Usgu Serkan, Akbey Hasan, Kocyigit Burhan Fatih, Akyol Ahmet, Yakut Yavuz
Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey.
Department of Physical Therapy and Rehabilitation, Fırat University, Elazig, Turkey.
Rheumatol Int. 2022 Apr;42(4):725-736. doi: 10.1007/s00296-021-05085-x. Epub 2022 Jan 11.
To investigate the effect of a structured exercise training program on pain, functional status, physical function and quality of life (QoL) in string and woodwind players with nonspecific cervical pain. This study had a prospective cohort design and conducted on 40 musicians (26 male, 14 female) aged between 18 and 65 years with persistent nonspecific neck pain in the previous 3 months. Forty musicians were assigned to either violin (n = 20, median age; 26.5 year, height; 1.67 m, body mass; 65 kg, BMI; 23.04 kg/m) or ney group (n = 20, median age; 27.5 year, height; 1.81 m, body mass; 75 kg, BMI; 23.35 kg/m) and followed the same structured exercise program (3 days/per week for 8 weeks). The primary outcome was neck pain intensity and assessed on a visual analog scale (VAS). Secondary outcomes; cervical range of motion (ROM) was measured using a goniometer, the jaw-to-sternum and jaw-to-wall distances were used for the assessment of cervical mobility, neck, shoulder and back muscles strength were assessed with a hand-held dynamometer, the Northwick Park Neck Pain and Short Form 36 (SF-36) questionnaires were also used. Normality of data distribution was checked using the Kolmogorov-Smirnov test. For evaluating the training effectiveness on outcome measures, Mann-Whitney U and Wilcoxon test were used compare pre-test and post-test values with/within groups, respectively. The primary outcome (pain intensity) was lowered %33 in both groups. However, the mean change was found similar (median mean changes; -2 for both groups) (p > 0.05). The secondary outcomes; cervical mobility, cervical flexion ROM, disability and muscle strength of the left middle trapezius, left hand grip, anterior and middle parts of the right deltoid, and cervical flexors also significantly improved in both groups (p < 0.05). Only the mean changes of right serratus anterior, middle trapezius and cervical flexor muscles were higher in violin group than ney group (p < 0.05). There was no significant difference in the cervical extension, right rotation, left rotation, right lateral flexion and left lateral flexion after the treatment in both groups (p > 0.05). There was no significant difference between the groups after the exercise program in terms of pain, mobility, range of motion and SF-36 subdomains (p > 0.05). Specific exercise program had similar positive effects on pain, cervical mobility, cervical fexion ROM and disability in string and woodwind players. Although several muscles showed similar improvements in strength, some muscle groups recovered differently. Physical needs specific to the instrument and performance should be taken into account when prescribing exercises to musicians having the same problem, but playing different instruments.
为研究结构化运动训练计划对患有非特异性颈部疼痛的弦乐器和木管乐器演奏者的疼痛、功能状态、身体功能和生活质量(QoL)的影响。本研究采用前瞻性队列设计,对40名年龄在18至65岁之间、在过去3个月中患有持续性非特异性颈部疼痛的音乐家(26名男性,14名女性)进行了研究。40名音乐家被分为小提琴组(n = 20,中位年龄26.5岁,身高1.67米,体重65千克,BMI 23.04千克/平方米)或奈伊笛组(n = 20,中位年龄27.5岁,身高1.81米,体重75千克,BMI 23.35千克/平方米),并遵循相同的结构化运动计划(每周3天,共8周)。主要结局是颈部疼痛强度,采用视觉模拟量表(VAS)进行评估。次要结局;使用量角器测量颈椎活动范围(ROM),用下颌到胸骨和下颌到墙壁的距离评估颈椎活动度,用手持测力计评估颈部、肩部和背部肌肉力量,还使用了诺斯威克公园颈部疼痛问卷和简短健康调查问卷36项版(SF - 36)。使用柯尔莫哥洛夫 - 斯米尔诺夫检验检查数据分布的正态性。为评估训练对结局指标的有效性,分别使用曼 - 惠特尼U检验和威尔科克森检验比较组间和组内的测试前和测试后值。两组的主要结局(疼痛强度)均降低了33%。然而,发现平均变化相似(两组的中位平均变化均为 -2)(p > 0.05)。次要结局;两组的颈椎活动度、颈椎前屈ROM、残疾程度以及左中斜方肌、左手握力、右三角肌前中部和颈椎屈肌的肌肉力量也均有显著改善(p < 0.05)。仅小提琴组右前锯肌、中斜方肌和颈椎屈肌的平均变化高于奈伊笛组(p < 0.05)。两组治疗后颈椎后伸、右旋转、左旋转、右侧弯和左侧弯均无显著差异(p > 0.05)。运动计划后两组在疼痛、活动度、活动范围和SF - 36子领域方面无显著差异(p > 0.05)。特定的运动计划对弦乐器和木管乐器演奏者的疼痛、颈椎活动度、颈椎前屈ROM和残疾程度有相似的积极影响。尽管几块肌肉的力量有相似的改善,但一些肌肉群的恢复情况不同。在为患有相同问题但演奏不同乐器的音乐家开运动处方时,应考虑到乐器和演奏的特定身体需求。