Playing Related Musculoskeletal Disorders Clinical Trial
Official title:
Scapular and Cervical Neuromuscular Deficits in Musicians With and Without Playing Related Musculoskeletal Disorders: A Case Control Study.
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.
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)
;
Observational Model: Case Control, Time Perspective: Retrospective