This study will analyze and compare scapular kinematics and muscle activation patterns between upper string musicians with and without neck pain during arm elevation and playing tasks (open strings, scales, musical pieces), providing insights for performance training and rehabilitation programs to reduce playing-related musculoskeletal disorders.
The study participants will be right-handed upper string musicians (violinists and violists) aged 18 years and older. Participants must have at least 5 years of playing experience and practice more than 6 hours per week. Neck pain group: non-specific neck pain (between superior nuchal line and T1) lasting at least 2 weeks with NRS ≥3. Healthy control group: no neck/shoulder pain history in the past year, matched for age, gender, handedness, playing experience (\>5 years), and practice hours (\>6 hours/week). The study involves arm elevation (0°, 30°, 60°, 90°, 120°); open string playing (at 60-120 bpm); A major scale (at 60-120 bpm); E major scale (at 60-120 bpm); and Vittorio Monti Csárdás.
Study Type
OBSERVATIONAL
Enrollment
60
Arm elevation (0°, 30°, 60°, 90°, 120°), open string playing, scale practice, and musical piece performance
National Yang Ming Chiao Tung University
Taipei, Taiwan, Taiwan
Scapular muscles activation during arm elevation and dynamic instrument-playing tasks.
Muscle activation levels of the upper trapezius, lower trapezius, and serratus anterior will be measured using surface electromyography (sEMG) during arm elevation (0°, 30°, 60°, 90°, 120°) and dynamic instrument-playing tasks. Data will be normalized to maximum voluntary isometric contraction (%MVIC) and expressed as root mean square (RMS) amplitude.
Time frame: Through study completion, an average of 1 hour
Scapular kinematics during arm elevation and dynamic instrument-playing tasks
Three-dimensional scapular orientation (upward/downward rotation, internal/external rotation, anterior/posterior tilt) will be measured using an electromagnetic tracking system during arm elevation (0°, 30°, 60°, 90°, 120°) and dynamic instrument-playing tasks. Data will be expressed in degrees.
Time frame: Through study completion, an average of 1 hour
Cervical muscles activation during arm elevation and dynamic instrument-playing tasks
Muscle activation levels of the sternocleidomastoid (SCM) and cervical extensors (CE) will be measured using surface electromyography (sEMG) during arm elevation and dynamic instrument-playing tasks. Data will be normalized to maximum voluntary isometric contraction (%MVIC) and expressed as root mean square (RMS) amplitude.
Time frame: : Through study completion, an average of 1 hour
Cervical kinematic during arm elevation and dynamic instrument-playing tasks
Three-dimensional movement of the cervical spine will be measured using the VIPER electromagnetic tracking system during arm elevation and dynamic instrument-playing tasks. Data will be expressed in degrees.
Time frame: Through study completion, an average of 1 hour
Shoulder muscle strength
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Isometric muscle strength of the upper/lower trapezius, and serratus anterior muscles will be evaluated using a hand-held dynamometer (MicroFET2). Data will be expressed in kilograms (kg).
Time frame: Immediately during the experiment
Cervical and Shoulder mobility
cervical range of motion (flexion, extension, lateral flexion, rotation) will be measured using CROM. Shoulder range of motion will be measured using inclinometer. Data will be expressed in degrees (°).
Time frame: Immediately during the experiment
Shoulder muscle length test
Resting length of the pectoralis minor and levator scapulae muscles will be measured using a tape measure and vernier caliper. Pectoralis minor index (PMI) and levator scapulae index (LSI) will be calculated and expressed as percentages (%). Pectoralis major flexibility assessed in supine via ability to rest the posterior shoulder flat on the table (pass/fail).
Time frame: Immediately during the experiment
Postural Angles (CVA and FSA)
Craniovertebral angle (CVA) and forward shoulder angle (FSA) will be measured using digital photography to assess static head and shoulder posture.
Time frame: Immediately during the experiment