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

March 31, 2016 updated by: Flavio Silva, Vanderbilt University

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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

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)

Study Type

Observational

Enrollment (Actual)

101

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Tennessee
      • Franklin, Tennessee, United States, 37067
        • Vanderbilt Orthopaedics Cool Springs

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 65 years (Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Musicians with and without playing related musculo-skeletal Injuries.

Description

Inclusion Criteria for Experimental Group:

  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.

Inclusion Criteria for Control group:

  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

    -

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
(No-PRMSDs)
Group 1 : No Playing Related Musculoskeletal Injury
Other: (1) cranio-cervical flexion test;
Test to determine level of strength for Deep Neck Flexor muscles
Other: (2) scapular dyskinesis test
Test to determine scapular control
Other: (3) deep neck flexor endurance test.
Test do determine endurance for the deep neck flexor muscle group.
(Yes-PRMSDs)
Group 2: Playing Related Musculoskeletal Injury
Other: (1) cranio-cervical flexion test;
Test to determine level of strength for Deep Neck Flexor muscles
Other: (2) scapular dyskinesis test
Test to determine scapular control
Other: (3) deep neck flexor endurance test.
Test do determine endurance for the deep neck flexor muscle group.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Cranio Cervical Flexion test Score
Time Frame: 1 day
Score of Cranio Cervical Flexion test
1 day
Presence of scapular dyskinesia
Time Frame: 1
Presence of scapular dyskinesia
1
Deep Neck Flexor Endurance Test Score
Time Frame: 1
Score of Deep Neck Flexor Endurance test
1

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Vanderbilt University

Investigators

  • Principal Investigator: Flavio Silva, BscPT, Vanderbilt University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

November 1, 2014

Primary Completion (Actual)

March 1, 2016

Study Completion (Actual)

March 1, 2016

Study Registration Dates

First Submitted

September 29, 2014

First Submitted That Met QC Criteria

October 13, 2014

First Posted (Estimate)

October 17, 2014

Study Record Updates

Last Update Posted (Estimate)

April 1, 2016

Last Update Submitted That Met QC Criteria

March 31, 2016

Last Verified

March 1, 2016

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 1212 (Copenhagen University)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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