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Sensory and Sensorimotor Features in Violinists and Violists With Neck Pain

  • Anke Steinmetz
    Correspondence
    Corresponding author Anke Steinmetz, MD, Department of Orthopaedics, Traumatology, and Physical Medicine, Martin-Luther-University of Halle, Ernst-Grube-Str. 40, 06120 Halle (Saale), Germany.
    Affiliations
    Department of Orthopaedics, Traumatology, and Physical Medicine, Martin-Luther-University of Halle, Halle (Saale), Germany

    Department of Manual Medicine and Pain Medicine, Institute of Musicians' Medicine, Kremmen/OT Sommerfeld, Germany
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  • Gwendolen A. Jull
    Affiliations
    National Health and Medical Research Council Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
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      Abstract

      Objective

      To investigate sensory and sensorimotor function in violin and viola players with and without neck pain.

      Design

      Prospective, cross-sectional study.

      Setting

      University laboratory.

      Participants

      Convenience sample of violin players with playing-related neck pain (n=22), violinists without neck pain (n=21), and healthy nonmusician comparison subjects (n=21).

      Interventions

      Not applicable.

      Main Outcome Measures

      Measures include thermal pain thresholds (cold and heat) and pressure pain thresholds (PPTs) over the cervical spine and over a remote region (tibialis anterior muscle). Motor performance tests including reaction times, speed of movement, accuracy, coordination, and tapping speed assessed with a special upper-limb test battery.

      Results

      Musicians with neck pain had significantly lower heat and elevated cold pain thresholds as well as lower PPTs over C5-6 (P<.01) and over the tibialis anterior (P<.05). Motor performance tests revealed no differences between the symptomatic and asymptomatic musicians and nonmusician comparison groups (P>.05).

      Conclusions

      Violin players with neck pain demonstrated signs of sensory impairment, suggesting that playing-related neck pain may be associated with augmented central pain processing consistent with findings in other neck pain groups. No differences were evident in the motor performance tests. Fine motor skills of violin players may be better assessed in the context of playing their musical instruments before definitive conclusions can be drawn about the presence or not of sensorimotor impairments in this group of musicians with playing-related neck pain.

      Keywords

      List of abbreviations:

      HPM/BEP (Human Performance Measurement/Basic Elements of Performance), ICC (intraclass correlation coefficient), NDI (Neck Disability Index), PPT (pressure pain threshold), SEM (standard error of measurement), VAS (visual analog scale)
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