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

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.

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