Kinematics and Muscle Activation of Scapula in Upper String Players With Neck Pain

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.

Study Overview

• Status: Recruiting
• Conditions: Non-specific Neck Pain; Playing Related Musculoskeletal Disorders
• Intervention / Treatment: Device: motion capture system, surface electromyography

Detailed Description

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 (Estimated): 60

Contacts and Locations

• Study Contact: Name: YIN-LIANG LIN, PhD; Phone Number: +886-2-28267288; Email: yllin1020@nycu.edu.tw
• Study Contact Backup: Name: HSUAN-I SU, MS; Email: pt313262019.be13@nycu.edu.tw

Study Locations

• Taiwan
  • Taiwan
    • Taipei, Taiwan, Taiwan, 112
      • Recruiting
      • National Yang Ming Chiao Tung University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

upper string musicians

Description

Inclusion Criteria:

• Age ≥ 18 years old.
• Having at least 5 years of string instrument playing experience and practicing for more than 6 hours per week.
• For the neck pain group: Experiencing non-specific neck pain for at least 2 weeks, with pain located between the superior nuchal line and the T1 spinous process, and a pain intensity of at least 3 on the Numeric Rating Scale (NRS ≥ 3).
• For the healthy control group: Having no history of neck or shoulder pain within the past year (matched with the neck pain group by age, gender, and handedness).

Exclusion Criteria:

• History of any neck or shoulder surgery or fracture.
• Experiencing pain below the elbow with an intensity of at least 3 (NRS ≥ 3).
• Diagnosed history of any structural cervical spine issues, such as herniation of intervertebral disc (HIVD), cervical spine spondylosis, or spondylolisthesis.
• Positive response on any of the following 5 cervical spine screening tests: cervical distraction test, Spurling's test, Valsalva test, rotational alar ligament stress test, or Sharp-Purser test.
• Any neurological disorders.
• Pregnancy during the study period.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
upper string musicians (healthy group); upper string musicians without non-specific neck pain	Device: motion capture system, surface electromyography; Arm elevation (0°, 30°, 60°, 90°, 120°), open string playing, scale practice, and musical piece performance
upper string musicians (neck pain group); upper string musicians with non-specific neck pain	Device: motion capture system, surface electromyography; Arm elevation (0°, 30°, 60°, 90°, 120°), open string playing, scale practice, and musical piece performance

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	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.	Through study completion, an average of 1 hour

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	: 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.	Through study completion, an average of 1 hour
Shoulder muscle strength	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).	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 (°).	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).	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.	Immediately during the experiment

Collaborators and Investigators

• Sponsor: National Yang Ming Chiao Tung University
• Investigators: Principal Investigator: YIN-LIANG LIN, PhD, National Yang Ming Chiao Tung University

Study record dates

Study Major Dates

• Study Start (Actual): May 10, 2026
• Primary Completion (Estimated): September 30, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: February 26, 2026
• First Submitted That Met QC Criteria: February 26, 2026
• First Posted (Actual): March 4, 2026

Study Record Updates

• Last Update Posted (Actual): May 14, 2026
• Last Update Submitted That Met QC Criteria: May 11, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: muscle activity; scapular kinematics; Non-specific neck pain; shoulder electromyography; upper string musicians; Playing Related Musculoskeletal Disorders
• Additional Relevant MeSH Terms: Diagnostic Techniques and Procedures; Diagnosis; Electrodiagnosis; Myography; Electromyography
• Other Study ID Numbers: NYCU114204AE

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