Tele-Based Postural Awareness and Breathing Training for Ergonomic Risk and Fatigue in Flute Students

January 29, 2026 updated by: Ayça Araci, Alanya Alaaddin Keykubat University

Effects of a Tele-Based Postural Awareness and Breathing Program on Ergonomic Risk, Sensorimotor Function, and Fatigue in Flute Students: A Randomized Controlled Study

This randomized controlled study investigates the effects of an eight-week tele-based postural awareness and pranayama-based breathing program on work-related ergonomic risk and cervical somatosensory function in flute students. A total of 30 undergraduate flute students were randomly allocated to either an intervention group or a control group.

Participants in the intervention group received a structured tele-rehabilitation program focusing on postural awareness exercises and pranayama-based breathing practices for eight weeks, while the control group did not receive any intervention during the study period.

Primary outcomes include work-related ergonomic risk assessed using the Rapid Upper Limb Assessment (RULA) and cervical somatosensory function evaluated through cervical joint position sense (horizontal, vertical, and global error). Secondary outcomes include deep cervical flexor muscle endurance, perceived fatigue, postural awareness, and musical performance anxiety.

Outcome measures were assessed at baseline and after the eight-week intervention period. The study aims to determine whether a tele-based postural awareness and breathing intervention can effectively reduce ergonomic risk and improve sensorimotor function in flute students who are exposed to prolonged asymmetric postures during instrument practice.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study is designed as a randomized controlled trial to examine the effects of a tele-based postural awareness and pranayama-based breathing program on ergonomic risk, cervical somatosensory function, and selected secondary outcomes in flute students.

Thirty undergraduate flute students enrolled in the Faculty of Fine Arts, Department of Music, were recruited and randomly assigned to either an intervention group (n = 15) or a control group (n = 15). Participants were required to have regular flute practice and no history of neurological or musculoskeletal disorders affecting the cervical region.

The intervention group participated in an eight-week tele-rehabilitation program consisting of postural awareness exercises and pranayama-based breathing practices. Sessions were delivered remotely and focused on improving postural alignment, body awareness, controlled breathing, and sensorimotor control relevant to prolonged instrument practice. The control group did not receive any intervention during the study period and continued their usual daily activities.

Outcome assessments were conducted at baseline and at the end of the eight-week intervention period. Primary outcome measures included work-related ergonomic risk, assessed using the Rapid Upper Limb Assessment (RULA), and cervical somatosensory function, evaluated through cervical joint position sense testing in horizontal, vertical, and global directions. Secondary outcome measures included deep cervical flexor muscle endurance, perceived fatigue assessed using the Modified Borg Scale, postural awareness, and musical performance anxiety assessed using a validated questionnaire.

This study aims to evaluate the feasibility and effectiveness of a tele-based postural awareness and breathing intervention in reducing ergonomic risk and improving sensorimotor function in flute students exposed to prolonged asymmetric postures during musical practice.

Study Type

Interventional

Enrollment (Actual)

28

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 Locations

  • Turkey (Türkiye)
    • Antalya
      • Alanya, Antalya, Turkey (Türkiye), 07425
        • Alanya Alaaddin Keykubat University

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

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Aged between 18 and 28 years
  • Enrolled as a student in the Department of Music at the Faculty of Fine Arts or Faculty of Education
  • Has been playing the flute for at least 3 years
  • Willing to participate in the study and able to provide informed consent

Exclusion Criteria:

  • History of upper extremity surgery
  • Presence of any diagnosed neurological disorder
  • History of cardiovascular disease
  • Presence of an acute musculoskeletal injury that could affect performance

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
Active Comparator: No Intervention / Usual Activity
Participants do not receive any intervention and continue their usual daily activities and regular flute practice during the 8-week study period.
Other: No Intervention
Participants do not receive any intervention and continue their usual daily activities and regular
Experimental: Tele-Based Postural Awareness and Pranayama-Based Breathing Program
Behavioral: Participants receive an 8-week tele-based program including postural awareness exercises and pranayama-based breathing practices delivered remotely.
Behavioral: Tele-Based Postural Awareness and Pranayama-Based Breathing Program
An 8-week tele-rehabilitation program delivered remotely, focusing on postural awareness exercises and pranayama-based breathing practices.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Total RULA Score and RULA B Score
Time Frame: Baseline and 8 weeks
Postural ergonomic risk is assessed during flute performance using the Rapid Upper Limb Assessment (RULA), which evaluates neck, trunk, and upper limb posture. The total RULA score ranges from 1 to 7, with higher scores indicating greater ergonomic risk.
Baseline and 8 weeks
Cervical Somatosensory Function (Joint Position Sense - JPS)
Time Frame: Baseline and 8 weeks
Cervical joint position sense is assessed using a laser-pointer repositioning method during flexion, extension, and rotation movements. Horizontal, vertical, and global angular errors are calculated. Higher error values indicate reduced proprioceptive accuracy.
Baseline and 8 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Postural Habits and Awareness Scale (PAFÖ) total score
Time Frame: Baseline and 8 weeks
A self-reported scale assessing postural habits and postural awareness across four domains: posture habit and awareness, awareness of posture-disturbing factors, position awareness, and ergonomic awareness. Higher scores indicate better postural awareness.
Baseline and 8 weeks
Deep Cervical Flexor Muscle Endurance
Time Frame: Baseline and 8 weeks
Participants maintain a chin-tuck with slight head lift in supine position. The duration the position is maintained without compensation is recorded in seconds.
Baseline and 8 weeks
Modified Borg Scale score
Time Frame: Baseline and 8 weeks
Fatigue is assessed using the Modified Borg Scale, which measures perceived exertion and fatigue following classes, rehearsals, and performances.
Baseline and 8 weeks
Kenny Music Performance Anxiety Inventory (K-MPAI) total score
Time Frame: Baseline and 8 weeks
A validated 25-item questionnaire assessing musical performance anxiety across psychological, somatic, and control-related domains. Higher scores indicate greater performance anxiety.Total score on the Kenny Music Performance Anxiety Inventory (range 0-240), where higher scores indicate greater performance anxiety.
Baseline and 8 weeks

Collaborators and Investigators

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

Sponsor

Alanya Alaaddin Keykubat University

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)

November 5, 2024

Primary Completion (Actual)

January 15, 2025

Study Completion (Actual)

May 30, 2025

Study Registration Dates

First Submitted

December 24, 2025

First Submitted That Met QC Criteria

December 24, 2025

First Posted (Actual)

January 8, 2026

Study Record Updates

Last Update Posted (Actual)

February 2, 2026

Last Update Submitted That Met QC Criteria

January 29, 2026

Last Verified

January 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • 22.12.2025

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data will not be shared because the study involves small sample sizes and includes sensitive personal, performance, and health-related information. Data sharing could increase the risk of participant identification. In accordance with the approval of the institutional ethics committee and applicable data protection regulations, the data will be used only by the research team for the purposes of this study.

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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