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

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.

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.