The value of health screening in music schools and conservatoires

A Longitudinal Study of Physical and Mental Health and Health-Related Attitudes Among Music Students: Potentials and Challenges for University Health Promotion Programs

Objective

Well-being of music students has been an increasing matter of concern since studies show that up to 50% of beginners suffer from playing-related pain or anxiety. The aim of this longitudinal study was to examine health status, health-related attitudes, behaviors, knowledge, skills, and coping strategies of students at the beginning of their education at a music university and at the end of their second semester.

Methods

Based on a longitudinal online survey conducted among students at a German music university since 2017, we investigated mental and physical health status, health-related attitudes, knowledge, skills, behaviors, and coping strategies of music students at the beginning of their first year (n = 205). We analyzed differences between performance and music education majors and between students playing different main instruments. In a subsample (n = 62), we additionally analyzed changes between the beginning of the music students’ first and the end of their second semester, also depending on whether they attended courses on musicians’ health.

Results

Music students are already in demand when they enter a music university, practicing on average almost 3 h daily. Compared to other body regions, pain in shoulders/back is most prevalent in first-year students, especially in those playing string instruments. Performance majors reported better knowledge about health risks and protective measures for musicians, better coping abilities, and practiced more than music education majors. First-year students assessed their overall and mental health status at the beginning of their first semester mainly as good, but we found a decrease in mental health status at the end of the second semester. After two semesters, students attending courses on musicians’ health showed increased knowledge and skills regarding different aspects of musicians’ health.

Conclusion

The health status of music students when they first enter a music university is still a concern. Information and practical courses enabling students to prevent overuse and cope with performing anxiety and other stressors are important components of a comprehensive study program. Knowledge about music students’ needs can help conservatories better respond to the requirements and develop courses and measures supporting students from the beginning of their education.

Multiple Factors Influencing Healthy Performance for Pre-professional and Professional Classical Violinists: An Exploratory Study Focusing on Physical Health

Musculoskeletal complaints are common in pre-professional and professional classical violinists and these complaints can affect violinists' performance. Therefore, it is important to identify the factors that contribute to healthy performance in this population. Qualitative studies with a variety of stakeholders are able to provide insights from different perspectives into factors influencing healthy performance for the pre-professional and professional classical violinist. In the current small-scale, exploratory study, semi-structured interviews were conducted with various stakeholders; two classical violin students, one classical violin teacher, a physiotherapist, a professional classical violinist, who is also a performance coach, and a health specialist who also graduated as a professional classical violist. Thematic analysis was conducted using Atlas.ti 9. We identified six themes that were indicated as important by the participants in terms of ensuring healthy performance for the pre-professional and professional classical violinist. The themes were: (1) physical aspects (involved in playing the violin); (2) practice routine and techniques; (3) interaction between physical and mental aspects; (4) culture; (5) role of the main subject teacher; and (6) preventive measures. Furthermore, when asked specifically about the development of a physical screening tool, the participants indicated that such a tool should include multiple factors covering various regions of the body, the inclusion of a questionnaire on risk-factors, and follow-up measurements. Also, collaborations between health professionals and main subject teachers were recommended as part of the screening tool to increase commitment of participating students. The results of the current study are based on the opinions, attitudes, and ideas of a small, selected group of participants only and cannot be generalized to a wider group of violinists. More research is needed regarding factors influencing healthy performance, before conservatoires and professional orchestras can develop programs for a healthy playing environment for pre-professional and professional violinists.

Physical health status of music students in a post-secondary institution: A cross-sectional study

BACKGROUND

Musicians' health is an essential field of healthcare that is specifically tailored to the needs of musicians, which encompasses multiple facets of health.

OBJECTIVE

The research seeks to determine the prevalence of physical injuries in music students and musicians, and to identify possible causes.

METHODS

A previously unvalidated 42-item survey was distributed to music students, non-music students, and professional musicians. The questions addressed demographics, physical health, mental health, medication use, and interest in musicians' health. The study was conducted from Fall semester 2017 to Winter semester 2019 at McGill University, with analysis completed in August 2019.

RESULTS

A total of 585 complete responses were obtained. Music students (35%) had higher prevalence of physical injuries than non-music students (18%), and professional musicians had the highest prevalence (56%). Multiple factors dictate the prevalence of physical injuries among musicians, including gender, age, program of enrollment, and instrument of choice. Of note, daily duration of practice was not one of these factors.

CONCLUSIONS

Several factors were identified through this cross-sectional analysis to be associated with musicians' physical injuries. These findings can serve as a foundation through which physicians and post-secondary institutions may implement changes to better enhance the physical health of musicians. It also cast doubts on previous assumptions associated with physical injury of musicians.

The effect of strategies to prevent and manage musicians' musculoskeletal symptoms: A systematic review

The objective of this systematic review was to determine the safety and effectiveness of any public health intervention designed to prevent and/or manage musculoskeletal symptoms (MSSs) in any type of musician. A total of 14 studies were included. Studies investigated exercise and/or education programs, and changes to equipment, with a range of musicians. There was some evidence to suggest that smaller piano keyboards, and exercise programs may be effective. Studies suggesting a benefit of exercise programs typically had lower level designs and higher risk of methodological bias, compared with those that reported no benefit. Future research should use more robust methods to reduce bias and come to definitive conclusions regarding the safety and effectiveness of interventions prior to implementation, to reduce the burden of MSSs for musicians.

Task-specific dystonia: pathophysiology and management

Task-specific dystonia is a form of isolated focal dystonia with the peculiarity of being displayed only during performance of a specific skilled motor task. This distinctive feature makes task-specific dystonia a particularly mysterious and fascinating neurological condition. In this review, we cover phenomenology and its increasingly broad-spectrum risk factors for the disease, critically review pathophysiological theories and evaluate current therapeutic options. We conclude by highlighting the unique features of task-specific dystonia within the wider concept of dystonia. We emphasise the central contribution of environmental risk factors, and propose a model by which these triggers may impact on the motor control of skilled movement. By viewing task-specific dystonia through this new lens which considers the disorder a modifiable disorder of motor control, we are optimistic that research will yield novel therapeutic avenues for this highly motivated group of patients.

Developing a dancer wellness program employing developmental evaluation

Wellness programs are being increasingly employed with performing artists. Given their aim of reducing injuries, injury tracking is commonly employed as an outcome measure. Evaluating the development and process of a wellness program can also enhance its effectiveness. Developmental evaluation offers one methodological framework within which to conduct such investigations. This paper reports on a 2-year process involving feedback from professional ballet dancers, management and artistic staff, and healthcare providers at a ballet company in order to develop a dancer screening and wellness program. Following a consultation phase, an initial program composed of an expanded medical team and annual injury prevention screen was proposed. Alongside implementation with 30 professional ballet dancers, formal and informal feedback was sought from stakeholders and members across all levels of the ballet company to facilitate ongoing development, evaluation, and revision of the wellness program. The use of a process informed by developmental evaluation helped identify strengths and limitations within the screening process. The collective expertise of the assessors was used to modify the components and process of the screen to strive for ecological appropriateness. The process also fostered buy-in from all involved. Participant feedback helped refine the medical team available to the dancers and influenced the treatment and referral pathways via which dancers are able to access each member of the medical team. Furthermore, reflective discussions with artistic and management staff brought to light potential interactions between repertoire programming, fitness, and injury patterns. This prompted a reconsideration of how artists are trained and supported. Evaluation methods that focus on experiences and insight gained during program development stand to result in more efficient screening programs and health-promotion models and, ultimately, healthier performing artists.