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Lundholm Tengvall I.1, Faleij R.1, Axlid E.1, Röijezon U.1
1Luleå University of Technology, Department of Health Sciences, Luleå, Sweden
Background: Professional violin and viola players have high demands on well- adjusted motor control, especially well-timed and accurate upper body movements. Neck and shoulder pain is relatively common among these instrumentalists. This may have impact on motor control and ability to perform. It has been argued that motor control dysfunctions can be both a consequence of pain, but also an increased risk for onset, retention and recurrence of pain disorders. Specific methods for assessment and training of motor control have therefore been developed. No study has, to our knowledge, investigated the inter-rater reliability of clinical movement control tests, so called dissociation tests, for neck and shoulder on professional musicians.
Purpose: The aim of the study is to increase knowledge about the inter-rater reliability of dissociation tests for neck and shoulder on violin and viola musicians.
Methods: Twenty professional viola/violin players, 13 women and 7 men, with a mean age of 48,9 (8,0) participated. Each participant was examined at the same time by two physiotherapists, specialized in Manual Therapy, by using visual observations. They performed eight Movement control test, dissociation test, for the shoulder and neck. Each test was rated as either Correct or Not correct. Cohens kappacoefficient (k), 95% confidenceinterval, percentage agreement and prevalence- and bias index were calculated for each test. In case of the test classified as Not correct the observer rated what factor failed from a list of variables.
Results: Two tests, Overhead arm lift and left Arm abduction showed excellent inter-rater reliability (k= 0,89 and,0,88, respectively). Head turn showed substantial (k=0,61) and left Arm flexion showed good (k=0,56) reliability. Four tests showed poor reliability, Occiput lift (k=0,38), Horizontal retraction (k=0,24), right Arm flexion (k=0,05) and right Arm abduction (k=0,37). The lower boundary of the 95% CI was relatively low ( 0.4) for all tests except Head turn, Overhead arm lift, and left Arm abduction. The two observers agreements in judging what variable that failed in the Not correct tests were very high, close to 100%.
Conclusion(s): This study shows substantial inter-rater reliability in three out of eight evaluated tests, "Head turn", "Overhead arm lift" and left "Arm abduction". In this study the tests were slightly modified compared to how they are commonly performed in the clinic. Only visual observation, and no palpation, was used to examine the musicians in order to minimise interference between the two examiners. This may have influenced the scoring of some of the tests.
Implications: The cervical tests Head turn and Overhead arm lift and the shoulder test left Arm abduction were found reliable when examined on professional violinists/violasts by two separate physiotherapist, while caution should be taken regarding the other tests, at least when assessed with visual observation only.
Funding acknowledgements: Ulrik Röijezon was partly funded by grants from the Swedish Council for Working Life and Social Research (2010-0814).
Topic: Research methodology & knowledge translation
Ethics approval: Ethic approval is given by the Umeå Ethics Committee Dnr 2012-471-31Ö and 2015-454-32Ö.
All authors, affiliations and abstracts have been published as submitted.
