Marker-Based Method for Analyzing the Three-Dimensional Upper Body Kinematics of Violinists and Violists: Development and Clinical Feasibility

AIMS: High string players (violin and viola) often suffer from musculoskeletal disorders. Although 3D motion analysis has proved helpful in diagnosing different musculoskeletal syndromes and identifying injurious movement patterns in violin and viola performance, more detailed analyses of upper body movement strategies and especially of the shoulder complex have not yet been recorded. The use of spherical surface markers on some anatomical landmarks is, however, inappropriate when an instrument is being played. The aim of this study was to develop and evaluate a novel marker-based method for analyzing upper body kinematics of high string players using conditions specific to violin and viola playing. METHODS: A custom upper body marker set was developed and a biomechanical model applied to 3D motion capture data of the pelvis, thorax, spine, head, and both upper limbs (scapula, upper arm, forearm, hand) of 12 professional violinists, to assess its clinical feasibility. FINDINGS: Lumbar and thoracic spine, thorax, neck, and left upper limb were quite static, while extensive motion occurred in the right upper limb. Most rotation angles showed a reasonable intersubject variability except for glenohumeral and wrist joints. Significant differences were observed between G- and D-string bowing, especially in the left wrist and right shoulder joints. INTERPRETATION: This study suggests that the proposed method is a valid tool for quantifying upper body movements in violin and viola performance. With the extended upper body model, it will improve understanding of the motor strategies adopted by high string players and may contribute to injury prevention, diagnosis, and treatment.