Comparative Analysis of Ankle Muscle Activation During Sitting and Standing in Individuals with Neck Pain: An Electromyographic Study

Background/Objectives: This study compared upper trapezius (UT), peroneus longus (PL), medial gastrocnemius (MGC), and tibialis anterior (TA) activation between university students with and without neck pain during sitting, standing, and writing. Methods: This cross-sectional study included 27 students: 19 with neck pain and 8 controls. Pain intensity and disability were assessed using the Numerical Rating Scale and Neck Disability Index. Bilateral surface electromyographic root-mean-square amplitudes were normalized to maximal voluntary contractions. Linear mixed-effects models assessed muscle activity, with Bonferroni-adjusted pairwise comparisons. Within-group positional analyses were exploratory. Results: Overall UT amplitude was higher in the neck pain group (mean difference: 6.117; 95% confidence interval: 3.045–9.190; p < 0.001). Within this group, UT amplitude was higher during sitting (mean difference: 5.937; p = 0.006) and writing than standing (mean difference: 9.212; p < 0.001), and higher on the right than the left (p = 0.002). PL and MGC amplitudes were higher during standing than sitting in both groups. Within the neck pain group, both muscles also showed higher amplitudes during writing than sitting. TA amplitude was higher during standing than during sitting (p = 0.002) and writing (p = 0.035) within the neck pain group. Conclusions: Neck pain was associated with higher overall UT activity. Positional differences in ankle muscle activity in patients with neck pain were also observed; however, additional studies with larger samples will be required to explore this observation further.