Article

Extent of Playing-Related Musculoskeletal Problems in the Irish Traditional Music Community: A Survey

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Abstract

Background: The literature related to playing-related musculoskeletal disorders (PRMDs) primarily includes classical musicians and instrument-specific studies. Previous work by our team identified that PRMDs are an issue for Irish traditional fiddle players; however, the extent of the problem was not known. Objective: To identify the type and extent of PRMDs in the Irish traditional music population, specifically fiddle players. Methods: A questionnaire was developed and administered to faculty and students related to all Irish traditional music courses in all higher education institutions in Ireland. Results: Seven institutions were included. The response rate was 77.5% (n=79 of 102 possible respondents). A fifth of respondents never had a PRMD, 36.7% (n=29) currently had a PRMD, and 34.2% (n=27) had a previous experience of a PRMD. The main symptoms were pain (62%, n=49), stiffness (41.8%, n=33), and tingling (35.4%, n=28). There was a positive association between the development of PRMDs and increased hours of play (p=0.017). Conclusions: PRMDs are a problem for Irish traditional fiddle players, especially during times of intense playing such as festivals.

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... Looking at the application fields of probability theory and mathematical statistics, it can be found that its main value lies in the ability to analyze the gap between things in time [19,20]. In the comparison of the development status of Chinese pop music and traditional music, the application of probability theory and mathematical statistics can intuitively analyze the differences between the two and give data explanations for subsequent predictions and experiments. ...
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In real life and activities, music is everywhere. With the development of the times, Chinese pop music and traditional music have also continued to develop and present new characteristics. However, there is no fixed law in the development of music, and traditional analysis methods cannot capture the current situation of music development in time. Probability theory and mathematical statistics is a subject that studies possibility, which contains many analytical methods. To this end, the article takes the current situation of music teaching development as an example. From the perspective of probability theory and mathematical statistics, the correlation coefficient is introduced and incorporated into the analysis of the development status of popular music and traditional music. In this study, first the general methods of probability theory and mathematical statistics are analyzed, then related experiments from the mathematical level are designed, and a series of investigations are carried out. Finally, starting from the four groups of schools, teachers, parents, and students, the article raises the field of comparison from the campus to the society and focuses on comparing the comprehensive development status of Chinese popular music and traditional music. After a series of experiments and analysis, it can be concluded that the correlation between the students’ interest level and the development status of popular music reaches 7.33, and the correlation with the development status of traditional music reaches 7.61. At the same time, after analysis, it is found that most of the students prefer popular music, but they know little about Chinese traditional music. This fully shows that the comparison of the status quo of Chinese popular music and traditional music based on probability theory and mathematical statistics can intuitively describe the development status of the two, which is very important for promoting the national music and creating a good music environment.
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Performance-related musculoskeletal disorders (PRMDs) are a frequent reality for practicing musicians. Many aspects of the bassoon make these players particularly susceptible to PRMDs, yet to date no study investigating PRMDs has been conducted solely in the bassoon community. The purpose of this study was to identify PRMD symptoms experienced among bassoon players, ascertain the most affected areas, and identify treatments used. Information was gathered using the International Bassoonist Questionnaire, a web-based survey designed by the author. Eighty-six percent of participants (n = 166) reported PRMDs. Pain was the most common PRMD symptom reported (78%). Thirty-one percent of bassoon players reported a medically diagnosed condition, with tendinitis being the most common diagnosis (54%). Bassoonists experienced multiple PRMD symptoms and reported numerous affected locations. PRMDs were most frequently reported in the arms and wrists (54%), and the left side had more PRMDs than the right side. Despite the number of treatment options available, bassoon players primarily used self-administered treatment, with only 31% consulting a medical doctor. Rest was the most common self-applied treatment (60%).
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Playing-related musculoskeletal disorders (PRMDs) as they affect the Irish traditional music community is a topic which, to date, has received scant attention. This paper draws on data generated through a series of four focus group interview studies conducted at the Universities of Ulster and Limerick and involving 22 musicians. Specifically, this paper looks at the wider issue of identity within the Irish traditional music community and at how the complexities inherent in this have, perhaps, affected musicians in recognizing, relating to, and dealing with PRMDs. Whether or not the injuries affecting Irish traditional musicians are similar to or different from what other musicians experience, what this study shows is that the sense of self and discrete identity among the Irish traditional music community is so very strong that merely a "one size fits all" approach to addressing these issues is not likely to yield positive results. Health professionals therefore need to be sensitive to such factors when considering their management of PRMDs and to develop approaches along with the traditional music community that are cognisant of their identity as well as their needs.
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Playing-related musculoskeletal disorders (PRMDs) are common in musicians and interfere with the ability to play an instrument at the accustomed level. There is limited research into injuries affecting folk musicians. To explore the Irish traditional musicians' experience of PRMDs. Focus group interviews were conducted in 2011 and 2012, in two venues in Ireland. Data were recorded and transcribed verbatim. Data collection ended when no new findings emerged from the analysis of interviews. The inclusion criteria were: males or females aged 18 and above, and who taught or played Irish traditional music on any instrument. The data were analysed using the interpretative phenomenological method. All participants (n=22) believed there was a link between playing music and musculoskeletal problems. The main body areas affected were the back, shoulders, arms and hands. The main theme that emerged was: 'PRMDs are an integral part of being a traditional musician', and that the musical experience was generally prioritised over the health of the musician. There were sub-themes of 'fear' and 'stresses that contributed to PRMDs'. PRMDs are an occupational hazard for traditional Irish musicians. There is an awareness of PRMDs, but changes (technique, environment) may threaten identity.
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Instrumentalists are at risk to develop upper-body musculoskeletal problems (MSKPs). Identified risk factors include age, gender, instrument played, joint laxity, and poor technique or posture. In this study, we established the prevalence of MSKPs that affect the ability to play an instrument in the population of a professional-level symphonic orchestra and the relation of these problems to gender, age, and instrument. The members of the Puerto Rico Symphony Orchestra were recruited voluntarily. A questionnaire was used to obtain information on demographics, instrument played, and history of MSKP severe enough to affect their playing ability. Questions also covered alleviating and aggravating factors, upper-body areas involved, type of symptoms, and type of treatment sought. After the questionnaire was completed, all players underwent a neuromusculoskeletal upper-body examination. Of the 75 musicians participating, 81.3% reported having had an MSKP that affected their ability to play. Of these, 83.6% reported their MSKP was directly associated to playing. Females were more commonly affected, 87.5% vs. 79.7% for males. Lower-body strings (cello, bass) players and percussionists (93.3% and 100%, respectively) and younger (22-29 yrs) and older (50-61 yrs) populations (83.3% and 90.9%, respectively) reported more MSKPs. These age groups played more hours per week (28.7 and 32.0 hrs, respectively). In all groups, low back pain was the most common complaint, present in 75.4% of those with MSKPs. Upperbody strings (violin, viola) players also reported neck and left shoulder problems. Contributing factors include hours of exposure and technical expertise. Female gender, age, and instrument played were found to be risk factors for developing MSKPs in this population.
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Computer pointing devices such as the mouse are widely used. Despite this, the relationship between musculoskeletal symptoms and mouse use has not been established. The aim of this cross-sectional study was to determine whether a relationship existed between computer mouse use and musculoskeletal symptoms in a sample of 270 computer mouse users. Factors demonstrating a significant association with symptoms were entered into a step-wise multiple logistic regression, adjusting for age and sex and controlling for potential interdependence between variables. No relationship was found between hours of mouse use per day and reported symptoms. A relationship was found between the variable of arm abduction which is specific to mouse use and symptoms in the neck. Relationships were found between non-mouse-specific risk factors such as stress, screen height and shoulder elevation. The findings of this study support the hypothesis that mouse use may contribute to musculoskeletal injury of the neck and upper extremity. Mouse users are exposed to the same recognised risk factors associated with keyboard use as well as the additional risk factor of arm abduction during mouse use.Relevance to industryComputer keyboard use has been associated with musculoskeletal injuries. Most people now use a pointing device such as the mouse to supplement the computer keyboard. Additional risk factors related to mouse use have the potential to increase prevalence of computer-related injuries.
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Several articles in this issue touch on some of the more athletic components of the performing arts. The article by Twitchett et al. describes fitness aspects of ballet, Gabrilo et al. discuss lung function in synchronized swimmers, and we also learn about how one flutist prepared for a very difficult piece by exercising (and practicing) in the letter by Borkowski. Of course, these are not the first articles in MPPA that look at performers as individuals who call on a variety of physical skills to create an artistic performance; examples of studies looking at both dancers and musicians dating back nearly a decade or more are easy to find. And this column has drawn on certain concepts borrowed from the world of sports medicine on more than one occasion. The connection between performing arts medicine and sports medicine is mentioned early on by Dr. Brandfonbrener in the new edition of Performing Arts Medicine. In this editorial I outline some of the similarities and differences between performing artists and athletes in an attempt to highlight opportunities for improving the health of performing artists in the future.
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This study investigated the effects of fatigue on performance quality induced by a prolonged musical performance. Ten participants prepared 10 min of repertoire for their chosen wind instrument that they played three times consecutively. Prior to the performance and within short breaks between performances, researchers collected heart rate, respiratory rate, blood pressure, blood lactate concentration, rating of perceived exertion (RPE), and rating of anxiety. All performances were audio recorded and later analysed for performance errors. Reliability in assessing performance errors was assessed by typical error of measure (TEM) of 15 repeat performances. Results indicate all markers of physical stress significantly increased by a moderate to large amount (4.6 to 62.2%; d = 0.50 to 1.54) once the performance began, while heart rate, respirations, and RPE continued to rise by a small to large amount (4.9 to 23.5%; d = 0.28 to 0.93) with each performance. Observed changes in performance between performances were well in excess of the TEM of 7.4%. There was a significant small (21%, d = 0.43) decrease in errors after the first performance; after the second performance, there was a significant large increase (70.4%, d = 1.14). The initial increase in physiological stress with corresponding decrease in errors after the first performance likely indicates "warming up," while the continued increase in markers of physical stress with dramatic decrement in performance quality likely indicates fatigue. Musicians may consider the relevance of physical fitness to maintaining performance quality over the duration of a performance.
Article
A number of neurological abnormalities associated with the playing of musical instruments have been described which can cause great difficulty for performers. However, there has been no attempt to consider this in an Irish context, a cultural setting which encompasses an unusual range of playing styles and musical instruments. We performed a retrospective assessment of musicians referred to our service for neurophysiological testing. In this series of 17 musicians, most (59%) had more than one abnormality on testing. We discovered fifteen cases of carpal tunnel syndrome, eleven cases of ulnar neuropathy, and four cases of focal dystonia. Compared to previously published reports, our series contains a greater proportion of amateur musicians, a group not well studied in the literature.
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Stretching exercises are either performed alone or with other exercises as part of the athlete's warm-up. The warm-up is designed to increased muscle/tendon suppleness, stimulate blood flow to the periphery, increase body temperature, and enhance free, coordinated movement. The purpose of this paper is to review the literature regarding stretching, with the aim of defining its role during the warm-up. Implications of stretching on muscle/tendon flexibility, minimizing injury, enhancing athletic performance, and generally preparing the athlete for exercise are discussed. Physiology applied to stretching is also discussed together with different related techniques and practical aspects. A proposed model stretching regime is presented based on the literature reviewed.
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Work-related musculoskeletal disorders cause pain, disability and loss of employment for many workers, including musicians. Although performing arts medicine is a growing field, the health problems of musicians remain under-recognized and under-researched. Therefore, the author undertook a systematic review of published information on the incidence and prevalence of playing-related musculoskeletal disorders (PRMDs) in classical musicians. Seven databases were searched for the period 1980 to 1996. The main textbook and performing arts medicine journals were searched manually, as were reference lists of all relevant papers. The author also contacted individuals familiar with the literature of performing arts medicine. Studies were included for review if they reported PRMD incidence or prevalence in classical musicians. Of the 24 studies identified, 18 cross-sectional surveys and cohort studies were reviewed. The author subjectively assessed the studies using criteria modified from an existing evaluation scale and used 4 criteria for data combination. On the basis of prevalence values from the eligible studies, chi 2 tests for heterogeneity were performed. Only one study estimated PRMD incidence. Ten of the 17 prevalence studies were ineligible for data combination, because of low response rates and other methodological problems. In the 7 eligible studies, PRMD point prevalence ranged from 39% to 87% in adult musicians and from 34% to 62% in secondary school music students. The best estimates of PRMD prevalence were derived from the 3 studies that excluded mild complaints; these studies indicated that PRMD prevalence was 39% and 47% in adults and 17% in secondary school music students respectively. Statistical combination of data across studies within each demographic category was not possible. Available data indicate that the prevalence of PRMD in adult classical musicians is comparable to the prevalence of work-related musculoskeletal disorders reported for other occupational groups. Several recommendations for future research are outlined.
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To examine the reliability and validity of a new outcome measure, the Upper Body Musculoskeletal Assessment (UBMA). Twenty subjects physician-diagnosed as having work-related musculoskeletal disorders (WRMD) and ten healthy subjects were assessed using the UBMA on three separate occasions. All subjects with WRMD attributed their injury to equipment use on their job. The WRMD group had significantly higher UBMA scores on the side of equipment use than on the other side (p <0.01), whereas the healthy group had similar scores on both sides (p> 0.05). UBMA scores for the WRMD group were significantly greater on both sides of the body than scores for the healthy group (p<0.01). Only one test occasion was required to produce excellent reliability coefficients (ICCs>0.88). Although group reliability was excellent, changes of 24% for patients with WRMD and 44% for healthy subjects would be required for confidence that UBMA scores for individual patients on the side of equipment use had changed from baseline. Although testing on one occasion produced reliable UBMA scores, healthy subjects could be distinguished from patients with WRMD, and the side of equipment use could be distinguished from the other side in patients with WRMD, prediction of individual UBMA scores was poor. In its present form, the UBMA is useful for making decisions about groups but not about individual patients. Modifications of the current UBMA are required to reduce measurement error.
Article
RULA (rapid upper limb assessment) is a survey method developed for use in ergonomics investigations of workplaces where work-related upper limb disorders are reported. This tool requires no special equipment in providing a quick assessment of the postures of the neck, trunk and upper limbs along with muscle function and the external loads experienced by the body. A coding system is used to generate an action list which indicates the level of intervention required to reduce the risks of injury due to physical loading on the operator. It is of particular assistance in fulfilling the assessment requirements of both the European Community Directive (90/270/EEC) on the minimum safety and health requirements for work with display screen equipment and the UK Guidelines on the prevention of work-related upper limb disorders.
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Unlabelled: The aim was to determine the incidence of tinnitus, impaired hearing and musculoskeletal disorders among musicians and the relation to the number of practicing hours and/or the instrument type before the onset of symptoms. Method: The study base consisted of students enrolled in the School of Music and Music Education at Göteborg University between the years 1980 and 1995. There were 407 of the 602 original students that answered a questionnaire (response rate of 68%). The questionnaire concerned exposure before and after the enrollment in the Music Academy, as well as onset of symptoms. Results: The highest incidence of symptoms was found for reported tinnitus with a rate of 10.6 per 1000 years of instrumental practice. There was a relationship between exposure to the number of hours of instrumental practice and incidence of impaired hearing. Among the musculoskeletal symptoms the highest incidences per 1000 years of instrumental practice were pain in the neck and in the left shoulder with a rate of 4.4 and 4.6 disorders per 1000 years of instrumental practice, respectively. There was 2.4 times higher incidence for musculoskeletal disorders in the right hand/wrist and a 2.2 times higher incidence in the left elbow/forearm for musicians who practiced for 20 h or more per week before the onset of disorders compared to those who practiced fewer than 20 h per week when controlling for age and gender. Musicians with a violin or a viola as the main instrument had four times the incidence for right elbow/forearm disorder and twice the incidence of neck pain, pain in the right shoulder and the left elbow/forearm compared to those who had piano as the main instrument.
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Musculoskeletal injuries in musicians range from common repetitive stress injuries to unusual, sometimes career‐ending disorders. Here's how to help the patient return to making music.
It's not like I can just stop': the lived experience of pain in Irish traditional fiddlers
  • B Dunn
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Dunn B., Pettigrew J., 'It's not like I can just stop': the lived experience of pain in Irish traditional fiddlers [Summary of MA thesis], Spéis Journal of the International Council for Traditional Music, Ireland 2011:(3);12. Available at www.ictm.ie: accessed on Nov 20, 2012
Development and validation of a Questionnaire on
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Maximising Respondent Engagement, The use of rich media, Congress 2007 -Excellence Celebrating 60 years
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Survey of music teachers: Perceptions about music-related injuries
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