Differences in Cervical Muscle Activity of Pilots and Nonpilots With and Without Neck Pain

INTRODUCTION: Neck pain is common and often persistent, especially among military pilots exposed to high physical demands during flight. These conditions may alter neuromuscular control, contributing to chronic symptoms. While surface electromyography can detect pain-related changes in muscle activity, little is known about these patterns during low-load exercises in pilots. This study identifies differences in cervical muscle activity between pilots and nonpilots with and without neck pain. METHODS: A total of 18 military pilots and 23 control subjects were categorized into symptomatic and asymptomatic subgroups. All subjects performed one reference movement and seven standardized mobility exercises while surface electromyogram recorded the activity of the cervical muscles. Wavelet analysis was applied to assess frequency and intensity patterns. RESULTS: Across the four subgroups, mean age ranged from 25.4 ± 0.9-48.7 ± 15.0 yr, mean body mass index from 24.1 ± 2.3-27.2 ± 3.4 kg · m-2, and current Visual Analog Scale scores from 0.0 ± 0.0-1.7 ± 1.8. In symptomatic nonpilots, the left trapezius muscle showed notably lower firing intensity compared to symptomatic pilots across multiple exercises. Symptomatic pilots demonstrated predominant activity in the lower frequency bands (wavelets) compared to all other subgroups during shoulder movements. DISCUSSION: These findings suggest that neck pain may be associated with reduced firing intensity and frequency shifts, potentially reflecting a protective adaptation. In pilots, this may help preserve function under load while minimizing further strain on cervical structures. Rochelt J, Saba N, Bron D. Differences in cervical muscle activity of pilots and nonpilots with and without neck pain. Aerosp Med Hum Perform. 2026; 97(6):394-402.