Analysis of neck and back muscle activity during the application of various pillow designs in patients with forward head posture

Abstract

BACKGROUND: There are currently no reports of biomechanical changes in patients with forward head posture (FHP) that result in altered muscle activation throughout various functions with muscle activation response during diverse sleep postures. OBJECTIVE: This study investigated neck and back muscle activity in individuals with and without FHP during a maintained side-sleeping position by incorporating various pillow designs. METHODS: Thirty-four participants (i.e., 17 in each group) were enrolled. The muscle activity was investigated via surface electromyography during the use of three trial pillows: orthopedic pillow, hollow pillow, and Thai neck support pillow. RESULTS: With the application of all three trial pillow, the FHP group demonstrated significantly greater middle-lower trapezius muscle activity than the normal head posture group (p< 0.05). Sternocleidomastoid and upper trapezius (UT) muscle activity were similar between the two groups (p> 0.05). Only UT muscle activity was affected by variations in pillow design. In the normal group, no difference was observed in the muscle activity between all three pillows (p> 0.05). CONCLUSIONS: Feasibly, the ability to appropriately modify a pillow configuration without creating undesired muscle activation was limited to those exhibiting FHP. Therefore, specially designed pillows or mattresses should be investigated in terms of their relevance to muscle fatigue and potential musculoskeletal pain in FHP patients.