Association Between Unilateral Water Container Carrying and Neck and Shoulder Asymmetry in Adolescents: A Cross-Sectional Study

Abstract

Introduction: Repetitive unilateral water container carrying during adolescence may induce asymmetric mechanical loading and alter postural alignment because the musculoskeletal system is still developing. Objective: This study investigated the association between unilateral water container carrying and the risk of neck and shoulder asymmetry among adolescents at SMA Negeri 1 Ndoso.
Methods: A cross-sectional study was conducted among 30 adolescents aged 15–20 years selected through purposive sampling. Unilateral loading was assessed using the Quick Exposure Check (QEC), whereas neck and shoulder asymmetry were evaluated using the AI Posture Evaluation and Correction System (APECS). Data were analyzed using Pearson correlation after the assumptions of normality and linearity had been satisfied, with statistical significance set at p < 0.05.
Results: Significant positive correlations were observed between unilateral loading and postural asymmetry. Shoulder/arm loading was associated with neck asymmetry (r = 0.544, p = 0.002) and shoulder asymmetry (r = 0.757, p = 0.003). Wrist loading showed the strongest association with shoulder asymmetry (r = 0.804, p = 0.003), whereas neck loading was significantly associated with neck asymmetry (r = 0.501, p = 0.005) and shoulder asymmetry (r = 0.760, p = 0.004).
Conclusion: Higher levels of unilateral water container carrying were significantly associated with greater neck and shoulder asymmetry among adolescents. These findings emphasize the importance of ergonomic interventions and preventive strategies to minimize musculoskeletal risks associated with repetitive unilateral load carrying.