Scapular and Cervical Neuromuscular Control Deficits in Musicians With and Without Playing Injuries.
Condition: Playing Related Musculoskeletal Disorders
MeSH terms: Musculoskeletal Diseases
Study type: Observational

Summary: 
      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.
    

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)
    

Intervention name(s): (1) cranio-cervical flexion test;; (2) scapular dyskinesis test; (3) deep neck flexor endurance test.
Intervention type(s): Other; Other; Other
Intervention description(s): Test to determine level of strength for Deep Neck Flexor muscles; Test to determine scapular control; Test do determine endurance for the deep neck flexor muscle group.
Observational model: Case-Control
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Musicians with and without playing related musculo-skeletal Injuries.
      
Keywords: Musicians, Injuries