# Associations Between Visual Accommodation and Cervical Muscle Activity and Symptomatology: A Systematic Review

## TL;DR

This study explores the link between visual stress and cervical muscle activity, finding that visual accommodation may contribute to neck pain and muscle fatigue.

## Contribution

The study systematically reviews evidence for a physiological connection between visual accommodation and cervical musculoskeletal symptoms.

## Key findings

- Visual accommodation is associated with increased trapezius muscle activity.
- Accommodative stress may lead to cervical muscle fatigue and pain.
- Seven experimental studies showed a link between visual and cervical systems.

## Abstract

Objectives: The aim of this study was to investigate the potential anatomical and physiological interconnections between the visual system and the cervical muscular system, as well as to examine the role of the visual system in the etiology and manifestation of cervical musculoskeletal pain or discomfort. Methods: A systematic review was conducted following the PRISMA guidelines, using databases such as PubMed, Scopus, Web of Science, CINAHL, and PEDro. The protocol was registered in PROSPERO. The included study designs comprised experimental studies, randomized controlled trials (RCTs), and pilot RCTs. Results: The literature search was conducted between January and May 2025 and yielded 51 studies across all databases. Seven experimental studies were finally included, all of which met the inclusion criteria and presented a mean methodological quality score of 5 on the PEDro methodological quality scale. The studies included data from a total of 308 participants (n = 261; 84.74% females). Subjects in the intervention group reported cervical pain or visual fatigue. Conclusions: Our results indicated a relationship between visual accommodation and increased electromyographic activity of the trapezius muscle, suggesting that accommodative stress may induce cervical muscle fatigue and pain.