Abstract / Summary
Abstract Background: Musculoskeletal symptoms are commonly reported among video gamers, but most available evidence is cross-sectional, limiting understanding of their subsequent development. The relationship between gaming exposure, ergonomic behaviour, and the development of musculoskeletal symptoms over time remains insufficiently characterised. Methods: We conducted a prospective cohort study of adult Nigerian gamers recruited between September and December 2024 and followed for 12 months. Gaming exposure was assessed using self-reported daily gaming duration, gaming days per week, session duration, years of gaming experience, gaming device, gaming activity, and gaming status. Ergonomic behaviour was assessed using an adapted gaming-related questionnaire. Musculoskeletal symptoms were assessed across nine anatomical regions using the Nordic Musculoskeletal Questionnaire-Extended. Incident symptoms were defined as symptoms reported at follow-up in an anatomical region that was symptom-free at baseline. Multivariable logistic regression was used to examine associations between gaming exposure, ergonomic behaviour, and incident symptoms. Results: Of 276 individuals assessed, 240 were enrolled and 226 provided complete baseline data. Of these, 216 completed the 12-month follow-up (95.6% retention). Among 144 participants who were symptom-free across all assessed regions at baseline, 45 developed a new musculoskeletal symptom, corresponding to a 12-month cumulative incidence proportion of 31.3%. Incident symptoms were most frequently observed in the neck, lower back, shoulders, and upper back. Higher gaming exposure, longer gaming experience, prolonged static sitting, and infrequent breaks remained associated with incident symptoms after adjustment. Among 78 participants with baseline symptoms who completed follow-up, 43 (55.1%) reported persistent symptoms. Conclusions: Approximately one-third of symptom-free gamers developed a new musculoskeletal symptom over 12 months. Both gaming exposure and ergonomic behaviour may be relevant to subsequent musculoskeletal symptoms. Prospective studies using objective exposure measures and validated gaming-specific ergonomic instruments are warranted.