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Objectives
During their lifetimes, a majority of musicians experience playing-related musculoskeletal disorders (PRMD). PRMD prevalence is tied to instrument choice, yet most studies examine heterogeneous groups of musicians, leaving some high-risk groups such as oboists understudied. This paper aims to (1) ascertain the prevalence and nature of PR...
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... La alta frecuencia de trastornos musculoesqueléticos en músicos profesionales ha llevado a diversos autores a diferenciarlos agrupándolos con el término Trastornos Musculoesqueléticos Relacionados con la Interpretación (playing-related musculoskeletal disorders, siglas en inglés PRMDs), los que se caracterizan por la presencia de dolor, debilidad, alteración del control motor, entumecimiento, parestesias y otros síntomas que interfieren con la capacidad interpretativa (Zaza, Charles, & Muszynski, 1998). Sin embargo, este concepto deja fuera la influencia del trabajo, la edad y los pasatiempos en la aparición de los síntomas en músicos (Bragge, Bialocerkowski, & McMeeken, 2006), por lo que no existe a la fecha consenso en el uso de este término dada la dificultad para diferenciar su etiología (Macdonald, Lavigne, Reineberg, & Thaut, 2022). Además, algunos autores han propuesto a la repetición gestual (esfuerzo repetitivo) como el factor más influyente, mientras otros concluyen que la postura no presenta evidencia significativa (Blanco-Piñeiro, Díaz-Pereira, & Martínez, 2017;Rousseau, Taha, Barton, Garden, & Baltzopoulos, 2023). ...
Resumen. Antecedentes: El dolor musculoesquelético (DME) es prevalente en los músicos y se localiza principalmente en el cuadrante superior, afectando la funcionalidad. Los movimientos repetitivos, el tipo de instrumento, la edad y el sexo condicionan este compor-tamiento, entre otros factores. Si bien la evidencia es limitada, pareciera ser que los músicos de cuerdas se encuentran dentro de quienes más frecuentemente reportan dolor y discapacidad de origen musculoesquelético. Objetivo: Caracterizar el DME y el nivel de disca-pacidad en el cuadrante superior asociado a la práctica de instrumentos de cuerda en estudiantes de conservatorio. Método: En este estudio piloto observacional de corte transversal, se aplicaron seis instrumentos de evaluación autoreportados a 14 estudiantes de cuer-das (8 hombres y 6 mujeres) de diferentes instrumentos (violín, viola, guitarra clásica, violoncello y contrabajo): Quick Dash Global (QDG) y de Alto Rendimiento/Músicos (QDL), Índice de Discapacidad Cervical (NDI), Escala de Graduación de Dolor Crónico (EGDC), el Cuestionario de Dolor Neuropático (DN4 abreviado) y el Mapa Corporal de Dolor (body chart). Resultados: El 100% de la muestra presentaba DME al momento de la evaluación, mayoritariamente de baja intensidad, siendo en el 21.42% de los casos de carácter crónico y diseminado. El 64.28% presentaba dolor neuropático. La funcionalidad general medida con EGDC se encontraba afectada en el 71.42% de los individuos. La funcionalidad del miembro superior presentó un QDG medio de 16.4 ±15.63 y un QDL medio de 32.11 ±16.78, mientras que a nivel cervical el 64.28% presentó discapacidad de leve a moderada medida con NDI. Conclu-sión: El DME y la discapacidad en el cuadrante superior son condiciones frecuentes en estudiantes músicos cordófonos. Futuros estudios deberán profundizar en las causas e indagar en estrategias eficientes para prevenir estas afecciones a lo largo de su proceso de formación. Abstract. Background: Musculoskeletal pain (MSP) is prevalent in musicians and is mainly located in the upper quadrant, affecting functionality. Repetitive movements, type of instrument, age, and sex influence this behavior, among other factors. Although the evidence is limited, it seems that string players are among those who most frequently report pain and disability of musculoskeletal origin. Objective: To characterize MSP and the level of upper quadrant disability associated with stringed instrument playing in conservatory students. Methods: In this cross-sectional observational pilot study, six self-reported assessment instruments were applied to 14 string students (8 males and six females) of different instruments (violin, viola, classical guitar, cello and double bass): Quick Dash Global (QDG) and High Performance/Musicians (QDL), Neck Disability Index (NDI), Chronic Pain Grading Scale (EGDC), the Neuropathic Pain Questionnaire (abbreviated DN4) and the Body Map of Pain (body chart). Results: 100% of the sample presented MSP at the time of the evaluation, mostly of low intensity, being in 21.42% of the cases of chronic and disseminated character. Neu-ropathic pain was present in 64.28% of cases. General functionality measured with EGDC was affected in 71.42% of the individuals. Upper limb functionality presented a mean QDG of 16.4 ±15.63 and a mean QDL of 32.11 ±16.78, while at the cervical level, 64.28% presented mild to moderate disability measured with NDI. Conclusion: DME and upper quadrant disability are frequent conditions in chordophone student musicians. Future studies should deepen the causes and investigate efficient strategies to prevent these conditions throughout their training process.
... Identification of the different parts of the body can help in understanding their functioning and avoiding errors in performing this function [1,2]. Most musicians, at some point in their careers, will experience musculoskeletal pain and dysfunction [3]. Pain and dysfunction from playing-related musculoskeletal disorders Anatomically accurate knowledge of the human body helps allow effortless and expressive movement, a prerequisite for any musician to have a long and sustainable career. ...
Anatomical knowledge of the human body is a prerequisite for effortless and expressive movement for musicians. A 35-year-old professional pianist, with no prior experience in the medical field, voluntarily completed a cadaveric dissection module of the upper extremity and spine. The pianist was able to explore the intricate connections between human anatomy and the performance of piano music, gaining knowledge to enhance music quality and to manage and prevent injuries. This case describes the pianist’s perceptions and reflections and highlights the potential value of anatomical education for individuals in non-medical fields. This is, to our knowledge, the first documented case of a musician learning anatomy through cadaveric dissection.
... Even at the beginning of their university studies, 79% of music students reported experiences of playing-related pain, and 29% of music students complained about playing-related health issues (both physical and psychological) during their first academic year [12,13]. Various factors have been discussed in the literature as potential predictors of physical health complaints, such as gender, age, professional status, instrument type, number of years playing, hypermobility, stress, and musculoskeletal dysfunction [12,[14][15][16][17]. Playing-related musculoskeletal problems are thought to be connected to activity, stress, and pain, as well as psychosocial variables such as performance anxiety [1,[18][19][20]. To provide musicians with effective therapeutic interventions and prevention strategies, it is crucial to identify the etiological mechanisms of playing-related complaints. ...
... Instead, we additionally identified increased bodily pain and reduced physical functioning as predictors for MHCs. Nonetheless, a comparison of the risk factors we identified to those from other research is of limited value because our results, in contrast to other studies, are, on the one hand, based partly on prospective longitudinal data and, on the other hand, adjusted for confounders such age and genderwhich are often lacking in other studies [15,20]. ...
... Only our data for current pain at baseline serves as a reference value for point prevalence. Here, our estimated value of 27% corresponds to other research [5,20]. ...
Background:
Evidence concerning the development of musculoskeletal health complaints (MHCs) among music students is limited due to inappropriate study designs. We aimed to assess the occurrences of MHCs and associated risk factors in freshmen music students compared to students from other disciplines.
Methods:
A prospective cohort study was conducted. Risk factors such as pain-related, physical, and psychosocial variables were measured at baseline. Episodes of MHCs were recorded monthly.
Results:
A total of 146 music students and 191 students from other disciplines were analyzed. In the cross-sectional comparison, pain-related, physical, and psychosocial variables were significantly altered in music students compared to students from other disciplines. Furthermore, music students with current MHCs differed significantly from music students without current MHCs with respect to physical health, pain, and history of MHCs. Our longitudinal analysis showed that monthly MHCs were higher in music students compared to students from other disciplines. Independent predictors for monthly MHCs in music students were current MHCs and reduced physical function. Predictors for MHCs in students from other disciplines were a history of MHCs and stress.
Conclusions:
We provided insight into the development of MHCs and risk factors in music students. This may help in the creation of targeted, evidence-based prevention and rehabilitation.
Objective
To evaluate prevalence of performance-related pain among musicians and compare pain characteristics, associated disability and approach to pain management, between music students and professional musicians.
Methods
A multicenter cross-sectional study was performed in a multi-stage stratified cluster random sample of 585 musicians, stratified by music students (294, among which 234 were at pre-university level and 60 at university level) and professional musicians (291). The main outcome was performance-related pain, measured by Performance-related Pain among Musicians Questionnaire (PPAM). Secondary outcomes were: pain management approach, physical activity levels, fatigue, distress, and health-related quality of life.
Results
The lifetime prevalence of performance-related pain was 55.0% (n = 322), being significantly higher among professionals (57.5% vs 42.5%, P < .001). Pain intensity scores were significantly higher in professional musicians (P < .05), but pain interference in performance was higher among music students, who also reported significantly higher levels of fatigue (P = .008) and distress (P < .001), and lower quality of life (P < .001). Regardless of the high levels of pain intensity and interference, fatigue, anxiety and depression, and low levels of quality of life, 33% musicians who developed pain had never looked for healthcare (this proportion is significantly higher for music students, 57%, P < .001).
Conclusions
We present the first multicenter study on performance-related pain among musicians with different backgrounds, using a validated tool, and distinguishing music students from professional musicians. Performance-related pain is a highly prevalent and disabling condition among musicians, however, its proper evaluation and management are still often underappreciated, contributing to significant impairments and reduced quality of life.
Antecedentes: La música rock, aunque apasionante y enérgica, impone demandas físicas significativas a los músicos. Históricamente, se ha especulado sobre la relación entre lesiones musculoesqueléticas y la carrera de un rockstar, especialmente aquellas que requieren intervención quirúrgica. Objetivo: Explorar la asociación entre las demandas físicas de ser un rockstar y la prevalencia de lesiones musculoesqueléticas, con un enfoque particular en aquellas que requieren cirugía. Metodología: Se realizó una revisión exhaustiva de la literatura y casos notables de rockstars que han sido sometidos a procedimientos quirúrgicos ortopédicos. Se examinaron las causas, el impacto y las estrategias de prevención y manejo. Resultados: Las lesiones musculoesqueléticas en rockstars son prevalentes y pueden ser el resultado de múltiples factores, incluida la técnica inadecuada, la postura, el estilo de vida y las demandas físicas de las actuaciones. Estas lesiones tienen un impacto significativo no solo en la salud física del músico, sino también en su bienestar emocional y psicológico. Conclusiones: Es esencial adoptar un enfoque proactivo y multidisciplinario para prevenir y tratar lesiones en rockstars. La combinación de investigación, educación y apoyo puede garantizar la salud y longevidad de la carrera de estos artistas.
We aim to present the first psychometric evaluation of the Performance-related Pain among Musicians Questionnaire (PPAM), the first questionnaire specifically designed to evaluate performance-related pain among musicians with different musical backgrounds, based on a multicenter validation study. The psychometric evaluation was performed in a validation sample of 458 musicians, at baseline and after seven days. We assessed the applicability, reliability, internal consistency, construct validity and factor structure of the PPAM. The Cronbach's α coefficients for the three subdimensions of PPAM - "pain intensity", "pain interference in general" and "pain interference in performance" - were 0.834, 0.864, and 0.930, respectively, suggesting a high degree of internal consistency. Test-retest reliability coefficients were substantial for all subscales of the PPAM Questionnaire. Exploratory factor analysis indicated a three-factor structure (pain intensity, interference in general activities and interference in performance) that explained 62% of the variance. Both convergent and divergent validity were well demonstrated, confirming more than 95% of the previously defined hypotheses regarding correlations with other measures. PPAM is the first validated questionnaire to evaluate pain among musicians with different musical backgrounds. This online self-reported questionnaire is a valid and reliable tool suitable for both clinical research and clinical practice, with excellent psychometric properties, both in terms of internal consistency, test-retest reliability, factor analysis, and construct validity. It will allow the development of more robust studies on pain and disability among musicians, comparative studies between different subgroups of musicians and the evaluation of predictive factors of pain development. PERSPECTIVE: This article presents the psychometric properties of the first questionnaire to evaluate pain among musicians (in general), the "Performance-related Pain among Musicians Questionnaire" (PPAM). This valid and reliable tool, composed by three constructs (pain intensity, interference in general activities and interference in performance), will improve the pain assessment among musicians.
Aim
To develop and perform the expert’s content validation and pretesting of the first questionnaire specifically designed to evaluate performance-related pain among musicians with different backgrounds.
Methods
The development of the Performance-related Pain Among Musicians Questionnaire (PPAM) was carried out in 4 phases: (1) item generation, (2) experts’ panel evaluation and content validation (3) pretesting, and (4) conceptualization of the final version. For item generation we conducted two systematic reviews to identify the existing tools evaluating similar constructs and the predictive factors of performance-related pain. Four expert panel meetings and three pilot tests were performed, with a total of 94 musicians.
Results
From the 1154 articles initially found in the literature search, 153 were included (65 related to pain tools and 88 related to predictive factors) and a pool of 115 items were created. After expert panel evaluation and pretesting, a final self-report questionnaire was defined, comprising 33 core items to evaluate 3 constructs (pain intensity, pain interference in general activities and pain interference in performance), as well as 32 additional items (optional module – predictive factors).
Conclusions
The PPAM Questionnaire is specifically designed and validated for musicians and can be applied for all types of musicians (professional, amateur and music students), allowing the development of comparative studies between musicians. It is a new enriched tool, easy to respond and disseminate to large, multicentre, and international samples. PPAM is suitable for research and clinical practice purposes and will allow the improved assessment and monitoring of pain in this occupational context.
