Abstract
Objective: To compare median nerve mechanosensitivity between dominant and non-dominant hand in university students.
Study Design: Cross-sectional comparative study.
Place and Duration of Study: Data were collected from university students at ARID Agriculture University, and the Center of Advanced Studies in Health and Technology (CASHT) Rawalpindi, over a period of four months (Feb to May).
Material and Methods: Ethical approval was obtained from CASHT IRB, Rawalpindi (CASHT/IRB/2026/014). A total of 85 university students (57 males, 28 females) were recruited via non-probability purposive sampling. High smartphone use was confirmed using the SAS-SV (cut-off ≥32 males, ≥34 females). Participants with neurological, musculoskeletal, or systemic conditions affecting the upper limb were excluded. Bilateral median nerve mechanosensitivity was assessed using standardized ULNT-1 with an ordinal scale (0–3), and data were analyzed using paired-samples t-test (SPSS v.20).
Results: The dominant hand showed significantly higher mechanosensitivity (mean = 1.08, SD = 1.207) than the non-dominant hand (mean = 0.29, SD = 0.553); t (84) = 6.403, p < 0.001, mean difference 0.788 (95% CI: 0.543–1.033), Cohen's d = 0.98.
Conclusion: High smartphone usage was significantly associated with greater median nerve mechanosensitivity in the dominant hand compared to the non-dominant hand among university students, confirming the disproportionate mechanical burden imposed by device operation. ULNT-1 is recommended as a simple and effective early screening tool in high smartphone-using populations.
Keywords: Median nerve mechanosensitivity, smartphone use, ULNT-1, neurodynamic testing, hand dominance, university students, carpal tunnel syndrome.
References
1. Pakistan Telecommunication Authority. Annual report 2022–2023. Government of Pakistan; 2023.
2. Patel A, Desai T, Shukla J. Subclinical median nerve electrophysiological changes associated with mobile phone use: A cross-sectional study. J Neurosci Rural Pract. 2018;9(4):507–512.
3. Trudeau MB, Asakawa DS, Jindrich DL, Dennerlein JT. Two-handed grip on a mobile phone affords greater thumb motor performance, decreased variability, and a more extended thumb posture than a one-handed grip. Appl Ergon. 2016;52:24–28.
4. Schmidt HM, Lanz U. Surgical anatomy of the hand. 3rd ed. Thieme; 2024.
5. Xie Y, Szeto G, Dai J. Prevalence and risk factors associated with musculoskeletal complaints among users of mobile handheld devices: A systematic review. Appl Ergon. 2017;59:132–142.
6. Hernández-Secorún M, Abenia-Bennedí H, Lucha-López MO, Durán-Serrano M, Hamam-Alcober JS, Krauss J, et al. Understanding the mechanosensitivity of the median nerve in pre-surgical carpal tunnel syndrome patients: A correlational study. Brain Sci. 2024;14(6):615.
7. Latif A, Mirza Baig AA, Wajid SA, Ali SS. Frequency of median nerve tightness and its association with upper limb functions among smartphone users of a public sector university, Karachi. J Pak Med Assoc. 2022;72(8):1529–1534.
8. İnal EE, Demirci K, Çetinürk A, Akgönül M, Savaş S. Effects of smartphone overuse on hand function, pinch strength, and the median nerve. Muscle Nerve. 2015;52(2):183–188.
9. Kwon M, Kim DJ, Cho H, Yang S. The smartphone addiction scale: Development and validation of a short version for adolescents. PLOS ONE. 2013;8(12):e83558.
10. Mustafaoğlu R, Yasaci Z, Zirek E, Griffiths MD, Ozdincler AR. The relationship between smartphone addiction and musculoskeletal pain prevalence among young population: A cross-sectional study. Korean J Pain. 2021;34(1):72–81.
11. Zirek E, Mustafaoğlu R, Yasaci Z, Griffiths MD. A systematic review of musculoskeletal complaints, symptoms, and pathologies related to mobile phone usage. Musculoskelet Sci Pract. 2020;49:102196.
12. Koulidis K, Veremis Y, Anderson C, Heneghan NR. Diagnostic accuracy of upper limb neurodynamic tests for the assessment of peripheral neuropathic pain: A systematic review. Musculoskelet Sci Pract. 2019;40:21–33.
13. Nee RJ, Jull GA, Vicenzino B, Coppieters MW. The validity of upper-limb neurodynamic tests for detecting peripheral neuropathic pain. J Orthop Sports Phys Ther. 2012;42(5):413–424.
14. Mousa DG, Abdel-Aal NM, Mourad HS, Al-Shenqiti AM. Effect of smartphone typing mode on median nerve cross-sectional area in physical therapy students: A within-subject experimental study. J Phys Ther Sci. 2019;31(9):710–714.
15. Hasib SW, Usmani A, Anwar SF, Mumtaz A. The morphology of a smartphonopathic hand – smartphone use and the median nerve cross-sectional area. Pak J Med Sci. 2025;41(1):200–204.
16. Osailan AM. Is smartphone overuse associated with reduced hand-grip and pinch-grip strength, and reduced hand dexterity? A cross-sectional study. Hand Surg Rehabil. 2021;40(4):479–484.
17. Alshahrani MS, Alshahrani A, Alkhamis BA, Alyami AH, Alqhtani RS, Joseph R. Effects of smartphone addiction on neck muscle endurance, hand grip, and pinch strength in college students. Int J Environ Res Public Health. 2021;18(7):3421.
18. Ergün Keşli R, Ata E, Karakaş M. The effect of smartphone addiction on handgrip strength, lateral pinch strength, upper extremity functions, pain threshold and pain tolerance. J Hand Ther. 2023;36(4):794–800.
19. Al-Busaidi M, Leelamani M, Al-Harthi A, Al-Balushi N. Retrospective analysis of carpal tunnel syndrome: Clinical profile, demographics, and risk factors at Sohar Hospital over a two-year period. Cureus. 2025;17(4):e82145.
20. Depreli O, Angin E. The relationship between smartphone usage position, pain, smartphone addiction, and hand function. J Back Musculoskelet Rehabil. 2024;37(6):1695–1704.
21. Papadatou-Pastou M, Ntolka E, Schmitz J, Martin M, Munafò MR, Ocklenburg S, et al. Human handedness: A meta-analysis. Psychol Bull. 2020;146(6):481–524.
22. Zimmerman NB, Hameed F, Tosti R. Nerve conduction velocities and hand dominance: Reference values for upper extremity peripheral nerve studies. J Hand Surg. 2021;46(3):241–247.
23. Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 9th ed. Wolters Kluwer; 2023.
24. Drake RL, Vogl AW, Mitchell AWM. Gray’s anatomy for students. 5th ed. Elsevier; 2024.
25. Coppieters MW, Butler DS. Do ‘sliders’ slide and ‘tensioners’ tension? An analysis of neurodynamic techniques and considerations regarding their application. Man Ther. 2008;13(3):213–221.Ali Raza, S. S. (2021). Incidence of plantar fasciitis in overweight patients of goverment hospital of faisalabad . The Professional Medical Journal, 718-724.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Copyright (c) 2026 Journal of Nursing and Allied Health