Physical and Functional Effects of Online Exercise Program on Musicians Playing Stringed Instruments

March 28, 2024 updated by: Sule Kecelioglu, Bandırma Onyedi Eylül University

The Effect of Online Exercise Program on Musculoskeletal Problems, Upper Extremity Function, Physical Activity Level, Muscle Oxygenation, Reaction Time, Grip Strength and Pressure Pain Threshold in Musicians Playing Stringed Instruments

Musculoskeletal problems related to instrument playing or performance are frequently seen in musicians. Different interventions such as strength training, endurance training and yoga have been used in the management of these problems. The first specific exercise program for professional orchestra musicians was developed by Chan et al. However, it has been stated that it is difficult to encourage musicians' participation in exercise due to their constantly changing work schedules, and at this point, the use of digital media such as DVDs, USBs, and educational exercise videos may have a potential role.

On the other hand, it has been stated that smart wearable devices with mobile applications (such as smart watches, smart band) as digital health interventions are an interesting, interactive and efficient psychological strategy to promote physical activity and can be used as an intervention to promote a healthy lifestyle. Based on the literature, in our study, the exercise program developed by Chan et al., will be done online via "Google Meet" and symptoms can be evaluated with objective evaluation methods. Unlike other studies using digital media, exercises will be performed synchronously and feedback will be given to the musicians simultaneously, as in face-to-face exercises. In addition, all participants will be given a smart band, they will be encouraged to use it until the end of the study, and the change in their physical activity levels will be evaluated.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

38

Phase

  • Not Applicable

Contacts and Locations

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

Study Contact

Study Locations

  • Turkey
      • Bursa, Turkey, 16000
        • Recruiting
        • Bursa Regional State Symphony Orchestra
        • Contact:
          • Umut Çanakçı, Musician
          • Phone Number: +90 (224) 225 59 70
        • Principal Investigator:
          • Sule Kecelioglu, MSc
        • Sub-Investigator:
          • Selnur Narin Aral, Assoc. Prof.
      • Bursa, Turkey, 16285
        • Recruiting
        • Bursa Uludağ University Faculty of Education Fine Arts Education Department, Department of Music Education
        • Principal Investigator:
          • Sule Kecelioglu, MSc
        • Sub-Investigator:
          • Selnur Narin Aral, Assoc. Prof.
        • Contact:
          • Gülnihal Gül, Assoc. Prof.
          • Phone Number: +90 (224) 294 09 42
      • Bursa, Turkey, 16285
        • Recruiting
        • Bursa Uludağ University State Conservatory
        • Principal Investigator:
          • Sule Kecelioglu, MSc
        • Sub-Investigator:
          • Selnur Narin Aral, Assoc. Prof.
        • Contact:
          • Görkem Çalgan, Prof. Dr.
          • Phone Number: +90 (224) 294 27 00
      • İzmir, Turkey, 35100
        • Recruiting
        • Ege University State Conservatory of Turkish Music
        • Principal Investigator:
          • Sule Kecelioglu, MSc
        • Sub-Investigator:
          • Selnur Narin Aral, Assoc. Prof.
        • Contact:
          • Nurdan Gürtunca, Assoc. Prof.
          • Phone Number: +90 (232) 311 29 44

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

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Volunteering to participate in the study
  • Agreeing to exercise once a week for 8 weeks
  • Being between the ages of 18-65
  • Playing a string instrument in Bursa Regional State Symphony Orchestra / Bursa Uludağ University State Conservatory / Bursa Uludağ University Faculty of Education Fine Arts Education Department, Department of Music Education / Ege University State Conservatory of Turkish Music
  • Main instrument being a stringed instrument (violin, viola, cello, double bass)
  • Playing an instrument for more than 5 years
  • Having a musculoskeletal problem related to playing an instrument or performance

Exclusion Criteria:

  • Having a musculoskeletal problem that is not related to playing an instrument or performance
  • Playing the instrument less than 15 hours per week
  • Having had a corticosteroid injection within 6 weeks
  • Having used anti-inflammatory or gabapentin within 3 weeks
  • Having had any surgical operation that would prevent exercise in the last 6 months
  • Having any diagnosed neurological and/or orthopedic problem that would prevent exercise in the last 6 months
  • Having a diagnosed psychiatric problem
  • Maximum subcutaneous fat thickness more than 12 mm

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

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention Group
A 40-minute online education presentation will be given on the role of postural and dynamic muscles, the importance of physical activity, the gradual adaptation of the body to workload and physical stressors, rest, and injury management. They will also be asked to wear a smart band. Additionally, the exercise program developed by Chan et al., will be practised online via "Google Meet" once a week for 8 weeks, each session lasting 40-45 minutes.
Other: The exercise program
The exercise program developed by Chan et al., consists of a 30-minute exercise period with 5 minute warm-up (diaphragmatic breathing, general body movements) and 5-10 minute cool-down (stretching exercises in addition to the exercises in the warm-up period) periods. Exercises include 6 steps and 5 series (neck, shoulder, spine, abdominals, hip) according to difficulty level. The total exercise program takes 40-45 minutes.
Other: Online education presentation
This online education presentation includes the role of postural and dynamic muscles, the importance of physical activity, gradual adaptation of the body to workload and physical stressors, rest, and injury management. The education takes 40 minutes and will be done once.
Device: Smart band
Participants will be given a Xiaomi Mi Smart Band 5 and will be asked not to remove the smart band except for bathing for 8 weeks, and to download the smart phone application (Zepp Life) compatible with the smart band to their phones, which will allow their steps to be recorded on a weekly basis.
Other: Control Group
A 40-minute online education presentation will be given on the role of postural and dynamic muscles, the importance of physical activity, the gradual adaptation of the body to workload and physical stressors, rest, and injury management. They will also be asked to wear a smart band.
Other: Online education presentation
This online education presentation includes the role of postural and dynamic muscles, the importance of physical activity, gradual adaptation of the body to workload and physical stressors, rest, and injury management. The education takes 40 minutes and will be done once.
Device: Smart band
Participants will be given a Xiaomi Mi Smart Band 5 and will be asked not to remove the smart band except for bathing for 8 weeks, and to download the smart phone application (Zepp Life) compatible with the smart band to their phones, which will allow their steps to be recorded on a weekly basis.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Musculoskeletal problems
Time Frame: baseline and 8 weeks after baseline
The Cornell Musculoskeletal Discomfort Questionnaire will be used to evaluate musculoskeletal problems. The questionnaire includes visuals of different parts of the body, and in these parts, the frequency and severity of pain, ache or discomfort felt by the person within a week, and whether it prevents work are questioned separately. The Turkish validity of the questionnaire was found to be good at .62-.92, and the test-retest reliability was found to be adequate at .56-.97. A high score from the questionnaire indicates that musculoskeletal problems are intense.
baseline and 8 weeks after baseline
Muscle oxygenation
Time Frame: baseline and 8 weeks after baseline

The Moxy muscle oxygen monitor is a lightweight and small device that measures regional blood flow and oxygenation by placing it on the skin non-invasively using near infrared spectroscopy (NIRS). The Moxy muscle oxygen monitor has been shown to be a valid and reliable device in terms of muscle oxygenation compared to other NIRS devices. Its validity in measuring muscle oxygenation (SROC: r = 0.842-0.993, ICC: r = 0.773-0.992, p < .01) was found to be strong or very good, and its reliability was moderate to high in low-intensity exercise. The left deltoid muscle will be evaluated in musicians. The evaluation will be made at rest (3 minutes), in the instrument holding position (3 minutes), during the instrument playing position (3 minutes) and at rest after playing the instrument (3 minutes).

Note: The maximum subcutaneous fat thickness that the device can measure is 12 mm. A skinfold caliper will be used to identify participants who will be excluded from the study.
baseline and 8 weeks after baseline
Pressure pain threshold
Time Frame: baseline and 8 weeks after baseline
Pressure pain threshold, defined as the minimum force that triggers pain, is measured with a tool called an algometer. The value obtained when the person indicates the time when the feeling of pressure turns into a painful feeling is recorded in kg/cm2. The lower the value, the lower the person's pressure pain threshold. In the reliability study of the algometer device, the ICC value was found to be high at = 0.91. For musicians, evaluations will be taken from the right and left trapezius muscle and the right and left lateral epicondyle.
baseline and 8 weeks after baseline
Reaction time
Time Frame: baseline and 8 weeks after baseline
BlazePod™ will be used to measure reaction time. It was stated that the ICC value was 0.82. A lighting protocol is created via the mobile application for the use of the device. In this device, which consists of sensors, the time taken for the participants to turn off the visual stimulus is recorded in milliseconds. The device planned to be used in the study will consist of 3 sensors. There will be 2 simple and 1 choice reaction time assessments. For simple reaction time, the participants' right hand will be evaluated first, then their left hand (with a blue light on the sensor). For choice reaction time, participants will be asked to use their right hand when the blue light is on and their left hand when the red light is on. Participant reaction time data will be accessed via the BlazePod mobile application.
baseline and 8 weeks after baseline
Grip strength
Time Frame: baseline and 8 weeks after baseline
Saehan dynamometer will be used to measure grip strength. The evaluation will be made with the elbow in 90° flexion and the forearm in a neutral position, which is the standard test position of the American Association of Hand Therapists. Evaluations will be made in 3 repetitions on the right and left hands and the average of the obtained values will be taken. Test-retest reliability was found to be excellent for the Saehan dynamometer (r=0.981 right hand and r=0.985 left hand).
baseline and 8 weeks after baseline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Upper extremity function
Time Frame: baseline and 8 weeks after baseline
The Disabilities of the Arm, Shoulder and Hand (DASH) will be used to evaluate upper extremity function. The Turkish validity and reliability study of the DASH was conducted by Düger et al. A high score from the DASH results indicates a high level of disability.
baseline and 8 weeks after baseline
Physical activity level
Time Frame: baseline and 8 weeks after baseline

Physical activity level will be evaluated both with the data obtained from the smart band and the International Physical Activity Questionnaire Short Form (IPAQ-SF).

Smart band: Participants' weekly step count will be recorded with Xiaomi Mi Smart Band 5. They will be asked to download the smart phone application (Zepp Life) for iOS or Android, which is compatible with the smart band to phones.

International Physical Activity Questionnaire Short Form (IPAQ-SF): The Turkish validity and reliability study of the questionnaire was conducted by Saglam et al. The questionnaire evaluates the time spent on vigorous and moderate physical activity, walking and sitting in the last 7 days.
baseline and 8 weeks after baseline

Collaborators and Investigators

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

Sponsor

Bandırma Onyedi Eylül University

Investigators

  • Study Director: Selnur Narin Aral, Assoc. Prof., Dokuz Eylül 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 (Actual)

January 22, 2024

Primary Completion (Estimated)

June 1, 2024

Study Completion (Estimated)

January 1, 2025

Study Registration Dates

First Submitted

March 28, 2024

First Submitted That Met QC Criteria

March 28, 2024

First Posted (Actual)

April 3, 2024

Study Record Updates

Last Update Posted (Actual)

April 3, 2024

Last Update Submitted That Met QC Criteria

March 28, 2024

Last Verified

March 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2023/41-10

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

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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