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Menzel J, Kreutz G, Jabusch HC, Becher H, Krist L, Keil T, Borngräber F, Schmidt A, Willich SN, Fernholz I, Weikert C. Musical activity in a subsample of the German National Cohort study. Sci Rep 2024; 14:14069. [PMID: 38890477 PMCID: PMC11189540 DOI: 10.1038/s41598-024-64773-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024] Open
Abstract
Musical activities (MA) such as singing, playing instruments, and listening to music may be associated with health benefits. However, evidence from epidemiological studies is still limited. This study aims at describing the relation between MA and both sociodemographic and health-related factors in a cross-sectional approach. A total of 6717 adults (50.3% women, 49.7% men, median age: 51 years (IQR 43-60) were recruited from the study center Berlin-Mitte of the German National Cohort (NAKO), a population-based prospective study. This study is based on a sample randomly selected from the population registry of Berlin, Germany, aged 20 to 69 years. 53% of the participants had been musically active at least once in their life (56.1% women, 43.9% men). Playing keyboard instruments (30%) and singing (21%) were the most frequent MA. Participants listened to music in median 90 min per day (IQR 30.0-150.0). Musically active individuals were more likely to have a higher education, higher alcohol consumption, were less likely to be physically active, and had a lower BMI compared to musically inactive individuals. This large population-based study offers a comprehensive description of demographic, health, and lifestyle characteristics associated with MA. Our findings may aid in assessing long-term health consequences of MA.
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Affiliation(s)
- Juliane Menzel
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, Germany
| | - Gunter Kreutz
- Institut für Musik, Carl von Ossietzky Universität Oldenburg, Oldenburg, Lower Saxony, Germany.
| | - Hans-Christian Jabusch
- Institute of Musicians' Medicine, University of Music Carl Maria von Weber, Dresden, Saxony, Germany
| | - Heiko Becher
- Institute of Global Health, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Lilian Krist
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friederike Borngräber
- Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Berlin Center for Musicians Medicine (BCMM), Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Alexander Schmidt
- Berlin Center for Musicians Medicine (BCMM), Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Kurt Singer Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Berlin, Germany
- Clinic for Audiology and Phoniatrics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Stefan N Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Isabel Fernholz
- Berlin Center for Musicians Medicine (BCMM), Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Kurt Singer Institute for Music Physiology and Musicians' Health, Hanns Eisler School of Music Berlin and University of the Arts Berlin, Berlin, Germany
- Clinic for Audiology and Phoniatrics, Charité - Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
- Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt Universität zu Berlin, Berlin, Germany
| | - Cornelia Weikert
- Institute of Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Department of Food Safety, German Federal Institute for Risk Assessment, Berlin, Germany
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2
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Bellinger D, Wehrmann K, Rohde A, Schuppert M, Störk S, Flohr-Jost M, Gall D, Pauli P, Deckert J, Herrmann MJ, Erhardt-Lehmann A. The application of virtual reality exposure versus relaxation training in music performance anxiety: a randomized controlled study. BMC Psychiatry 2023; 23:555. [PMID: 37528410 PMCID: PMC10394851 DOI: 10.1186/s12888-023-05040-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/20/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND Performance anxiety is the most frequently reported anxiety disorder among professional musicians. Typical symptoms are - on a physical level - the consequences of an increase in sympathetic tone with cardiac stress, such as acceleration of heartbeat, increase in blood pressure, increased respiratory rate and tremor up to nausea or flush reactions. These symptoms can cause emotional distress, a reduced musical and artistical performance up to an impaired functioning. While anxiety disorders are preferably treated using cognitive-behavioral therapy with exposure, this approach is rather difficult for treating music performance anxiety since the presence of a public or professional jury is required and not easily available. The use of virtual reality (VR) could therefore display an alternative. So far, no therapy studies on music performance anxiety applying virtual reality exposure therapy have investigated the therapy outcome including cardiovascular changes as outcome parameters. METHODS This mono-center, prospective, randomized and controlled clinical trial has a pre-post design with a follow-up period of 6 months. 46 professional and semi-professional musicians will be recruited and allocated randomly to an VR exposure group or a control group receiving progressive muscle relaxation training. Both groups will be treated over 4 single sessions. Music performance anxiety will be diagnosed based on a clinical interview using ICD-10 and DSM-5 criteria for specific phobia or social anxiety. A behavioral assessment test is conducted three times (pre, post, follow-up) in VR through an audition in a concert hall. Primary outcomes are the changes in music performance anxiety measured by the German Bühnenangstfragebogen and the cardiovascular reactivity reflected by heart rate variability (HRV). Secondary outcomes are changes in blood pressure, stress parameters such as cortisol in the blood and saliva, neuropeptides, and DNA-methylation. DISCUSSION The trial investigates the effect of VR exposure in musicians with performance anxiety compared to a relaxation technique on anxiety symptoms and corresponding cardiovascular parameters. We expect a reduction of anxiety but also a consecutive improvement of HRV with cardiovascular protective effects. TRIAL REGISTRATION This study was registered on clinicaltrials.gov. (ClinicalTrials.gov Number: NCT05735860).
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Affiliation(s)
- Daniel Bellinger
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany.
| | - Kristin Wehrmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Anna Rohde
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
| | | | - Stefan Störk
- Department Clinical Research & Epidemiology, Comprehensive Heart Failure Center Würzburg, University Hospital Würzburg, Würzburg, Germany
| | - Michael Flohr-Jost
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Center for Mental Health, University of Würzburg, Würzburg, Germany
| | - Dominik Gall
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Center for Mental Health, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), Center for Mental Health, University of Würzburg, Würzburg, Germany
| | - Jürgen Deckert
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Angelika Erhardt-Lehmann
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Center for Mental Health, University Hospital Würzburg, Würzburg, Germany
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
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3
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Jha S, Stogios N, de Oliveira AS, Thomas S, Nolan RP. Getting Into the Zone: A Pilot Study of Autonomic-Cardiac Modulation and Flow State During Piano Performance. Front Psychiatry 2022; 13:853733. [PMID: 35492712 PMCID: PMC9044034 DOI: 10.3389/fpsyt.2022.853733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Music performance anxiety is a common experience among elite and professional musicians and impedes performers from achieving flow state, or a state of focused, sustained engagement that promotes optimal performance. OBJECTIVE The aim of this study was to use heart rate variability (HRV) to determine the psychophysiological underpinnings of optimal music performance. METHODS We assessed HRV to study how autonomic-cardiac modulation was associated with flow during piano performance. Twenty-two pianists (15-22 years) with at least a Grade 8 Royal Conservatory of Music certification prepared two standardized pieces and a self-selected piece. Performer heart rate data were measured with a Polar 800 watch in 5-min periods immediately before performances, during performances and post-performance. HRV was employed to assess autonomic modulation of cardiac intervals. HRV indices of sympathetic and parasympathetic modulation of the heart were analyzed in 2.5-min segments to monitor short-term autonomic adjustments using the Kubios HRV Software. Flow state was measured using the 36-item Flow State Scale (FSS). Relationships were analyzed using zero-order correlations and multiple linear regressions. RESULTS Our sample consisted of 22 RCM Grade 8 certified pianists. Participants achieved the highest level of flow during performance of the Bach piece. Decreased HRV was observed during performance, as indicated by a significant drop in total power. Flow state was positively associated with High Frequency (HF) power during the pre-performance phase, and inversely associated with Low Frequency (LF) power during performance. CONCLUSION Inverse association of flow with LF-HRV during performance affirms the importance of vagal-HR modulation for achievement of flow state. Increased HF-HRV and reduced LF-HRV immediately prior to performance suggests that flow state may be shaped as much by physiological preparation during pre-performance as it is by physiologic responses during performance. Further research is required to validate the correlation between autonomic modulation of the heart and flow state. Evidence of this correlation between autonomic modulation of the heart and achievement of flow state may pave the way for further research on enhancing musical performance and targeting MPA through HRV-based interventions.
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Affiliation(s)
- Shreya Jha
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Faculty of Music, University of Toronto, Toronto, ON, Canada
| | - Nicolette Stogios
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | | | - Scott Thomas
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Robert P Nolan
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Cardiac eHealth and Behavioural Cardiology Research Unit, University Health Network (UHN), Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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Niarchou M, Lin GT, Lense MD, Gordon RL, Davis LK. Medical phenome of musicians: an investigation of health records collected on 9803 musically active individuals. Ann N Y Acad Sci 2021; 1505:156-168. [PMID: 34414577 PMCID: PMC8688228 DOI: 10.1111/nyas.14671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/25/2021] [Accepted: 07/12/2021] [Indexed: 11/29/2022]
Abstract
Previous studies suggest that musicians may be at higher risk for a set of medical problems; however, this literature has been limited by relatively small sample sizes, self‐reports, and lack of controls. To address such limitations, we examined trends in the medical care of musicians in an Electronic Health Record database. On the basis of a collection of keywords and regular expressions in the patients’ clinical notes, we identified 9803 “musicians” that we matched for sex, median age (across the medical record), ethnicity, race, the length of record, and the number of visits with 49,015 controls. We fitted 1263 logistic regression models to determine whether the phenotype was correlated with musicianship. Two hundred fifty‐seven phenotypes were more prevalent in musicians than controls after Bonferroni adjustment (P < 7.6 × 10–6), including diseases of the larynx and vocal cords (OR = 2.32 (95% CI: 2.25–2.40)), and hearing loss (OR = 1.36 (95% CI: 1.32–1.39)). Fifteen phenotypes were significantly more prevalent in controls than musicians, including coronary atherosclerosis (OR = 0.91 (95% CI: 0.89–0.94)). Although being a musician was related to many occupational health problems, we identified protective effects of musicianship in which certain disorders were less common in musicians than in controls, indicating that active musical engagement could have health benefits analogous to athletic engagement.
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Affiliation(s)
- Maria Niarchou
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - George T Lin
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Miriam D Lense
- Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Reyna L Gordon
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Otolaryngology - Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Psychology, Vanderbilt University, Nashville, Tennessee
| | - Lea K Davis
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, Tennessee.,Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee.,Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, Tennessee
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5
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Wright SE, Palmer C. Physiological and Behavioral Factors in Musicians' Performance Tempo. Front Hum Neurosci 2020; 14:311. [PMID: 33192375 PMCID: PMC7478117 DOI: 10.3389/fnhum.2020.00311] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/14/2020] [Indexed: 11/13/2022] Open
Abstract
Musicians display individual differences in their spontaneous performance rates (tempo) for simple melodies, but the factors responsible are unknown. Previous research suggests that musical tempo modulates listeners' cardiovascular activity. We report an investigation of musicians' melody performances measured over a 12-h day and subsequent changes in the musicians' physiological activity. Skilled pianists completed four testing sessions in a single day as cardiac activity was recorded during an initial 5 min of baseline rest and during performances of familiar and unfamiliar melodies. Results indicated slower tempi for familiar and unfamiliar melodies at early testing times. Performance rates at 09 h were predicted by differences in participants' alertness and musical training; these differences were not explained by sleep patterns, chronotype, or cardiac activity. Individual differences in pianists' performance tempo were consistent across testing sessions: participants with a faster tempo at 09 h maintained a faster tempo at later testing sessions. Cardiac measures at early testing times indicated increased heart rates and more predictable cardiac dynamics during music performance than baseline rest, and during performances of unfamiliar melodies than familiar melodies. These findings provide the first evidence of cardiac dynamics that are unique to music performance contexts.
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Affiliation(s)
- Shannon E Wright
- Department of Psychology, McGill University, Montreal, QC, Canada
| | - Caroline Palmer
- Department of Psychology, McGill University, Montreal, QC, Canada
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6
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Autonomic Modulation Improves in Response to Harder Performances While Playing Wind Instruments. ARCHIVES OF NEUROSCIENCE 2020. [DOI: 10.5812/ans.101969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Araújo LS, Wasley D, Redding E, Atkins L, Perkins R, Ginsborg J, Williamon A. Fit to Perform: A Profile of Higher Education Music Students' Physical Fitness. Front Psychol 2020; 11:298. [PMID: 32210876 PMCID: PMC7066496 DOI: 10.3389/fpsyg.2020.00298] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 02/07/2020] [Indexed: 11/13/2022] Open
Abstract
The physical demands of music making are well acknowledged, but understanding of musicians' physical and fitness profiles is nonetheless limited, especially those of advanced music students who are training to enter music's competitive professional landscape. To gain insight into how physical fitness is associated with music making, this study investigated music students' fitness levels on several standardized indicators. Four hundred and eighty three students took part in a fitness screening protocol that included measurements of lung function, flexibility (hypermobility, shoulder range of motion, sit and reach), strength and endurance (hand grip, plank, press-up), and sub-maximal cardiovascular fitness (3-min step test), as well as self-reported physical activity (IPAQ-SF). Participants scored within age-appropriate ranges on lung function, shoulder range of motion, grip strength, and cardiovascular fitness. Their results for the plank, press-up, and sit and reach were poor by comparison. Reported difficulty (22%) and pain (17%) in internal rotation of the right shoulder were also found. Differences between instrument groups and levels of study were observed on some measures. In particular, brass players showed greater lung function and grip strength compared with other groups, and postgraduate students on the whole were able to maintain the plank for longer but also demonstrated higher hypermobility and lower lung function and cardiovascular fitness than undergraduate students. Seventy-nine percent of participants exceeded the minimum recommended weekly amount of physical activity, but this was mostly based on walking activities. Singers were the most physically active group, and keyboard players, composers, and conductors were the least active. IPAQ-SF scores correlated positively with lung function, sit and reach, press-up and cardiovascular fitness suggesting that, in the absence of time and resources to carry out comprehensive physical assessments, this one measure alone can provide useful insight into musicians' fitness. The findings show moderate levels of general health-related fitness, and we discuss whether moderate fitness is enough for people undertaking physically and mentally demanding music making. We argue that musicians could benefit from strengthening their supportive musculature and enhancing their awareness of strength imbalances.
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Affiliation(s)
- Liliana S Araújo
- Centre for Performance Science, Royal College of Music, London, United Kingdom.,Faculty of Medicine, Imperial College London, London, United Kingdom.,Trinity Laban Conservatoire of Music and Dance, London, United Kingdom
| | - David Wasley
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Emma Redding
- Trinity Laban Conservatoire of Music and Dance, London, United Kingdom
| | - Louise Atkins
- Centre for Performance Science, Royal College of Music, London, United Kingdom
| | - Rosie Perkins
- Centre for Performance Science, Royal College of Music, London, United Kingdom.,Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Jane Ginsborg
- Royal Northern College of Music, Manchester, United Kingdom
| | - Aaron Williamon
- Centre for Performance Science, Royal College of Music, London, United Kingdom.,Faculty of Medicine, Imperial College London, London, United Kingdom
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