29","author":"Bayar B","year":"2023","journal-title":"Int J Occup Saf Ergon"},{"issue":"4","key":"ref15","first-page":"455","article-title":"Upper extremity musculoskeletal discomfort among occupational notebook personal computer users: work interference, associations with risk factors and the use of notebook computer stand and docking station","volume":"39","author":"Erdinc O","year":"2011","journal-title":"Work"},{"issue":"1","key":"ref16","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.apergo.2011.03.008","article-title":"Development and evaluation of an office ergonomic risk checklist: ROSA--rapid office strain assessment","volume":"43","author":"Sonne M","year":"2012","journal-title":"Appl Ergon"},{"key":"ref17","first-page":"3","article-title":"Development of the STAI trait anxiety inventory","author":"Spielberg CHAD","year":"1971","journal-title":"Interam J Psychol"},{"issue":"5","key":"ref18","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1080\/13697137.2023.2190511","article-title":"Postmenopausal women's cognitive function and performance of virtual reality tasks","volume":"26","author":"Zangirolami-Raimundo J","year":"2023","journal-title":"Climacteric"},{"issue":"1","key":"ref19","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.4102\/sajp.v77i1.1490","article-title":"Time to re-think our strategy with musculoskeletal disorders and workstation ergonomics","volume":"77","author":"Redivo VS","year":"2021","journal-title":"S Afr J Physiother"},{"issue":"6","key":"ref20","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1080\/13697137.2022.2088275","article-title":"Use of interventions involving virtual reality tasks during the climacteric: a systematic review","volume":"25","author":"Zangirolami-Raimundo J","year":"2022","journal-title":"Climacteric"},{"issue":"1","key":"ref21","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1186\/s12884-022-04587-1","article-title":"The \u2018new normal\u2019 includes online prenatal exercise: exploring pregnant women's experiences during the pandemic and the role of virtual group fitness on maternal mental health","volume":"22","author":"Silva-Jose C","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"100168","DOI":"10.1016\/j.clinsp.2023.100168","article-title":"Adaptation to the driving simulator and prediction of the braking time performance, with and without distraction, in older adults and middle-aged adults","volume":"78","author":"Canonica AC","year":"2023","journal-title":"Clinics (Sao Paulo)"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0104-42302026000302201&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T10:38:53Z","timestamp":1781519933000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302026000302201&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026]]}},"alternative-id":["S0104-42302026000302201"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.20251229","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e20251229"}}