Üst Yaylı Çalgı Çalan Müzisyenlerde Omurga ve Pelvisin Açısal Parametreleri ile Gövde ve Servikal Bölgenin Endurans, Stabilite, Pozisyon Hissi ve Fonksiyonel Düzeyinin İncelenmesi

Abstract

This study aimed to examine musculoskeletal, postural, pain, muscle endurance, stabilization strength, joint range of motion, joint position sense, functional level, and body awareness parameters in professional upper string instrument players depending on their playing posture. The study included 38 professional musicians (27 females, 11 males) who had been playing the violin (n=24) or viola (n=14) for an average of 22.13 ± 13.40 years and had a minimum of 6 years of playing experience (mean age: 32.60 ± 12.92 years), and a control group of 38 healthy individuals (27 females, 11 males; mean age: 33.60 ± 11.91 years).Participants were assessed using the Visual Analog Scale (VAS), DIERS 4D postural analysis system, trunk and cervical muscle endurance tests, stabilization strength measurements, joint range of motion and joint position sense evaluations, scapular dyskinesis tests, muscle shortening tests, grip strength measurements, as well as the DASH, Neck Disability Index (NDI), Oswestry Disability Index, Fremantle Back and Neck Awareness Questionnaires, and the Kenny Music Performance Anxiety Inventory. Additionally, standing and sitting instrument-playing postures of the musician group were compared using the DIERS 4D system. Relationships between years of instrument playing and all clinical parameters were also investigated.As a result, the musician group showed significantly higher values in scoliosis angle and incidence, pain levels during day, night, and rest, shortening ratios of pectoral and lumbar extensor muscles, positive scapular dyskinesis test results, and scores on the DASH and Neck Disability Index (p<0.05). Conversely, the musician group demonstrated higher trunk anterior, posterior, left lateral, and cervical muscle endurance, as well as longer contraction durations of the Transversus Abdominis, Multifidus, and cervical muscles. Range of motion in cervical right/left lateral flexion and lumbar lateral flexion/extension was also found to be greater in musicians.Errors in joint position sense during cervical right and left rotation were higher in musicians, while the error in left lateral flexion was lower. In the standing playing posture, sagittal imbalance, kyphosis, lordosis, and pelvic inclination values were elevated; whereas in the sitting posture, trunk length was found to be greater. A significant negative correlation was identified between years of instrument playing and the following parameters: error in cervical left rotation joint position sense, Neck Disability Index score, Fremantle Back and Neck Awareness scores, VAS pain scores during night, day, post-playing, during concerts and practice, and Kenny Music Performance Anxiety score (p<0.05). Based on the findings, it is recommended that professional musicians receive early postural awareness training under the guidance of physiotherapists, with the inclusion of individualized exercise programs to prevent muscle imbalances and support spinal symmetry, scapular control training, and ergonomic adjustments integrated into music education programs.