Medical problems of performing artists最新文献

Introduction: Playing wind instruments may promote neck, arm, or shoulder pain, as well as temporomandibular pain. The cervical and orofacial regions are associated, due to their proximity and the influence they both have on body posture. In wind musicians, the mouth is responsible for producing the sound. Any alteration in the characteristics of the orofacial system can affect the embouchure when playing a wind instrument.

Aim: To observe demographic and physical characteristics in the cervicomandibular region in a sample of university wind students.

Methods: An observational descriptive cross-sectional study was carried out with wind students in the two higher conservatories of the region of Galicia, Spain. We studied the posture of the head and neck, the range of cervical movement and mouth opening, the presence of trigger points in the upper trapezius and masseter, as well as their algometry and electromyographic value.

Results: 30 woodwind and 19 brass students were evaluated, 51% of whom were female. A tendency towards a forward position of the head and protraction of the shoulders was observed, maintaining horizontality in the frontal plane in both the head and shoulders. Cervical movements were diminished, while the mouth opening was greater than standard. In this sample, a relatively high prevalence of trigger points in the upper trapezius was observed, while the masseters showed greater sensitivity to pain and greater activation during trapezius contraction.

Conclusions: Musicians in this study presented an anteriorized position of the head and shoulders in the sagittal plane, with a decrease in cervical range of motion particularly in the transverse plane.

Objective: Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered care (PCC). The purpose of this study was to explore healthcare providers (HCPs) who MB artists have access to and the artists' perceptions of PCC.

Methods: We used a cross-sectional, web-based survey to explore which providers MB artists had access to. In total, 751 MB artists (age 20±8 yrs) completed the survey. Respondents who reported no access or were unsure were prompted to complete an open-ended response describing what they would do if an injury or illness occurred. Participants who had access to an athletic trainer (AT) completed the Global Perceptions of Athletic Trainer Patient-Centered Care Tool (GPATPCC; a=0.90; 15 items [1 reverse-scored]; 4-point Likert scale [1=strongly disagree, 4=strongly agree, 0=unsure]; score=average). Participants with access to other HCPs completed the Consultation and Relational Empathy tool (CARE; a=0.97; 10 items; 5-point Likert scale [1=poor, 5=excellent]; score=sum). Scores for the tools were standardized (z-score), and a Mann-Whitney U test determined PCC differences between those with access to ATs and those with access to other HCPs.

Results: Overall, 42.5% of MB artists had access to a HCP. The MB artists with access to ATs expressed satisfaction (mean 3.05±0.67) on the GPATPCC tool. Participants who completed the CARE tool expressed they were satisfied (mean 39.59±8.78). However, 57.5% of MB artists reported having no access or being unsure, who commonly relied upon communicated with MB leadership (33.8%) when injured. No significant differences were identified between ATs and other HCP ratings of PCC (U=4615, z=-0.36 p=0.719).

Conclusion: Over half of MB artists reported a lack of access or a lack of familiarity with what HCPs are available. Those with access to HCPs were satisfied with the care they received. Continued efforts should be focused on improving MB artists' access to HCPs.

Purpose: The health concerns of drag queens remain understudied. This paper examines the physical health and healthcare access of drag queens and reflects on ways to holistically promote their well-being.

Methods: Professional drag queens in the United States underwent the Dance/USA Task Force on Dancer Health Annual Post-Hire Health Screen, which assesses medical history, musculoskeletal metrics, and cardiovascular fitness. To discuss healthcare needs, this paper draws from the authors' expertise in physiatry, dermatology, gender studies, mental health, and medical anthropology.

Results: Seven performers chose to participate in the study, with 6 participants participating in both the history and physical examination portions. While 3 (50%) had excellent cardiovascular fitness, 2 had below aver¬age or very poor results. None of the performers met the Beighton criteria for hypermobility. Bilateral hip flexion tightness was seen in 5 (83%) of performers, while 100% had tightness in bilateral hip internal rotation. The weakest muscle groups included lower abdominals and hip extensors bilaterally, left weaker than right. Four out of 7 reported a current or prior musculoskeletal injury. Three of 7 have health insurance, 4 felt they would benefit from psychology counseling, and 4 reported binge drinking at least three times in the past year. Four out of 7 were overdue (>24 months) for visiting their primary care physician.

Conclusions: Drag queens may be at risk for musculoskeletal injuries and strength asymmetries, dermatologic issues, and psychosocial harms. An urgent need exists for a comprehensive understanding of drag queen health to promote the well-being of understudied LGBTQIA+ populations.

Background: In ballet, a single movement can be developed into multiple variations by changing factors such as direction or magnitude. Similarly, the Dance-Specific Graded Rehabilitation Program (DSGRP) is built on the progression of three factors: (1) movement (relevés, heel raises; explosive relevés [EXrelevé], heel raises with the intention to jump but not actually jumping; and sautés, small jumps), (2) leg support (double-leg and single-leg), and (3) barre support (two hands, one hand, and no hands). However, these factors are yet to be fully analyzed biomechanically.

Objective: This study aimed to investigate the influence of movement, leg support, and barre support on mechanical load and impact characteristics of a dance-specific heel raise to jump progression.

Methods: Eighteen healthy dancers performed the stages of the progression in a semi-randomized order. Mechanical load was quantified by peak vertical ground reaction force (vGRF) and illustrated by weight-bearing profiles. Impact characteristics relating to force-time dynamics were quantified by the rate of force attenuation (RFA) during takeoff and the rate of force development (RFD) during landing. Linear mixed models assessed the significance and incremental contributions of each factor for peak vGRF, RFA, and RFD, while weight-bearing profiles were analyzed descriptively.

Results: Results revealed increasing load and impact characteristics with movement type and leg support, though negligible influence of barre support. Incre¬mental increases were quantified for the first time in a dance-specific context.

Conclusion: Findings support the inclusion of EXrelevés as an intermediary movement between relevés and sautés. Barre support did not influence vertical kinetics, suggesting the need to explore its potential role in transverse plane stabilization. The reported increments suggest the following progression for optimal loading: double-leg relevés, double-leg EXrelevé, single-leg relevé, single-leg EXrelevé, double-leg sauté, and single-leg sauté. Incremental effects of observed factors inform optimal sequencing for training and rehabilitation progressions in dance.

Objective: To investigate via video review the intra-rater and inter-rater reliability of three pointe-readiness tests: the topple test, airplane test, and sauté test.

Methods: Ten ballet-trained pre-professional and professional dancers were videotaped performing the topple test, airplane test, and sauté test from the front and side views. The videos, written instructions, and rater score sheets were provided to the raters via individually linked electronic access over four sessions, with a washout period of 2 weeks between sessions. The videos were reviewed at slow speed and at real-time speed, with two sessions at each speed, assigned in random order. Raters received a training session prior to the start of their first session. Intraclass correlation coefficients were calculated for intra-rater and inter-rater reliability for all raters for each test and for the total score of the three tests.

Results: Twenty-two raters assessed the 10 dancers. Intra-rater reliability was good between session 1 and session 2 for the real-time speed (ICC range = 0.83-0.88), good for the slow speed (ICC = 0.83-0.85), good to excellent for the average of real-time vs slow speed (ICC = 0.88-0.94), and excellent for session 1 vs session 2 (ICC = 0.93-0.96). Inter-rater reliability was good to excellent for the first real-time speed (ICC = 0.88-0.94), for the first slow speed (ICC = 0.85-0.96), and for the first session regardless of speed (ICC = 0.88-0.96).

Conclusion: The criteria for the pointe-readiness tests are acceptable. Raters with and without a dance background were able to conduct the movement assessments with good to excellent intra-rater and inter-rater reliability in real-time review.

Level of evidence: III.

Marching performers spend a significant amount of time on their feet practicing precise movements. Presumably, individuals choose footwear to practice in that is comfortable and suits their individual needs. However, when it comes to competition, there are a limited number of footwear options available, and they are not specialized to the individual. The purpose of this letter is to advocate for more research and the continued evolution of competitive footwear design for marching arts.

For dancers who undergo anterior cruciate ligament (ACL) reconstruction, it is crucial to establish criteria for safely returning to dance without risking reinjury. Given the specific demands of dance, this case study aims to quantify the ability to coordinate knee movements with sounds and to analyze kinematics during the rehabilitation period. A female recreational street dancer participated in this study while undergoing rehabilitation after ACL reconstruction surgery. She performed knee flexion and extension movements to the beat of a metronome while standing, with both the movements and timing of the metronome beats recorded. Findings indicate that the muscle strength of her injured leg approached that of the uninjured side, suggesting steady rehabilitation progress. Although the range of knee joint angles did not differ between the injured and uninjured legs during the task, the injured knee exhibited less flexion and more extension. The participant was unaware of this increased extension in the injured leg. Additionally, the phase relationship between her rhythmic knee movements and the metronome beat changed unintentionally over the course of rehabilitation. Quantifying these unintentional changes in kinematics and their relationship to auditory beats can help establish appropriate criteria for a safe return to dance.

A comparative approach was used to determine, relative to a broader college student population, 1) the differences in music majors' exercise behaviors and 2) motivation to engage in regular exercise. Participants consisted of 115 non-music and 99 music college majors. Music majors reported engaging in significantly less global (work and leisure) physical activity, leisure physical activity, and moderate intensity exercise. There were no significant differences between music and non-music majors' weekly exercise frequency and engagement in light- and strenuous-intensity exercise. Regarding motivation, music majors endorsed stronger amotivation towards exercise, while non-music majors made stronger endorsements of three more self-determined motivations: identified regulation, integrated regulation, and intrinsic motivation to experience pleasurable sensations. No differences were observed for intrinsic motivation to learn or to accomplish. All participants failed to exceed the threshold for recommended physical activity, but music majors were even less engaged in moderate exertion exercise and overall leisure activities. Future studies are needed to assess how best to increase music majors' exercise engagement.

Background: In dance, injuries are significant factors that can bring an active dance career to an end. A patient-reported outcomes questionnaire with established validity and reliability is useful for determining and evaluating the functional status of dancers before or after injuries. However, no valid and reliable survey is available in Turkish to assess dancers' functionality levels. The objective of this study was to translate, culturally adapt, and validate the characteristics of the Turkish version of the Dance Functional Outcome Survey (DFOS-TR) in adult dancers.

Methods: The DFOS-TR underwent forward translation, reconciliation, backward translation, and thorough review by an expert committee to ensure optimal alignment with the original English DFOS. A sample of 113 dancers (55 injured and 58 healthy) voluntarily participated in the research. Construct validity was assessed by comparing DFOS-TR to SF-36 using Pearson correlations; exploratory factor analysis and internal consistency were conducted; and sensitivity was evaluated through the generation of receiver operating characteristic curves and calculation of the area under the curve (AUC). Test-retest reliability was assessed by examining 26 dancers over a 15-day period, employing intraclass correlation (ICC). Various methods were employed, including ICC, standard error of measurement (SEM), minimal detectable change at the 95% confidence interval (MDC95), and standardized response mean (SRM). DFOS-TR scores were compared using paired samples t-test and two-way repeated measures ANOVA (p<0.05). The scores of injured dancers were examined to identify any floor or ceiling effects.

Results: The DFOS-TR demonstrated very high test-retest reliability (ICC=0.84). Single-factor loading in exploratory factor analysis confirmed the scale's unidimensionality and high internal consistency (a=0.79), A positive moderate correlation was found between SF-36 physical component and DFOS-TR total score (r=0.44; p=0.046) and activities of daily living (ADL) subscore (r=0.58; p=0.006). Cut-off value of 85.5 for DFOS-TR total score yielded in 87.3% sensitivity and 36.2% specificity. The scale did not exhibit ceiling or floor effects among the injured dancers, indicating robust measurement properties.

Conclusion: The DFOS-TR can be used as a reliable, internally consistent, and effective measurement tool for Turkish-speaking dancers in health as well as during and after lumbar or lower extremity injuries.

There are few opportunities in life to participate in a truly pioneering venture. Certainly the appearance of a new medical journal in itself is not startling news. However, a new journal that pertains to a new medical specialty with unique subject matter provides a potentially innovative and exciting experience. The purpose of Medical Problems of Performing Artists is to promote interest in the medical problems of performing artists, to help in the search for and dissemination of information, and by these means to promote the well-being of this vulnerable and valuable segment of our society. [This Editorial is reprinted from MPPA, March 1986, vol. 1, issue 1, page 1].