Factors associated with increased risk of playing-related disorders among classical music students within the Risk of Music Students (RISMUS) longitudinal study.

Playing-related musculoskeletal disorders (PRMDs) are common among musicians but longitudinal data on risk factors are limited. The aim of the study was to longitudinally identify the factors associated with increased risk of PRMD onset among music students enrolled in different pan-European music institutions. A further goal was to assess the occurrence of PRMDs during a 12-month period. A total of 442 students without PRMDs from 56 European music universities completed a web-based questionnaire on lifestyle and practice habits, health history, physical activity, psychological distress, perfectionism, and fatigue. PRMD onset was assessed prospectively at 6 and 12 months. Logistic regression analysis showed that changes in physical activity level (6-month AOR = 2.343, 12-month AOR = 2.346), increased levels of fatigue (6-month AOR = 1.084, 12-month AOR = 1.081) and socially-prescribed perfectionism (6-month AOR = 1.102) were significantly associated with PRMD onset, which had occurred in 49% of participants during 12 months. Musculoskeletal complaints reported at baseline (6-month AOR = 0.145, 12-month AOR = 0.441) and changes to BMI (12-month AOR = 0.663) limited the onset of PRMDs. The study's novel longitudinal findings were appraised critically within the contexts of potential factors for PRMD onset and evidence-based preventive strategies to minimise the impact of PRMDs.

Patterns of pain location in music students: a cluster analysis.

BACKGROUND: According to existing literature, musicians experience high rates of musculoskeletal (MSK) disorders involving different anatomical areas. The aim of the study was to identify patterns of pain location in a sample of music students enrolled in different pan-European music institutions. A further goal was to explore the association between the identified pain patterns and students' characteristics. METHODS: A total of 340 music students (mean age 23.3 years, 66.2% female) with current MSK pain completed a web-based questionnaire including both background information (i.e. lifestyle and physical activity, practice habits) and clinical features (i.e. pain characteristics, disability, pain self-efficacy, psychological distress, perfectionism and fatigue). RESULTS: Five patterns of pain location were identified by hierarchical cluster analysis: wrist pain (WP) representing 22.6% of the total sample, widespread pain (WSP) (16.9%), right shoulder pain (RSP) (18.5%), both shoulders pain - left concentrated (LSP) (23.2%), neck and back pain (NBP) (18.8%). Amongst the identified patterns of pain location, bivariate analysis identified the WSP cluster as containing the largest number of associated variables. Participants in this cluster reported a higher percentage of women (p < .05), a higher perceived exertion (p < .01) and psychological distress (p < .001), as well as a lower level of self-efficacy (p < .01). Similarly, a higher percentage of participants included in the WSP cluster perceived their musical activity as the main cause of their MSK pain (p < .01). Additionally, a higher level of disability in relation to playing-related activity was reported by participants included in the WP and WSP clusters (p < .001). The RSP cluster was characterised by a higher percentage of participants playing an instrument in a neutral position (p < .001) and lower levels of socially prescribed perfectionism (p < .01). A higher percentage of participants playing an instrument with both arms elevated in the left quadrant position were included in the LSP cluster and a higher percentage of singers were included in the NBP cluster (p < .001). CONCLUSIONS: Five distinct patterns of pain location were identified and their associations with the students' characteristics were explored. These findings may be helpful in the exploration of different aetiologies of MSK pain among musicians and in the development of targeted preventive strategies and treatments.

Prevalence and associated factors of playing-related musculoskeletal disorders among music students in Europe. Baseline findings from the Risk of Music Students (RISMUS) longitudinal multicentre study.

Musculoskeletal (MSK) conditions among professional musicians and music students are frequent and may have significant physical and psychosocial consequences on their lives and/or on their playing abilities. The Risk of Music Students (RISMUS) research project was set up in 2018 to longitudinally identify factors associated with increased risk of playing-related musculoskeletal disorders (PRMDs) in a large sample of music students enrolled in pan-European institutions. The aim of this cross-sectional study was to describe the prevalence of playing-related musculoskeletal disorders (PRMDs) in this novel population at baseline of the RISMUS project. A further goal was to begin to identify variables that might be associated with the self-reported presence of PRMDs among music students. Eight hundred and fifty students from fifty-six conservatories and music universities in Europe completed a web-based questionnaire on lifestyle and physical activity participation levels, musical practice habits, health history and PRMDs, psychological distress, perfectionism and fatigue. A total of 560 (65%) out of 850 participants self-reported a positive history of painful MSK conditions in the last 12 months, 408 (48%) of whom self-reported PRMDs. Results showed that coming from West Europe, being a first- or a second-year Masters student, having more years of experience and higher rates of perceived exertion after 45 minutes of practice without breaks were factors significantly associated with self-reported presence of PRMDs. According to the authors' knowledge, a large-scale multicentre study investigating prevalence and associated factors for PRMDs among music students at different stages of their education (from Pre-college to Masters levels) has not been conducted before. The high prevalence of PRMDs among music students, especially those studying at university-level, has been confirmed in this study and associated factors have been identified, highlighting the need for relevant targeted interventions as well as effective prevention and treatment strategies.

A longitudinal investigation of the factors associated with increased RISk of playing-related musculoskeletal disorders in MUsic students (RISMUS): a study protocol.

BACKGROUND: The achievement and improvement of skills in musical techniques to reach the highest levels of performance may expose music students to a wide range of playing-related musculoskeletal disorders (PRMDs). In order to establish effective solutions for PRMDs and to develop future preventive measures, it is fundamental to firstly identify the main risk factors that play a significant role in the development of musculoskeletal conditions and symptoms. The aim of the study is to identify those factors associated with increased risk of PRMDs among music students. A further goal is to characterise this population and describe the clinical features of PRMDs, as well as to determine the evolving course of PRMDs in music students during their training. METHODS: One hundred and ninety schools have been invited to participate in this study, sixty of which have already confirmed officially their support for the investigation's recruitment procedures, by means of a subsequent distribution of the link to a web-based questionnaire to their student groups (total potential student numbers available: n = 12,000 [based on ~ 200 students per school on average, and 60 volunteering schools]; expected number of students: n = 3000 [based on a 25% response rate from the 12,000 students attending the 60 volunteering schools]). The web-based questionnaire includes questions about any PRMD that students have experienced during their training, and different potential risk factors (i.e. lifestyle and physical activity, practice habits, behaviour toward prevention and health history, level of stress, perfectionism, fatigue and disability). Overall recurrence or new onsets of PRMDs will be assessed at 6 and 12 months after the first data collection to investigate and record the development of new incidents within a period of a year and to enable characterisation of the nature and the evolving course of PRMDs. DISCUSSION: To the best of our knowledge, no other longitudinal studies on risk factors for PRMDs among music students have been conducted so far. Therefore, this study can be considered as an opportunity to begin filling the gaps within current research in this field and to generate new knowledge within musical contexts in education and employment. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT03622190 ), registration date 09/08/2018.

Profiling the Location and Extent of Musicians' Pain Using Digital Pain Drawings.

BACKGROUND AND AIMS: According to existing literature, musicians are at risk of experiencing a range of painful musculoskeletal conditions. Recently, a novel digital technology was developed to investigate pain location and pain extent. The aim of this study was to describe pain location and pain extent in musicians using a digital method for pain drawing (PD) analysis. Additionally, the association between PD variables and clinical features were explored in musicians with pain. METHODS: One hundred and fifty-eight musicians (90 women and 68 men; aged 22.4 ± 3.6 years) were recruited from Swiss and U.K. conservatories. Participants were asked to complete a survey including both background musical information and clinical features, the QuickDASH (QD) questionnaire, and the digital PDs. RESULTS: Of the 158 participants, 126 musicians (79.7%) reported having pain, with higher prevalence in the areas of the neck and shoulders, the lower back, and the right arm. The mean percentage of pain extent was 3.1% ± 6.5%. The mean QD score was higher for musicians with pain than for those without pain. Additionally, the results indicated a positive correlation between the QD score and pain extent, and there were significant correlations between age and pain intensity, as well as between pain extent and pain intensity. CONCLUSIONS: The high prevalence of pain among musicians has been confirmed using a digital technique for PD acquisition and analysis. In addition, positive correlations between pain extent and upper limb disability have been demonstrated. Our findings highlight the need for effective prevention and treatment strategies for musicians.

Stage call: Cardiovascular reactivity to audition stress in musicians.

Auditioning is at the very center of educational and professional life in music and is associated with significant psychophysical demands. Knowledge of how these demands affect cardiovascular responses to psychosocial pressure is essential for developing strategies to both manage stress and understand optimal performance states. To this end, we recorded the electrocardiograms (ECGs) of 16 musicians (11 violinists and 5 flutists) before and during performances in both low- and high-stress conditions: with no audience and in front of an audition panel, respectively. The analysis consisted of the detection of R-peaks in the ECGs to extract heart rate variability (HRV) from the notoriously noisy real-world ECGs. Our data analysis approach spanned both standard (temporal and spectral) and advanced (structural complexity) techniques. The complexity science approaches-namely, multiscale sample entropy and multiscale fuzzy entropy-indicated a statistically significant decrease in structural complexity in HRV from the low- to the high-stress condition and an increase in structural complexity from the pre-performance to performance period, thus confirming the complexity loss theory and a loss in degrees of freedom due to stress. Results from the spectral analyses also suggest that the stress responses in the female participants were more parasympathetically driven than those of the male participants. In conclusion, our findings suggest that interventions to manage stress are best targeted at the sensitive pre-performance period, before an audition begins.