The Influence of Neck–Shoulder Pain on Trapezius Muscle Activity among Professional Violin and Viola Players: An Electromyographic Study

2002 ◽  
Vol 17 (2) ◽  
pp. 68-75 ◽  
Author(s):  
Patrice Berque ◽  
Heather Gray

Work-related musculoskeletal disorders in the neck-shoulder area are common among violin and viola players. The aim of this study was to investigate the influence of playing-related musculoskeletal disorders (PRMDs) on muscle activity, by measuring electromyographic activity in the upper trapezius (UT) muscles of violin and viola players under three experimental conditions: rest, performance of an easy piece, and performance of a difficult piece. Ten professional violin and viola players from a Scottish orchestra volunteered to take part in the study. Five subjects complained of pain in the neck-shoulder region; five were pain-free. Bilateral surface electromyography (EMG) was used, following submaximal reference voluntary contractions, to record the muscle activity of the UT muscles during the three experimental conditions. Subjects were randomly allocated to the conditions. A four-factor balanced analysis of variance (ANOVA) was performed. The results revealed that the pain-free subjects developed more UT muscle activity than subjects experiencing neck-shoulder pain (F = 4.07, df = 1, p = 0.05). Furthermore, the subjects developed significantly more UT activity when progressing from the rest condition to performance of the difficult piece (F = 36.64, df = 2, p> < 0.001). The PRMD subjects developed more UT activity than the pain-free subjects at rest. The opposite tendency was observed for the playing conditions. However, the results were not statistically significant for this interaction (F = 1.85, df = 2, p = 0.169). The results suggest that redistribution of the load to other synergistic muscles may be a strategy used by PRMD subjects to alleviate pain or discomfort at the nec-shoulder area. The voluntary monitoring of shoulder muscle activity may be of great importance in the prevention of PRMDs in viola and violin players.

2021 ◽  
Author(s):  
Julia Barthelme ◽  
Martha Sauter ◽  
Charlotte Mueller ◽  
Falk Liebers

Abstract Background: Musculoskeletal disorders are the leading cause of work-related sick leave and incur substantial socioeconomic costs. With the aging of our society and employees, the problem is exacerbating, and prevention is becoming increasingly important. According to previous studies, exposure to awkward postures, such as overhead work, is associated with musculoskeletal problems. Objective: This study aimed to determine the current prevalence of employees who work in awkward postures, specifically overhead, stratified by age, gender and occupation in the context of the 2018 BIBB/BAuA Employment Survey and to analyze associations between awkward working postures, in particular overhead work, and pain in the shoulder region. Method: The study is based on secondary data from the German 2018 BIBB/BAuA Employment Survey . We have included 14,327 of the 20,012 employees aged between 15 and 67 who work at least 35 hours per week who took part in the survey. The classification of participants in occupational groups is based on the Blossfeld classification. The multivariate analysis was conducted by applying robust Poisson regression models adjusted block by block to obtain the relation between the self-reported frequency of working in awkward postures, in particular overhead work, and the occurrence of arm and neck/shoulder pain. Prevalence ratios (PR) are reported as effect estimates. Results: 12.6 % of participants indicated that they are often exposed to awkward postures at work; 5 % stated they often performed overhead work. The majority of these employees work in agricultural, unskilled, and skilled manual occupations. The crude prevalence is 17.4 % for arm pain and 48.4 % for neck and shoulder pain. If subjects reported that they often performed overhead work, the risk of arm pain increased by 18 % (PR 1.18, CI 1.04 – 1.34, final model). Conclusion: Working in awkward postures, especially overhead work, is a risk factor for musculoskeletal disorders in the arms. The development of prevention strategies should focus on the workforce in agricultural, unskilled and skilled manual occupations.


2000 ◽  
Vol 80 (3) ◽  
pp. 276-291 ◽  
Author(s):  
Paula M Ludewig ◽  
Thomas M Cook

AbstractBackground and Purpose. Treatment of patients with impingement symptoms commonly includes exercises intended to restore “normal” movement patterns. Evidence that indicates the existence of abnormal patterns in people with shoulder pain is limited. The purpose of this investigation was to analyze glenohumeral and scapulothoracic kinematics and associated scapulothoracic muscle activity in a group of subjects with symptoms of shoulder impingement relative to a group of subjects without symptoms of shoulder impingement matched for occupational exposure to overhead work. Subjects. Fifty-two subjects were recruited from a population of construction workers with routine exposure to overhead work. Methods. Surface electromyographic data were collected from the upper and lower parts of the trapezius muscle and from the serratus anterior muscle. Electromagnetic sensors simultaneously tracked 3-dimensional motion of the trunk, scapula, and humerus during humeral elevation in the scapular plane in 3 hand-held load conditions: (1) no load, (2) 2.3-kg load, and (3) 4.6-kg load. An analysis of variance model was used to test for group and load effects for 3 phases of motion (31°–60°, 61°–90°, and 91°–120°). Results. Relative to the group without impingement, the group with impingement showed decreased scapular upward rotation at the end of the first of the 3 phases of interest, increased anterior tipping at the end of the third phase of interest, and increased scapular medial rotation under the load conditions. At the same time, upper and lower trapezius muscle electromyographic activity increased in the group with impingement as compared with the group without impingement in the final 2 phases, although the upper trapezius muscle changes were apparent only during the 4.6-kg load condition. The serratus anterior muscle demonstrated decreased activity in the group with impingement across all loads and phases. Conclusion and Discussion. Scapular tipping (rotation about a medial to lateral axis) and serratus anterior muscle function are important to consider in the rehabilitation of patients with symptoms of shoulder impingement related to occupational exposure to overhead work.


2005 ◽  
Vol 85 (11) ◽  
pp. 1128-1138 ◽  
Author(s):  
Lori A Michener ◽  
N Douglas Boardman ◽  
Peter E Pidcoe ◽  
Angela M Frith

Abstract Background and Purpose. Scapular muscle performance evaluated with a handheld dynamometer (HHD) has been investigated only in people without shoulder dysfunction for test-retest reliability of data obtained with a single scapular muscle test. The purpose of this study was to assess the reliability, error, and validity of data obtained with an HHD for 4 scapular muscle tests in subjects with shoulder pain and functional loss. Subjects and Methods. Subjects (N=40) with shoulder pain and functional loss were tested bymeasuring the kilograms applied with an HHD during 3 trials for muscle tests for the lower trapezius, upper trapezius, middle trapezius, and serratus anterior muscles. Concurrently, surface electromyography (sEMG) data were collected for the 4 muscles. The same procedures were performed 24 to 72 hours after the initial testing by the same tester. Muscle tests were performed 3 times, and the results were averaged for data analysis. Results. Intraclass correlation coefficients for intratester reliability of measurements of isometricforce obtained using an HHD ranged from .89 to .96. The standard error of the measure (90% confidenceinterval [CI]) ranged from 1.3 to 2.7 kg; the minimal detectable change (90% CI) ranged from 1.8 to 3.6 kg. Construct validity assessment, done by comparing the amounts of isometric muscle activity (sEMG) for each muscle across the 4 muscle tests, revealed that the muscle activity of the upper trapezius and lower trapezius muscles washighest during their respective tests. Conversely, the isometric muscle activity of the middle trapezius and serratus anterior muscles was not highest during their respective tests. Discussion and Conclusion. In people with shoulder pain and functional loss, the intrarater reliability and error over 1 to 3 days were established using an HHD for measurement of isometric force for the assessment of scapular muscle performance. Error values can be used to make decisions regarding individual patients. Construct validity was established for the lower and upper trapezius muscle tests; therefore, these tests are advocated for use. However, construct validity was not demonstrated for the serratus anterior and middle trapezius muscle tests as performed in this study. Further investigation of these muscle tests is warranted.


Author(s):  
Suzanne Lerato Merkus ◽  
Svend Erik Mathiassen ◽  
Lars-Kristian Lunde ◽  
Markus Koch ◽  
Morten Wærsted ◽  
...  

Abstract Objective To determine whether a composite metric of arm elevation and trapezius activity (i.e. neck/shoulder load) is more strongly associated with the 2-year course of neck and shoulder pain intensity (NSPi) among construction and healthcare workers than each exposure separately. Methods Dominant arm elevation and upper trapezius muscle activity were estimated in construction and healthcare employees (n = 118) at baseline, using accelerometry and normalized surface electromyography (%MVE), respectively. At baseline and every 6 months for 2 years, workers reported NSPi (score 0–3). Compositions of working time were determined for arm elevation (< 30°; 30–60°;  > 60°), trapezius activity (< 0.5%; 0.5–7.0%; > 7.0%MVE), and a composite metric “neck/shoulder load” (restitution, low, medium, and high load). Associations between each of these three compositions and the 2-year course of NSPi were determined using linear mixed models. Results Associations between exposure compositions and the course of NSPi were all weak and in general uncertain. Time spent in 0.5–7.0%MVE showed the largest and most certain association with changes in NSPi during follow-up (β = − 0.13; p = 0.037; corresponding to a −0.01 change in NPSi every 6 months). Among pain-free workers at baseline, medium (β = − 0.23; p = 0.039) and high (β = 0.15; p = 0.031) neck/shoulder load contributed the most to explaining changes in NSPi. Conclusion The composite metric of neck/shoulder load did not show a stronger association with the course of NSPi than arm elevation or trapezius activity alone in the entire population, while some indications of a stronger association were found among those who were pain-free at baseline.


2013 ◽  
Vol 39 (4) ◽  
pp. 390-400 ◽  
Author(s):  
Therese N Hanvold ◽  
Morten Wærsted ◽  
Anne Marit Mengshoel ◽  
Espen Bjertness ◽  
Hein Stigum ◽  
...  

Author(s):  
Nathan B. Fethke ◽  
Fred Gerr ◽  
Daniel C. Anton ◽  
Joseph E. Cavanaugh ◽  
Thomas M. Cook

The purpose of this cross-sectional study was to compare the observed associations between upper trapezius muscle activity, as estimated with several summary measures obtained from surface electromyography (EMG), and self-reported neck/shoulder pain among a sample of 231 manufacturing workers. EMG methods used in this study included mean root-mean-square amplitude, the amplitude probability distribution function (APDF), EMG gaps analysis, and clustered exposure variation analysis. The observed seven-day prevalence of neck/shoulder pain was 13.9%. Of the EMG summary measures, only the 90 th percentile of the APDF was significantly associated with symptoms, with crude and adjusted odds ratios of 2.57 (1.02–6.49) and 2.78 (1.07–7.21) per natural log unit, respectively. This study was largely inconclusive due to the similarity in the distributions of the summary measures between symptomatic and non-symptomatic participants, and explicit measures of posture and repetition may produce stronger associations with symptoms.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Julia Barthelme ◽  
Martha Sauter ◽  
Charlotte Mueller ◽  
Falk Liebers

Abstract Background Musculoskeletal disorders are the leading cause of work-related sick leave and incur substantial socioeconomic costs. With the aging of our society and employees, the problem is exacerbating, and prevention is becoming increasingly important. According to previous studies, exposure to awkward postures, such as overhead work, is associated with musculoskeletal problems. Objective This study aimed to determine the current prevalence of employees who work in awkward postures, specifically overhead, stratified by age, gender and occupation in the context of the 2018 BIBB/BAuA Employment Survey and to analyze associations between awkward working postures, in particular overhead work, and pain in the shoulder region. Method The study is based on secondary data from the German 2018 BIBB/BAuA Employment Survey. We have included 14,327 of the 20,012 employees aged < 67 years who work at least 35 h per week who took part in the survey. The classification of participants in occupational groups is based on the Blossfeld classification. The multivariate analysis was conducted by applying robust Poisson regression models adjusted block by block to obtain the relation between the self-reported frequency of working in awkward postures, in particular overhead work, and the occurrence of arm pain and neck and shoulder pain. Prevalence ratios (PR) are reported as effect estimates. Results 12.7% of participants indicated that they are often exposed to awkward postures at work; 5.0% stated they often performed overhead work. The majority of these employees worked in agricultural, unskilled and skilled manual occupations. The crude prevalence is 17.4% for arm pain and 48.4% for neck and shoulder pain. If subjects reported that they often performed overhead work, the risk of arm pain increased by 18% (PR 1.18, CI 1.04–1.34, final model). Conclusion Working in awkward postures, especially overhead work, is a risk factor for upper extremity musculoskeletal disorders. The development of prevention strategies should focus on the workforce in agricultural, unskilled and skilled manual occupations.


2021 ◽  
Vol 16 (01) ◽  
pp. e51-e55
Author(s):  
Jasmine J. Lin ◽  
Gromit Y.Y. Chan ◽  
Cláudio T. Silva ◽  
Luis G. Nonato ◽  
Preeti Raghavan ◽  
...  

Abstract Background The trapezius muscle is often utilized as a muscle or nerve donor for repairing shoulder function in those with brachial plexus birth palsy (BPBP). To evaluate the native role of the trapezius in the affected limb, we demonstrate use of the Motion Browser, a novel visual analytics system to assess an adolescent with BPBP. Method An 18-year-old female with extended upper trunk (C5–6–7) BPBP underwent bilateral upper extremity three-dimensional motion analysis with Motion Browser. Surface electromyography (EMG) from eight muscles in each limb which was recorded during six upper extremity movements, distinguishing between upper trapezius (UT) and lower trapezius (LT). The Motion Browser calculated active range of motion (AROM), compiled the EMG data into measures of muscle activity, and displayed the results in charts. Results All movements, excluding shoulder abduction, had similar AROM in affected and unaffected limbs. In the unaffected limb, LT was more active in proximal movements of shoulder abduction, and shoulder external and internal rotations. In the affected limb, LT was more active in distal movements of forearm pronation and supination; UT was more active in shoulder abduction. Conclusion In this female with BPBP, Motion Browser demonstrated that the native LT in the affected limb contributed to distal movements. Her results suggest that sacrificing her trapezius as a muscle or nerve donor may affect her distal functionality. Clinicians should exercise caution when considering nerve transfers in children with BPBP and consider individualized assessment of functionality before pursuing surgery.


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