The effect of pillow height on muscle activity of the neck and mid-upper back and patient perception of comfort

J Manipulative Physiol Ther. 2015 Jul-Aug;38(6):375-81. doi: 10.1016/j.jmpt.2015.06.012. Epub 2015 Jul 21.


Objective: The purpose of this study was to evaluate the comfort and the electromyographic (EMG) activity of the neck and mid-upper back of asymptomatic adults using foam pillows of 3 different heights.

Methods: Twenty-one asymptomatic adults used foam pillows of 3 different heights (1: 5 cm, 2: 10 cm, and 3: 14 cm). Comfort was assessed using a 100-mm visual analog scale. Electromyographic activity was assessed in the lateral position. We calculated the root mean square (RMS) in 500-millisecond windows of bilateral EMG activity of the sternocleidomastoid and upper and middle trapezius, normalized by maximal isometric contraction of each individual. The RMS of the EMG signals was compared among pillow heights using repeated-measures analysis of variance (P < .05).

Results: The middle trapezius muscle of the down-side showed the highest RMS in height 1 when compared with heights 2 (P = .0163) and 3 (P = .0313), with no statistical significance between pillow heights 2 and 3 for this muscle. There were no statistical differences between pillows 2 and 3 in any muscle activity. Height 2 was considered the most comfortable (P < .001) compared with heights 1 and 3, and height 1 the least comfortable (P < .001) compared with the other heights.

Conclusion: For the participants in this study, there was an association among pillow height, myoelectric activity, and comfort.

Keywords: Bedding and Linens; Electromyography; Neck Muscles; Sleep.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Back Muscles / physiology*
  • Back Pain / prevention & control*
  • Bedding and Linens*
  • Electromyography / methods
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Muscle Contraction / physiology
  • Neck Muscles / physiology*
  • Neck Pain / prevention & control*
  • Pain Perception / physiology
  • Posture / physiology
  • Spasm / prevention & control
  • Young Adult