Effects of cervical stabilization/strengthening exercises in violinists with chronic nonspecific neck pain

Abstract

Violinists frequently assume an asymmetrical neck posture and activate their superficial neck flexor muscles to stabilize the violin for prolonged playing. It is unclear whether this augmented activation of superficial neck flexors may influence the effects of stabilization exercises for violinists with neck pain. The aim of this study was to investigate the effect of cervical stabilization/strengthening exercises on pain intensity, function, sensorimotor function, and upper body posture in violin players with chronic nonspecific neck pain. The one-group pretest-posttest design with a double pretest was used. Violin players with chronic nonspecific neck pain were recruited from students of a university symphony orchestra. Pain intensity (numeric rating scale), function (Neck Disability Index), sensorimotor function (Craniocervical Flexion Test, cervical muscle endurance tests, cervical range of motion tests, and cervical reposition error tests), and upper body posture were assessed at three time points (week 0, 4, and 10). After the completion of two pretests, participants followed instructional videos and performed cervical stabilization/strengthening exercises, 20 minutes a day, 3 days a week for 6 weeks. Twenty-four participants were initially enrolled, and 20 completed all testing sessions. Participants reported moderate neck pain and no disability at week 0. The outcome measures of pain intensity, function, and sensorimotor function showed statistically significant improvement during the intervention period (week 4 vs. week 10). Meanwhile, these outcome measures remained relatively unchanged during the baseline period (week 0 vs. week 4). For the outcome measure of upper body posture, only the craniovertebral angle relative to the horizontal plane significantly increased during the intervention period. Six-week video based cervical stabilization/strengthening exercises resulted in clinically meaningful and beneficial effects. A randomized controlled study with a larger sample is suggested to further investigate the effects of cervical stabilization/strengthening exercises in violin players with more severe neck pain.