A study of head and shoulder posture and cervical muscle electromyographic characteristics in college students with chronic neck pain: A case–control study

Chronic neck pain (CNP) is a common musculoskeletal disorder among college students and is closely linked to poor head-shoulder posture and alterations in neuromuscular activity. Exploring postural and electromyographic (EMG) characteristics can provide essential insights for diagnosis and rehabilitation. This study aimed to comprehensively examine head-shoulder posture (including craniocervical angle, forward head posture [FHP], supine acromial distance, and rounded shoulder posture [RSP]) and cervical muscle function (strength and EMG characteristics) in college students with CNP to provide a reference for clinical diagnosis and rehabilitation. A total of 22 college students with CNP and 22 healthy students were recruited. Head-shoulder posture was evaluated using the craniocervical angle, supine acromial distance, FHP abnormality rate, and RSP abnormality rate. The isometric strength of the neck extensor muscles was measured at the neutral, natural anteversion, and maximum forward flexion positions. Surface EMG of the splenius capitis muscle and upper trapezius muscle was performed. Compared with their healthy peers, students with CNP had significantly smaller craniocervical angles and a greater incidence of abnormal FHP (P < .01). They had greater supine acromial distance and a greater incidence of a RSP (P < .01). Isometric muscle strength and EMG activity of the neck extensor muscles were significantly reduced in all positions (P < .01). During flexion-extension testing, the EMG flexion-relaxation response decreased, with CNP students showing higher flexion-relaxation ratio values (P < .01). College students with CNP show significant abnormalities in head-shoulder posture, decreased neck extensor strength, and altered EMG activity, including a diminished flexion-relaxation response. These findings highlight the critical role of postural and neuromuscular dysfunction in CNP, providing a valuable reference for clinical diagnosis and rehabilitation in the college student population.