Factors Associated with Musculoskeletal Pain Among Music Students in Iran.

BACKGROUND: Playing-related musculoskeletal pain is common among music students. We aimed to assess the prevalence of musculoskeletal pain and the factors associated with the presence of musculoskeletal pain among music students in public music conservatories in Tehran, Iran. METHODS: Participants included 383 music students, age 12-18 years, from Tehran, Iran. A cross-sectional study was performed from October to November 2021 through convenience sampling. Demographic characteristics and musculoskeletal pain were collected using a self-report questionnaire, the Numerical Rating Scale, and the Nordic Body Map questionnaire, respectively. Postural behavior of participants was assessed using the Rapid Entire Body Assessment checklist. RESULTS: In the convenience sample, 59.3% of music students reported at least one symptomatic musculoskeletal pain in the last week. Female gender (OR 2.34, 95% C:1.37-3.99, p<0.001), age (OR 1.66, 95% C:1.08-2.54, p<0.001), postural behavior (OR 1.07, 95% CI 0.81-1.39, p<0.001), and duration of playing (OR 0.97, 95% CI 0.95-0.99, p<0.001) were significantly associated with the playing-related musculoskeletal pain. History of playing and instrument type had no relationship to pain. DISCUSSION: The main risk factors associated with playing-related musculoskeletal pain in music students were the participants' characteristics (female gender and age), postural behavior, and playing duration. The findings support the need to design educational programs for music students in order to prevent playing-related musculoskeletal pain.

Impact of El-Poems study: the e-learning for postural education in music students: a randomized controlled trial protocol.

BACKGROUND: Musculoskeletal pain (MP) has today intensified in a large proportion of music students in Iran. Poor posture while playing an instrument is thus assumed as a very significant risk factor affecting such a condition in this population. The present study aims to evaluate the impact of electronic learning (e-learning) for postural education to music students on posture behavior and MP (abbreviated as an El-Poems study). METHODS: This study is a matched-pair, two-arm, parallel randomized controlled trial (RCT). The participants, as the 7th-to-12th-grade music students, will be accordingly assigned to intervention (n = 204) and control (n = 204) groups, based on the inclusion and exclusion criteria. The postural education will be also presented through the web-based Student Education Network (with the acronym, SHAD) at the Tehran Conservatory of Music, Tehran, Iran. The intervention program consists of four sessions, using the Integrated Change (I-Change) model. It will be also implemented by a trained physical education instructor and a health educator. The content of the program includes raising awareness, building motivation, and developing skills. Besides, its components are comprised of specific proper postures viz. standing, sitting, lifting, carrying, and hand position while playing a musical instrument. The primary outcome is the MP that will be assessed by the Nordic Body Map (NBM) questionnaire and a numerical rating scale (NRS), and the secondary outcome is the posture behavior that will be evaluated objectively, using the Rapid Entire Body Assessment (REBA) tool. The data will be also collected at baseline and after a six-month follow-up. CONCLUSION: This RCT is an innovative study as a pioneer to represent the first attempt for web-based postural education as well as an attractive intervention to prevent MP in Iranian music students. TRIAL REGISTRATION: Current Controlled Trials IRCT20180528039885N2 . Prospectively registered on 11 September 2021.

Correction to: Effectiveness of a theory-based back care intervention on spine-related behavior among pupils: a school-based randomised controlled trial (T-Bak study).

An amendment to this paper has been published and can be accessed via the original article.

The Back-care Behavior Assessment Questionnaire (BABAQ) for schoolchildren: development and psychometric evaluation.

BACKGROUND: Back pain is an important public health problem and the leading cause of adult disability worldwide and is rising among schoolchildren populations. Despite numerous studies reporting on back care interventions in pediatric population; there is currently no existing theory-based instrument to assess impact and outcome of these programs. This paper reports on development and psychometric testing of a theory based back-care behavior instrument for use among elementary schoolchildren. METHODS: This was a three-phases study that included the following steps: a) a literature research to review existing instruments that assess healthy spine-related behavior in elementary schoolchildren; b) development of a new instrument namely the Back-care Behavior Assessment Questionnaire (BABAQ) based on the Social Cognitive Theory and existing instruments, and c) conducting a cross sectional study to test psychometric properties of the BABAQ by estimating the content validity ratio (CVR), the content validity index (CVI), performing confirmatory factor analysis (CFA), reliability analysis, and convergent validity as estimated by the Average Variance Extracted (AVE). RESULTS: First, a questionnaire (the BABAQ) was developed. It contained of 49 items tapping into 5 pre-defined constructs (skills, knowledge, self-efficacy, expectation beliefs, and behavior). Then, 610 fifth-grade female schoolchildren were entered into a cross sectional study and they completed the BABAQ. The CVR and the CVI of the questionnaire was found to be ≥0.54 and > 0.7, respectively. The CFA confirmed the five constructs and showed good fit for the data. The intraclass correlation (ICC) and the Cronbach's alpha coefficients for the BABAQ were 0.84 (P < 0.001) and 0.93, respectively. The convergent validity as measured by the AVE also showed satisfactory results. CONCLUSION: The findings suggest that the Back-care Behavior Assessment Questionnaire (BABAQ) is a valid instrument for measuring healthy spine-related behaviors among schoolchildren.

Effectiveness of a theory-based back care intervention on spine-related behavior among pupils: a school-based randomised controlled trial (T-Bak study).

BACKGROUND: Children's health and welfare have a special place in research and policy in many countries. One of the most important concerns is the increasing rate of backache in children due to many of behavioral risk factors. The aim of this study was to evaluate the effectiveness of an educational program on promoting back-related behavior as well as knowledge, skills, beliefs, and self-efficacy among fifth grade girls. METHODS: The theory-based back care (T-Bak) study was a school-based randomised controlled trial (RCT) that assessed the effectiveness of developing a back care training program based on the social cognitive theory (SCT). A total of 104 schoolchildren aged 11 ± 1.0 years were assigned to intervention (n = 52) and control (n = 52) groups. The intervention group received six sessions training on proper lifting and carrying techniques, having proper posture during daily activities, and correct backpack wearing techniques with a 1-week interval while the control group received nothing. Then, the two groups were assessed for knowledge, skills, self-efficacy, beliefs, and behavior at four points in time: baseline, immediate, three and six-months post-intervention. The changes of the outcomes investigated using univariate repeated measures analysis of variance. Partial eta squared measure (ηp2) was used to calculate effect sizes. RESULTS: A positive change was found for the intervention group back-related behavior from baseline to immediate post-intervention and follow-ups (F = 78.865, p < 0.001, ηp2 = 0.22). Overall there were 36.4% improvement for knowledge (ηp2 = 0.21), 53.2% for the skills (ηp2 = 0.25), 19.5% for the self-efficacy (ηp2 = 0.11), and 25.6% for the beliefs (ηp2 = 0.14) scores from baseline to 6 months' follow-up assessments among the intervention group (p < 0.001). The results also showed a significant interaction effect between group and time. CONCLUSION: The T-Bak intervention was effective in improving back-related behavior in pupils. It is now available and could be evaluated further in back-care related studies. TRIAL REGISTRATION: Current Controlled Trials IRCT20180528039885N1, 30th Oct 2018, 'Prospectively registered'. https://www.irct.ir/trial/31534.