Effects of Motor Control-Based Interventions on Pain and Functional Outcomes in Bowed String Musicians: A Systematic Review

Background/Objective: Playing-related musculoskeletal disorders are highly prevalent among bowed string musicians and may impair performance and career longevity. This study aimed to evaluate the effects of motor control-based interventions on pain, functional outcomes, range of motion, and neuromuscular parameters in musicians playing bowed string instruments. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. PubMed, Scopus, Web of Science Core Collection, and Cochrane CENTRAL were searched from inception to October 2025, and the search was updated before resubmission to identify any newly published eligible studies. Eligibility screening, full-text assessment, data extraction, and risk-of-bias assessment were independently verified by a second reviewer. Risk of bias was assessed according to study design using RoB 2 for the randomized controlled trial and ROBINS-I for non-randomized interventional studies. Results: Four interventional studies met the inclusion criteria. Three studies reported improvements in pain-related outcomes or PRMD severity, and three reported improvements in functional outcomes. One study demonstrated improved cervical range of motion, whereas one study reported altered shoulder girdle muscle activation patterns with reduced playing comfort. Overall, the certainty of the available evidence was limited by small sample sizes, non-randomized designs, and risk of bias. Conclusions: Limited evidence suggests that motor control-based interventions may be associated with improvements in pain and playing-related function in bowed string musicians; however, the evidence base remains small and methodologically heterogeneous, and conclusions should be interpreted with caution.