Physical and mental practices of music students as they relate to the occurrence of music-related injuries

A proposed rapid upper limb assessment for pianists (RULA-p)1

BACKGROUND

Pianists often suffered from postural related problems due to prolonged sitting and awkward postures. Despite that postural related problems are common among pianists, there is only one study found by the authors, which applied RULA to assess pianists' postures, without any modification to the original RULA worksheet. None of the other existing literature has applied this postural assessment tool to assess the pianists' overall posture. There is no existing Rapid Upper Limb Assessment (RULA) checklist that exactly fits into the context of piano playing, at least not without some modifications.

OBJECTIVE

To propose a Rapid Upper Limb Assessment for Pianists (RULA-p) for postural assessment, which will allow pianists to identify awkward postures (if any) during piano playing, thus, achieving healthful playing for injury prevention.

METHOD

This study modified (i) the muscle use score; and (ii) the force/load score, from the existing RULA as a rapid assessment for pianists' posture.

RESULTS

Proposed the modified RULA for pianists (RULA-p) in the worksheet format.

CONCLUSION

Overall, this study is intended to further expand the existing literature on the early prevention of pianists' PRMDs.

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.

Imagine, Sing, Play- Combined Mental, Vocal and Physical Practice Improves Musical Performance

Classical musicians face a high demand for flawless and expressive performance, leading to highly intensified practice activity. Whereas the advantage of using mental strategies is well documented in sports research, few studies have explored the efficacy of mental imagery and overt singing on musical instrumental learning. In this study, 50 classically trained trumpet students performed short unfamiliar pieces. Performances were recorded before and after applying four prescribed practice strategies which were (1) physical practice, (2) mental imagery, (3) overt singing with optional use of solfege, (4) a combination of 1, 2 and 3 or a control condition, no practice. Three experts independently assessed pitch and rhythm accuracy, sound quality, intonation, and musical expression in all recordings. We found higher gains in the overall performance, as well as in pitch accuracy for the physical practice, and the combined practice strategies, compared to no practice. Furthermore, only the combined strategy yielded a significant improvement in musical expression. Pitch performance improvement was positively correlated with previous solfege training and frequent use of random practice strategies. The findings highlight benefits from applying practice strategies that complement physical practice in music instrument practice in short term early stages of learning a new piece. The study may generalize to other forms of learning, involving cognitive processes and motor skills.

Adaptation of the Corticomuscular and Biomechanical Systems of Pianists

Independent control of movements between the fingers plays a role in hand dexterity characterizing skilled individuals. However, it remains unknown whether and in what manner neuromuscular and biomechanical constraints on the movement independence of the fingers depend on motor expertise. Here, we compared motor dexterity, corticospinal excitability of multiple muscles, muscular activation, and anatomical features of the fingers between the pianists and nonpianists. When the ring finger was passively moved by a robot, passive motions produced at the adjacent fingers were smaller for the pianists than the nonpianists, indicating reduced biomechanical constraint of fingers in the pianists. In contrast, when the ring finger moved actively, we found no group difference in passive motions produced at the adjacent fingers; however, reduced inhibition of corticospinal excitability of the adjacent fingers in the pianists compared with the nonpianists. This suggests strengthened neuromuscular coupling between the fingers of the pianists, enhancing the production of coordinated finger movements. These group differences were not evident during the index and little finger movements. Together, pianists show expertise-dependent biomechanical and neurophysiological adaptations, specifically at the finger with innately low movement independence. Such contrasting adaptations of pianists may subserve dexterous control of both the individuated and coordinated finger movements.

Role of occupational therapy in musicians' health: a scoping review protocol

REVIEW QUESTION/OBJECTIVE

The purpose of this proposed review is twofold: first, to understand the role of occupational therapy presented in the musicians' health literature; and second, to explore the potential for this role.

INTRODUCTION

The intense movement, awkward postures, concentration and emotional communication required of musicians can place them at increased risk of music-related health conditions, such as musculoskeletal disorders and performance anxiety. The development of music-related health conditions can be emotionally and financially devastating. The role of occupational therapy in musicians' health has been previously discussed; however, no rigorous reviews of the scholarly literature have been published. We will, therefore, undertake a scoping review with the following research questions: (1) what is known about the role of occupational therapy in instrumental musicians' health? and (2) what is the potential role of occupational therapy in musicians' health?

METHODS AND ANALYSIS

A preliminary search of Medline, CINAHL, SCOPUS and Web of Science was previously undertaken by the first author to determine the extent of the research on this topic and to confirm that no other reviews have been conducted or are in progress. Study selection and analysis will follow the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guidelines for conducting a scoping review.

ETHICS AND DISSEMINATION

Formal ethics approval is not required at our institution for a review of published literature. The results of this review will be shared through peer-reviewed publications, conference presentations and traditional and social media.

The correlation between upper extremity musculoskeletal symptoms and joint kinematics, playing habits and hand span during playing among piano students

Objective

We aimed to investigate the correlations between Upper Extremity Musculoskeletal Symptoms (MSD) and joint kinematics while playing the piano, as well as correlations between MSD and psychosocial, professional and personal habits, and bio-demographic risk factors of piano students.

Method

This cross-sectional study included 15 piano students. The research tools included 3D motion capture, anthropometric measurements, and questionnaires for obtaining data about MSD, psychological, and personal factors.

Results

The piano students recruited for this study experienced a variety of MSD during the past 12 months, with a particularly high prevalence of neck pain (80%). Extreme wrist extension and/or elbow flexion while playing the piano also correlated with MSD. Additionally, this study identified correlations between MSD and hand span (r = -.69, p≤.004) and number of playing hours per week (r = .58, p≤.024).

Conclusions

Anthropometric factors and playing patterns should be considered together with well-known MSD risk factors, like extreme and repetitive movements. However, considering each joint singularly might not be sufficient to prevent the development of MSD when instructing the piano player; accordingly, joint synchronization should also be considered.

The occurrence of musculoskeletal complaints among professional musicians: a systematic review

Purpose

This study gives a systematic overview of the literature on the occurrence of musculoskeletal complaints in professional instrumental musicians.

Methods

A systematic review. Nine literature databases were searched without time limits on June 25, 2015, also the complete index of the journal Medical Problems of Performing Artists (MPPA) until June 2015 (30;2) was searched, and citation tracking and reference checking of the selected articles were performed. The search consisted of the combination of three groups of keywords: musician (e.g., musician, violin, music student, instrument player) AND musculoskeletal (e.g., musculoskeletal, tendon, shoulder, arthritis) AND epidemiology (e.g., prevalence, incidence, occurrence).

Results

The initial literature search strategy resulted in 1258 potentially relevant articles. Finally, 21 articles describing 5424 musicians were included in this review. Point prevalences of musculoskeletal complaints in professional musicians range between 9 and 68 %; 12-month prevalences range between 41 and 93 %; and lifetime prevalences range between 62 and 93 %. Ten out of 12 studies show a higher prevalence of musculoskeletal complaints among women. Brass instrumentalists are reported to have the lowest prevalence rates of musculoskeletal complaints. The neck and shoulders are the anatomic areas most affected; the elbows are least affected. Although some information is reported concerning age, the high risk of bias in and between these studies makes it impossible to present reliable statements with respect to this.

Conclusion

Musculoskeletal symptoms are highly prevalent among musicians, especially among women instrumentalists. Future research concerning the epidemiology of musculoskeletal complaints among musicians should focus on associated risk factors and follow the current guidelines to optimize scientific quality.