Scapular and Cervical Neuromuscular Control Deficits in Musicians With and Without Playing Injuries.

NCT ID: NCT02267395

Last Updated: 2016-04-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

101 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-11-30

Study Completion Date

2016-03-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The study will investigate if there are differences in the presence of: (1) prior injury, playing patterns, and physical fitness habits; (2) scapular control; and (3) cervical neuromuscular control and endurance deficits between musicians with and without current playing related musculoskeletal injuries.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Background: The art of professionally playing a musical instrument can be physically demanding. Such activity involves maintaining static postures and producing repetitive motions for countless hours of playing time between practice and performances, often with very little rest. More than 50% of musicians will develop upper extremity injuries and pain related to instrument use, which can negatively affect or interrupt their careers. Efficient cervical spine and shoulder girdle neuromuscular control is essential for upper quarter musculoskeletal injury prevention. Neuromuscular control deficits are linked to a higher upper extremity occupational injury incidence in most professions. However, no research to date has investigated if there are differences in scapular and cervical endurance and neuromuscular control between musicians with and without playing-related cervical and upper extremity musculoskeletal disorders.

Design: Case-control study Setting: Musical venue and university setting. Participants: Eighty subjects including student musicians from different universities and professional musicians in Tennessee.

Methods: Musicians will be consecutively recruited to fill in a questionnaire regarding the presence of cervical and upper extremity PRMSDs. Those subjects with PRMSDs (Yes-PRMSDs) will undergo clinical testing for the presence of scapular dyskinesis and cervical neuromuscular control and endurance deficits using the following tests: (1) cranio-cervical flexion test; (2) scapular dyskinesis test; and (3) deep neck flexor endurance test. Asymptomatic musicians (No-PRMSDs) will be recruited consecutively, matched by gender, type of instrument (string instrument or other) and number of hours played per week and tested following the same protocol.

Reliability testing: To determine intrarater reliability prior to data collection, a convenience sample of twenty subjects not included in the study will be evaluated over two days for (1) Cranio-cervical flexion test; (2) Scapular dyskinesis test; and (3) deep neck flexor endurance test. Tests will be repeated with at least a 24-hour interval between testing sessions. Intra-class correlation coefficient (model 3, 2) for the two cervical tests and Kappa statistics model for the scapular dyskinesis test will be calculated for determination of intrarater reliability.

Interventions: Subjects will complete a comprehensive demographic questionnaire that includes playing patterns, as well as general health related questions and fitness activities exposure. In a second visit, subjects in both groups will complete a test battery that includes cranio-cervical flexion test, scapular dyskinesis assessment and deep neck flexor endurance test. Blinding of the assessor as to the group in which subjects are members (Yes-PRMSDs versus No-PRMSDs) will be ensured.

Purpose: The purposes of this research will be to investigate if there are differences in the presence of: (1) prior injury, playing patterns, and physical fitness habits; (2) scapular dyskinesis; and (3) cervical neuromuscular control and endurance deficits between musicians with and without playing related musculoskeletal Disorders (PRMSDs)

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Playing Related Musculoskeletal Disorders

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

(No-PRMSDs)

Group 1 : No Playing Related Musculoskeletal Injury

(1) cranio-cervical flexion test;

Intervention Type OTHER

Test to determine level of strength for Deep Neck Flexor muscles

(2) scapular dyskinesis test

Intervention Type OTHER

Test to determine scapular control

(3) deep neck flexor endurance test.

Intervention Type OTHER

Test do determine endurance for the deep neck flexor muscle group.

(Yes-PRMSDs)

Group 2: Playing Related Musculoskeletal Injury

(1) cranio-cervical flexion test;

Intervention Type OTHER

Test to determine level of strength for Deep Neck Flexor muscles

(2) scapular dyskinesis test

Intervention Type OTHER

Test to determine scapular control

(3) deep neck flexor endurance test.

Intervention Type OTHER

Test do determine endurance for the deep neck flexor muscle group.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

(1) cranio-cervical flexion test;

Test to determine level of strength for Deep Neck Flexor muscles

Intervention Type OTHER

(2) scapular dyskinesis test

Test to determine scapular control

Intervention Type OTHER

(3) deep neck flexor endurance test.

Test do determine endurance for the deep neck flexor muscle group.

Intervention Type OTHER

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. Student musicians or professional musicians playing instrument 6 hours or more per week.
2. Current pain or history of cervical or upper extremity PRMSDs and or history of pain during the past year with symptoms lasting more than one week and affecting musical performance.
3. Between 18 and 65 years of age.


1. Student musician or professional musician playing instrument more than 6 hours a week.
2. No history of cervical or upper extremity injury and or pain during the past year with symptoms lasting more than one week
3. Between 18 and 65 years of age.

Exclusion Criteria

1. History of trauma or injury other than playing related injury, currently affecting the ability to play musical instrument.
2. Pregnancy
3. Neurological disorder affecting motor control (including but not limited to Parkinson' s, multiple sclerosis, Amyotrophic lateral sclerosis, muscular dystrophy, myasthenia gravis, Guillain-Barre)
4. Rheumatoid arthritis or ankylosing spondylitis
5. Diagnosis of any connective tissue disorder (Including but not limited to Marfan's syndrome, Ehlers-Danlos syndrome, systemic lupus erythematosus, scleroderma)
6. Presence of cervical radiculopathy
7. History of recent (within the last year) cervical or shoulder surgery

\-
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Vanderbilt University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Flavio Silva

Clinical Coordinator of Physical Therapy

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Flavio Silva, BscPT

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Vanderbilt Orthopaedics Cool Springs

Franklin, Tennessee, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Ackermann B, Driscoll T, Kenny DT. Musculoskeletal pain and injury in professional orchestral musicians in Australia. Med Probl Perform Art. 2012 Dec;27(4):181-7.

Reference Type BACKGROUND
PMID: 23247873 (View on PubMed)

Barton PM, Hayes KC. Neck flexor muscle strength, efficiency, and relaxation times in normal subjects and subjects with unilateral neck pain and headache. Arch Phys Med Rehabil. 1996 Jul;77(7):680-7. doi: 10.1016/s0003-9993(96)90008-8.

Reference Type BACKGROUND
PMID: 8669995 (View on PubMed)

Bruno S, Lorusso A, L'Abbate N. Playing-related disabling musculoskeletal disorders in young and adult classical piano students. Int Arch Occup Environ Health. 2008 Jul;81(7):855-60. doi: 10.1007/s00420-007-0279-8. Epub 2008 Jan 22.

Reference Type BACKGROUND
PMID: 18210148 (View on PubMed)

Chan C, Driscoll T, Ackermann B. Development of a specific exercise programme for professional orchestral musicians. Inj Prev. 2013 Aug;19(4):257-63. doi: 10.1136/injuryprev-2012-040608. Epub 2012 Dec 4.

Reference Type BACKGROUND
PMID: 23211353 (View on PubMed)

Chiu TT, Law EY, Chiu TH. Performance of the craniocervical flexion test in subjects with and without chronic neck pain. J Orthop Sports Phys Ther. 2005 Sep;35(9):567-71. doi: 10.2519/jospt.2005.35.9.567.

Reference Type BACKGROUND
PMID: 16268243 (View on PubMed)

Cools AM, Struyf F, De Mey K, Maenhout A, Castelein B, Cagnie B. Rehabilitation of scapular dyskinesis: from the office worker to the elite overhead athlete. Br J Sports Med. 2014 Apr;48(8):692-7. doi: 10.1136/bjsports-2013-092148. Epub 2013 May 18.

Reference Type BACKGROUND
PMID: 23687006 (View on PubMed)

De Mey K, Danneels L, Cagnie B, Cools AM. Scapular muscle rehabilitation exercises in overhead athletes with impingement symptoms: effect of a 6-week training program on muscle recruitment and functional outcome. Am J Sports Med. 2012 Aug;40(8):1906-15. doi: 10.1177/0363546512453297. Epub 2012 Jul 11.

Reference Type BACKGROUND
PMID: 22785606 (View on PubMed)

Dick RW, Berning JR, Dawson W, Ginsburg RD, Miller C, Shybut GT. Athletes and the arts--the role of sports medicine in the performing arts. Curr Sports Med Rep. 2013 Nov-Dec;12(6):397-403. doi: 10.1249/JSR.0000000000000009.

Reference Type BACKGROUND
PMID: 24225525 (View on PubMed)

Domenech MA, Sizer PS, Dedrick GS, McGalliard MK, Brismee JM. The deep neck flexor endurance test: normative data scores in healthy adults. PM R. 2011 Feb;3(2):105-10. doi: 10.1016/j.pmrj.2010.10.023.

Reference Type BACKGROUND
PMID: 21333948 (View on PubMed)

Falla D, O'Leary S, Farina D, Jull G. The change in deep cervical flexor activity after training is associated with the degree of pain reduction in patients with chronic neck pain. Clin J Pain. 2012 Sep;28(7):628-34. doi: 10.1097/AJP.0b013e31823e9378.

Reference Type BACKGROUND
PMID: 22156825 (View on PubMed)

Fry HJ. Overuse syndromes in instrumental musicians. Semin Neurol. 1989 Jun;9(2):136-45. doi: 10.1055/s-2008-1041317. No abstract available.

Reference Type BACKGROUND
PMID: 2557662 (View on PubMed)

Grieco A, Occhipinti E, Colombini D, Menoni O, Bulgheroni M, Frigo C, Boccardi S. Muscular effort and musculo-skeletal disorders in piano students: electromyographic, clinical and preventive aspects. Ergonomics. 1989 Jul;32(7):697-716. doi: 10.1080/00140138908966837.

Reference Type BACKGROUND
PMID: 2806217 (View on PubMed)

Harris KD, Heer DM, Roy TC, Santos DM, Whitman JM, Wainner RS. Reliability of a measurement of neck flexor muscle endurance. Phys Ther. 2005 Dec;85(12):1349-55.

Reference Type BACKGROUND
PMID: 16305273 (View on PubMed)

Hidalgo-Lozano A, Calderon-Soto C, Domingo-Camara A, Fernandez-de-Las-Penas C, Madeleine P, Arroyo-Morales M. Elite swimmers with unilateral shoulder pain demonstrate altered pattern of cervical muscle activation during a functional upper-limb task. J Orthop Sports Phys Ther. 2012 Jun;42(6):552-8. doi: 10.2519/jospt.2012.3875. Epub 2012 Jan 25.

Reference Type BACKGROUND
PMID: 22282107 (View on PubMed)

Holmgren T, Bjornsson Hallgren H, Oberg B, Adolfsson L, Johansson K. Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: randomised controlled study. BMJ. 2012 Feb 20;344:e787. doi: 10.1136/bmj.e787.

Reference Type BACKGROUND
PMID: 22349588 (View on PubMed)

Hoppmann RA. Instrumental musicians' hazards. Occup Med. 2001 Oct-Dec;16(4):619-31, iv-v.

Reference Type BACKGROUND
PMID: 11567922 (View on PubMed)

James G, Doe T. The craniocervical flexion test: intra-tester reliability in asymptomatic subjects. Physiother Res Int. 2010 Sep;15(3):144-9. doi: 10.1002/pri.456.

Reference Type BACKGROUND
PMID: 20146239 (View on PubMed)

Jull G, Barrett C, Magee R, Ho P. Further clinical clarification of the muscle dysfunction in cervical headache. Cephalalgia. 1999 Apr;19(3):179-85. doi: 10.1046/j.1468-2982.1999.1903179.x.

Reference Type BACKGROUND
PMID: 10234466 (View on PubMed)

Jull GA, Falla D, Vicenzino B, Hodges PW. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Man Ther. 2009 Dec;14(6):696-701. doi: 10.1016/j.math.2009.05.004. Epub 2009 Jul 25.

Reference Type BACKGROUND
PMID: 19632880 (View on PubMed)

Jull GA, O'Leary SP, Falla DL. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther. 2008 Sep;31(7):525-33. doi: 10.1016/j.jmpt.2008.08.003.

Reference Type BACKGROUND
PMID: 18804003 (View on PubMed)

Juul T, Langberg H, Enoch F, Sogaard K. The intra- and inter-rater reliability of five clinical muscle performance tests in patients with and without neck pain. BMC Musculoskelet Disord. 2013 Dec 3;14:339. doi: 10.1186/1471-2474-14-339.

Reference Type BACKGROUND
PMID: 24299621 (View on PubMed)

Kaufman-Cohen Y, Ratzon NZ. Correlation between risk factors and musculoskeletal disorders among classical musicians. Occup Med (Lond). 2011 Mar;61(2):90-5. doi: 10.1093/occmed/kqq196. Epub 2011 Jan 26.

Reference Type BACKGROUND
PMID: 21273187 (View on PubMed)

Kibler WB, McMullen J. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg. 2003 Mar-Apr;11(2):142-51. doi: 10.5435/00124635-200303000-00008.

Reference Type BACKGROUND
PMID: 12670140 (View on PubMed)

Kibler WB, Sciascia A. Current concepts: scapular dyskinesis. Br J Sports Med. 2010 Apr;44(5):300-5. doi: 10.1136/bjsm.2009.058834. Epub 2009 Dec 8.

Reference Type BACKGROUND
PMID: 19996329 (View on PubMed)

Kibler WB, Sciascia A, Wilkes T. Scapular dyskinesis and its relation to shoulder injury. J Am Acad Orthop Surg. 2012 Jun;20(6):364-72. doi: 10.5435/JAAOS-20-06-364.

Reference Type BACKGROUND
PMID: 22661566 (View on PubMed)

Kibler WB, Sciascia AD. Introduction to the Second International Conference on Scapular Dyskinesis in Shoulder Injury--the 'Scapular Summit' Report of 2013. Br J Sports Med. 2013 Sep;47(14):874. doi: 10.1136/bjsports-2013-092424. Epub 2013 Apr 11. No abstract available.

Reference Type BACKGROUND
PMID: 23580419 (View on PubMed)

Kibler WB, Ludewig PM, McClure PW, Michener LA, Bak K, Sciascia AD. Clinical implications of scapular dyskinesis in shoulder injury: the 2013 consensus statement from the 'Scapular Summit'. Br J Sports Med. 2013 Sep;47(14):877-85. doi: 10.1136/bjsports-2013-092425. Epub 2013 Apr 11.

Reference Type BACKGROUND
PMID: 23580420 (View on PubMed)

Leaver R, Harris EC, Palmer KT. Musculoskeletal pain in elite professional musicians from British symphony orchestras. Occup Med (Lond). 2011 Dec;61(8):549-55. doi: 10.1093/occmed/kqr129. Epub 2011 Oct 14.

Reference Type BACKGROUND
PMID: 22003061 (View on PubMed)

Lexell JE, Downham DY. How to assess the reliability of measurements in rehabilitation. Am J Phys Med Rehabil. 2005 Sep;84(9):719-23. doi: 10.1097/01.phm.0000176452.17771.20.

Reference Type BACKGROUND
PMID: 16141752 (View on PubMed)

Mehrparvar AH, Mostaghaci M, Gerami RF. Musculoskeletal disorders among Iranian instrumentalists. Med Probl Perform Art. 2012 Dec;27(4):193-6.

Reference Type BACKGROUND
PMID: 23247875 (View on PubMed)

McClure P, Tate AR, Kareha S, Irwin D, Zlupko E. A clinical method for identifying scapular dyskinesis, part 1: reliability. J Athl Train. 2009 Mar-Apr;44(2):160-4. doi: 10.4085/1062-6050-44.2.160.

Reference Type BACKGROUND
PMID: 19295960 (View on PubMed)

O'Leary S, Falla D, Jull G. The relationship between superficial muscle activity during the cranio-cervical flexion test and clinical features in patients with chronic neck pain. Man Ther. 2011 Oct;16(5):452-5. doi: 10.1016/j.math.2011.02.008. Epub 2011 Mar 10.

Reference Type BACKGROUND
PMID: 21396876 (View on PubMed)

Olson LE, Millar AL, Dunker J, Hicks J, Glanz D. Reliability of a clinical test for deep cervical flexor endurance. J Manipulative Physiol Ther. 2006 Feb;29(2):134-8. doi: 10.1016/j.jmpt.2005.12.009.

Reference Type BACKGROUND
PMID: 16461172 (View on PubMed)

Paarup HM, Baelum J, Holm JW, Manniche C, Wedderkopp N. Prevalence and consequences of musculoskeletal symptoms in symphony orchestra musicians vary by gender: a cross-sectional study. BMC Musculoskelet Disord. 2011 Oct 7;12:223. doi: 10.1186/1471-2474-12-223.

Reference Type BACKGROUND
PMID: 21978278 (View on PubMed)

Quarrier NF. Performing arts medicine: the musical athlete. J Orthop Sports Phys Ther. 1993 Feb;17(2):90-5. doi: 10.2519/jospt.1993.17.2.90.

Reference Type BACKGROUND
PMID: 8467339 (View on PubMed)

Ranelli S, Straker L, Smith A. Playing-related musculoskeletal problems in children learning instrumental music: the association between problem location and gender, age, and music exposure factors. Med Probl Perform Art. 2011 Sep;26(3):123-39.

Reference Type BACKGROUND
PMID: 21987067 (View on PubMed)

Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005 Mar;85(3):257-68.

Reference Type BACKGROUND
PMID: 15733050 (View on PubMed)

Steinmetz A, Moller H, Seidel W, Rigotti T. Playing-related musculoskeletal disorders in music students-associated musculoskeletal signs. Eur J Phys Rehabil Med. 2012 Dec;48(4):625-33. Epub 2012 Nov 9.

Reference Type BACKGROUND
PMID: 23138678 (View on PubMed)

Steinmetz A, Seidel W, Muche B. Impairment of postural stabilization systems in musicians with playing-related musculoskeletal disorders. J Manipulative Physiol Ther. 2010 Oct;33(8):603-11. doi: 10.1016/j.jmpt.2010.08.006. Epub 2010 Oct 12.

Reference Type BACKGROUND
PMID: 21036282 (View on PubMed)

Struyf F, Nijs J, Mollekens S, Jeurissen I, Truijen S, Mottram S, Meeusen R. Scapular-focused treatment in patients with shoulder impingement syndrome: a randomized clinical trial. Clin Rheumatol. 2013 Jan;32(1):73-85. doi: 10.1007/s10067-012-2093-2. Epub 2012 Oct 2.

Reference Type BACKGROUND
PMID: 23053685 (View on PubMed)

Wilke C, Priebus J, Biallas B, Frobose I. Motor activity as a way of preventing musculoskeletal problems in string musicians. Med Probl Perform Art. 2011 Mar;26(1):24-9.

Reference Type BACKGROUND
PMID: 21442133 (View on PubMed)

Zaza C, Farewell VT. Musicians' playing-related musculoskeletal disorders: an examination of risk factors. Am J Ind Med. 1997 Sep;32(3):292-300. doi: 10.1002/(sici)1097-0274(199709)32:33.0.co;2-q.

Reference Type BACKGROUND
PMID: 9219660 (View on PubMed)

Zaza C. Playing-related musculoskeletal disorders in musicians: a systematic review of incidence and prevalence. CMAJ. 1998 Apr 21;158(8):1019-25.

Reference Type BACKGROUND
PMID: 9580730 (View on PubMed)

Kava K, Larson C, Stiller C, Maher S. Trunk endurance exercise and the effect on instrumental performance: a preliminary study comparing pilates exercise and a trunk and proximal upper extremity endurance exercise program. Music Performance Research. Royal Northern College of Music. 2010;3(1):1-30

Reference Type BACKGROUND

Silva FM, Brismee JM, Sizer PS, Hooper TL, Robinson GE, Diamond AB. Musicians injuries: Upper quarter motor control deficits in musicians with prolonged symptoms - A case-control study. Musculoskelet Sci Pract. 2018 Aug;36:54-60. doi: 10.1016/j.msksp.2018.04.006. Epub 2018 Apr 27.

Reference Type DERIVED
PMID: 29738929 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

1212

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Art and Surface Electromyography (EMG)
NCT00731991 COMPLETED PHASE1/PHASE2