The Effects of Mental Fatigue Created by Social Media on Upper Extremity Performance

Primary outcomes

1. 1-Isometric Elbow Flexion Strength

   Time frame: Baseline

   The participant will sit in a chair with upper arms at their sides, elbow bent 90 degrees, and forearm supinated. A velcro strap attached to a digital dynamometer fixed to a portable wooden platform placed under the chair will be secured tightly around the participant's wrist, proximal to the distal wrist crease. The tester will check the strap's tension to ensure no slack. When instructed, the participant will endeavor to move their hand as forcefully as possible towards the shoulder for 2-3 seconds. Any compensatory movement in trunk extension or lateral flexion outside the tested arm will be observed.

2. 1-Isometric Elbow Flexion Strength

   Time frame: 1 week later

   The participant will sit in a chair with upper arms at their sides, elbow bent 90 degrees, and forearm supinated. A velcro strap attached to a digital dynamometer fixed to a portable wooden platform placed under the chair will be secured tightly around the participant's wrist, proximal to the distal wrist crease. The tester will check the strap's tension to ensure no slack. When instructed, the participant will endeavor to move their hand as forcefully as possible towards the shoulder for 2-3 seconds. Any compensatory movement in trunk extension or lateral flexion outside the tested arm will be observed.

3. 2-Hand grip strength

   Time frame: Baseline

   Hand grip strength will be assessed using a Jamar hand dynamometer (Lafayette Instrument Company, USA). The participant will sit holding the dynamometer with the upper arm at the side, elbow bent 90 degrees, and forearm centered between pronation and supination. When instructed, the participant will squeeze the dynamometer as forcefully as possible for 2-3 seconds while the tester verbally encourages.

4. 2-Hand grip strength

   Time frame: 1 week later

   Hand grip strength will be assessed using a Jamar hand dynamometer (Lafayette Instrument Company, USA). The participant will sit holding the dynamometer with the upper arm at the side, elbow bent 90 degrees, and forearm centered between pronation and supination. When instructed, the participant will squeeze the dynamometer as forcefully as possible for 2-3 seconds while the tester verbally encourages.

5. 3- Upper extremity reaction test

   Time frame: Baseline

   It is planned to use the BlazePod sensor, validated for the upper extremity reaction time test (de-Oliveira et al. 2021).

6. 3- Upper extremity reaction test

   Time frame: 1 week later

   It is planned to use the BlazePod sensor, validated for the upper extremity reaction time test (de-Oliveira et al. 2021).

7. 4-Finger reaction test

   Time frame: Baseline

   The participant will be asked to place the dominant hand's index finger on the left button of a computer mouse and press the left button as soon as the green lights up on the traffic light shape on the screen. The time between the light stimulus and the participant's reaction will be recorded in milliseconds.

8. 4-Finger reaction test

   Time frame: 1 week later

   The participant will be asked to place the dominant hand's index finger on the left button of a computer mouse and press the left button as soon as the green lights up on the traffic light shape on the screen. The time between the light stimulus and the participant's reaction will be recorded in milliseconds.

9. 5-Hand performance test

   Time frame: Baseline

   The nine-hole peg test will be used. The 9-hole peg test (9-DPT) is a validated method widely used in research and clinical settings as a measure of finger dexterity (Y. A. Smith, Hong, & Presson, 2000).

10. 5-Hand performance test

    Time frame: 1 week later

    The nine-hole peg test will be used. The 9-hole peg test (9-DPT) is a validated method widely used in research and clinical settings as a measure of finger dexterity (Y. A. Smith, Hong, & Presson, 2000).

11. 6-Mental stopwatch

    Time frame: Baseline

    The Nine Hole Peg Test (9-DPT) was used to assess the temporal correspondence between actual and imagined movement. The 9-DPT will be administered according to standard protocols. The participant performed the test according to the standard 9-DPT protocol, during which the stopwatch will be started, and the time from the beginning to the end of the test will be recorded. In the imagined 9-DPT, a mental stopwatch will be used, and the same test will be performed with the individual visualizing the same activity while sitting with his/her eyes closed (Allali, 2012).

12. 6-Mental stopwatch

    Time frame: 1 week later

    The Nine Hole Peg Test (9-DPT) was used to assess the temporal correspondence between actual and imagined movement. The 9-DPT will be administered according to standard protocols. The participant performed the test according to the standard 9-DPT protocol, during which the stopwatch will be started, and the time from the beginning to the end of the test will be recorded. In the imagined 9-DPT, a mental stopwatch will be used, and the same test will be performed with the individual visualizing the same activity while sitting with his/her eyes closed (Allali, 2012).

13. 7-Evaluation of position sense

    Time frame: Baseline

    In the study, a Baseline® digital goniometer with a sensitivity of 1° will be used to assess the glenohumeral joint position sense. The tested person will be asked to perform shoulder flexion at 55°, 90° and 125° and to lift the arm from the position adjacent to the body to the angles mentioned (Balke et al., 2011).

14. 7-Evaluation of position sense

    Time frame: 1 week later

    In the study, a Baseline® digital goniometer with a sensitivity of 1° will be used to assess the glenohumeral joint position sense. The tested person will be asked to perform shoulder flexion at 55°, 90° and 125° and to lift the arm from the position adjacent to the body to the angles mentioned (Balke et al., 2011).

15. 8-Upper extremity endurance test:

    Time frame: Baseline

    After weighing the body weight, the weight in the hand will be calculated as 2% of the body weight and rounded to the nearest 0.5 kg if it is fractional. The participant will hang from the bed with his/her arm out. He/she should then take the weight in his/her hand and lift it with the "thumb pointing upwards" and the arm at 90° to the horizontal. A metronome set to 60 Hz will then be used to standardize the test, whereby participants will be instructed to raise their arm on the first beat, hold it at 90 abductions for the next beat and then lower it to the starting position on the third beat. The test will be terminated by fulfilling any of the following termination criteria (Moore, Uhl, & Kibler, 2013).

16. 8-Upper extremity endurance test:

    Time frame: 1 week later

    After weighing the body weight, the weight in the hand will be calculated as 2% of the body weight and rounded to the nearest 0.5 kg if it is fractional. The participant will hang from the bed with his/her arm out. He/she should then take the weight in his/her hand and lift it with the "thumb pointing upwards" and the arm at 90° to the horizontal. A metronome set to 60 Hz will then be used to standardize the test, whereby participants will be instructed to raise their arm on the first beat, hold it at 90 abductions for the next beat and then lower it to the starting position on the third beat. The test will be terminated by fulfilling any of the following termination criteria (Moore, Uhl, & Kibler, 2013).