Cervical Pain and Exercise in Musicians

Effectiveness of the Selected Exercise Program on Non-specific Cervical Pain in Ney and Violin Performers

Exercise training that is one of the effective treatment methods for cervical pain, is crucial in developing mobility and stability. Exercise training significantly reduces cervical pain as it advances postural alignment and neuromuscular coordination. In many single group studies on cervical pain in violin performers, it has been reported that the stabilization exercises have favorable consequences on pain relief and postural correction. But, there are no studies comparing ney and violin performers and analyzing the effectiveness of exercise training on non-specific cervical pain. The aim of this study is to search the effects of selected exercise training on pain, disability, range of motion, flexibility, strength and quality of life in ney and violin performers with non-specific cervical pain.

Study Overview

• Status: Completed
• Conditions: Cervical Pain
• Intervention / Treatment: Other: Selected Exercise

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Gaziantep, Turkey, 27144
    • Hasan Kalyoncu University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Being professional musicians
• Using violin or ney musical instruments
• Had non-specific cervical pain during 3 months

Exclusion Criteria:

• Had cervical surgery in the last 3 months, discogenic pain, radiculopathy, neurological or systemic disorders,
• Missing exercise training session more than 2

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Violin Performers; Violin performers received three 40-45 minute exercise sessions each week for eight weeks. The selected exercise program designed to correct postural alignment.	Other: Selected Exercise; The violin and ney groups performed a structured exercise training program 3 times a week for a total of 8 weeks. Adherence to the exercise training program was checked using a follow-up schedule to ensure regular participation of the musicians. The 8-week exercise training program was given with same physiotherapist under the same conditions. The every exercise session consisted of warm-up (3-5 min), main exercise (30-35 min) and cooling periods (3-5 min). The main exercise period was included ROM (10 min), stretching (5-7 min), isometric (5-10 min) and stabilization exercises (5 min).
Experimental: Ney Performers; Ney performers received three 40-45 minute exercise sessions each week for eight weeks. The selected exercise program designed to correct postural alignment.	Other: Selected Exercise; The violin and ney groups performed a structured exercise training program 3 times a week for a total of 8 weeks. Adherence to the exercise training program was checked using a follow-up schedule to ensure regular participation of the musicians. The 8-week exercise training program was given with same physiotherapist under the same conditions. The every exercise session consisted of warm-up (3-5 min), main exercise (30-35 min) and cooling periods (3-5 min). The main exercise period was included ROM (10 min), stretching (5-7 min), isometric (5-10 min) and stabilization exercises (5 min).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain intensity	Visual Analog Scale (VAS) was used to measure the severity of pain. In this scale, "0" indicates no pain, "10" indicates the highest value for perceived pain. Participants were asked to illustrate the intensity of the pain they felt on a material with a horizontal line of 10 cm and was recorded as VAS score.	8 weeks
Functional Status	The Northwick Park Neck Pain Questionnaire (NPQ) was used to specify functional status. NPQ was developed to designate the level of disability in neck pain; It is a 9-item scale including neck pain severity, neck pain and sleep, numbness and tingling in the arms at night, duration of symptoms and complaints, weight-bearing, reading and watching television, work and housework, social activities, and driving. It evaluates the severity, symptoms, duration of neck pain and disability in the activities specified in each item. Each of them consists of 5 items and is scored between 0-4 points. Neck pain total score consists of 36 points. If the patients are not driving, the total score is calculated over 32 points.	8 weeks
Life Quality	Quality of life was evaluated with the SF-36 scale. The scale consists of 8 sub-parameters with a total of 36 items. These sub-parameters are listed as; physical function, physical role limitation, pain, general health, energy (vitality), social function, emotional role limitation and mental health.	8 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle Strength	Muscle strength was measured with a digital muscle dynamometer (Jtech Commander Muscle Testing). Anterior and middle part of deltoid, serratus anterior, upper and middle part of trapezius, cervical flexor and extensor muscles were measured.	8 weeks
Grip Strength	The grip strength was measured with a hand dynamometer (Baseline, Hydraulic Hand Dynamometer). Measurements were made in a sitting position, regardless of the right or left hand, with the elbow flexed at 90° and the arms in contact with the body without any abduction movement. In this position, Individuals were asked to squeeze their hand with maximum force and measurements were repeated for other arm.	8 weeks
Range of Motion	Cervical Flexion, extension, rotation and lateral flexion were measured by using a universal goniometer. Head and trunk were held upright while participants were in a sitting position.	8 weeks
Spinal Mobility	The jaw-sternum and jaw-wall distance were measured with a tape measure. Participants was asked to stand upright in an anatomical position while leaning against the wall. In this position, the distance of chin tip to wall and chin tip to the incisura jugularis were used.	8 weeks

Collaborators and Investigators

• Sponsor: Hasan Kalyoncu University

Publications and helpful links

General Publications

• 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.
• Kuo YL, Lee TH, Tsai YJ. Evaluation of a Cervical Stabilization Exercise Program for Pain, Disability, and Physical Impairments in University Violinists with Nonspecific Neck Pain. Int J Environ Res Public Health. 2020 Jul 28;17(15):5430. doi: 10.3390/ijerph17155430.
• 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.

Study record dates

Study Major Dates

• Study Start (Actual): February 2, 2018
• Primary Completion (Actual): June 2, 2019
• Study Completion (Actual): July 9, 2019

Study Registration Dates

• First Submitted: March 13, 2021
• First Submitted That Met QC Criteria: March 13, 2021
• First Posted (Actual): March 17, 2021

Study Record Updates

• Last Update Posted (Actual): March 30, 2021
• Last Update Submitted That Met QC Criteria: March 25, 2021
• Last Verified: March 1, 2021

More Information

Terms related to this study

• Keywords: Exercise; Musicians; Cervical Pain; Disabilities
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Neck Pain
• Other Study ID Numbers: 2017/14

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No