Medical problems of performing artists最新文献

Aims: Over 8,650 Highland dancers registered to compete in Royal Scottish Official Board of Highland Dancing events worldwide in 2019. While the burden of dance-related injuries is high among dancers, there are few studies examining Highland dance. The purpose of this study was to describe the prevalence of self-reported 1-year injury history and safe dance practices among female Highland dancers.

Methods: Sixty-five female Canadian Highland dancers (median age 18; range 14-47) completed an anonymous online survey at the beginning of the 2019 championship season. Demographics (i.e., age, body mass index), exposure (e.g., months/year dancing), safe dance practices (e.g., environmental, physical, psychological), and 1-year injury history (i.e., yes/no) were self-reported. Three definitions of dance-related injury were used: 1) time-loss (missed ≥1 class, practice, performance, and/or competition); 2) medical attention (requiring professional medical care); and 3) any physical complaint that affected full participation.

Results: Most participants were training at the elite standard/premier level (86%, 95%CI 75-93) and for ≥8 months/year (83%, 95%CI 75-93). The proportion of dancers reporting at least one physical complaint in the previous 1 year was 71% (95%CI 58-81). Sixty percent (95%CI 47-71) of dancers reported ≥1 medical attention and/or time-loss injury. All participants reported warming up regularly, with 59% (95%CI 46-70) participating in regular cool-downs.

Conclusion: The prevalence of 1-year injury history among female Highland dancers is high. Education on the benefits of safe dance practice for Highland dancers may be useful. Prospective cohort studies are needed to understand the dynamic nature of dance injuries across a full competitive season.

Objective: The study aimed to translate, culturally adapt, and test the psychometric properties of the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM) in an Italian population of professional and amateur musicians.

Methods: The translation and cultural adaptation process followed international guidelines, while the reliability and validity of the questionnaire were assessed against the COSMIN checklist. The internal consistency was calculated using Cronbach's alpha (a) coefficient. Construct validity was analyzed using exploratory factor analysis (EFA) with principal axis factoring (PAF) extraction. The sample adequacy and data suitability were assessed through the Kaiser-Meyer-Olkin (KMO) and Bartlett's sphericity tests, respectively. Concurrent validity was analyzed by assessing Pearson's correlation coefficient with the Italian version of the Musculoskeletal Health Questionnaire (MSK-HQ-I). Finally, the cross-cultural validity was investigated by analyzing score differences between amateur and professional musicians, and differences based on musical practice habits.

Results: The tool was administered to 311 subjects recruited from across Italy. The MPIIQM-IT was found to have high levels of internal consistency for the entire tool and each of the two subscales (Cronbach's a = 0.875, 0.877, and 0.845, respectively). The recruited sample was found to be adequate (KMO = 0.810) and the data suitable (C2 = 341.040, p < 0.001) for factor analysis, which produced 9 items contained in two main factors. Pearson's correlation coefficients showed a positive, statistically significant correlation between the MSK-HQ-I and the two subscales of the MPIIQM-IT with p < 0.01. Analysis of Student's t-test for independent samples and the ANOVA test for continuous variables showed statistically significant differences between male and female, professional and non-professional musicians, and conservatory and non-conservatory students.

Conclusions: The MPIIQM-IT is a valid and reliable tool, useful for investigating the presence of pain and playing-related musculoskeletal disorders (PRMDs) in both professional and non-professional musicians.

Background: High-string players, such as violinists and violists, are prone to neck problems. One factor can be their body posture, with often a rotated and flexed neck position with the jaw placed on a flat chinrest. The Kréddle chinrest (EC) was specifically designed to promote a more neutral neck position and prevent musculoskeletal problems among high-string players. This case report aims to evaluate the preliminary feasibility and acceptability of using the EC, with a low shoulder rest, in a pain-free professional high-string player. A secondary aim was to register newly developed pain and fatigue.

Methods: A 32-year-old professional viola player was instructed to use the EC for most of her playing time during a 6-week trial period. Outcome measures such as compliance (% of use out of total playing time over the last 7 days), performance, comfort and acceptability were assessed at baseline and at the end of each trial week. The Rapid Upper Limb Assessment (RULA) tool was used to evaluate the body posture at baseline when using the EC versus her own chinrest and shoulder rest.

Results: The initial trial period was interrupted after 2 days due to pain. A second 6-week period was completed. While compliance was high and there was positive feedback on how the EC affected her performance and comfort while holding the instrument, the case report identified a challenge with the complex instruction material, which made it difficult to install and adjust the product. The viola player was positive towards using EC in the end despite pain and fatigue during the trial period.

Conclusion: This case report examined a professional viola player's 6-week experience with an EC. While positive outcomes were observed in posture, performance, and product acceptance, issues with complex instructions were noted. This study marks the first exploration of individual challenges with EC use.

Background: In wind instrument performance, there is a constant contact between the player and the instrument, during which microorganisms in the mouth flora of the player are transferred into the instrument. The inner surface of the brass instruments provides the perfect environment for microorganisms to grow. As a result, players repeatedly interact with these micro-organisms during playing. In previous studies, different kinds of microorganisms were detected in brass instruments, some of which can carry serious health hazards.

Purpose: Revealing the common bacterial populations of brasswind instruments will be helpful in raising awareness among musicians and establishing their habits of cleaning/disinfecting their instruments.

Methods: In this study, samples from 4 different areas of 14 brass instruments were collected and analyzed using culture-dependent and -independent (16 S rRNA amplicon sequencing) approaches. The bacterial loads in different parts of the instruments were compared.

Results: The amount and variety of bacteria detected in the sampled instruments were unexpectedly large. While some of the found bacteria are harmless, others, such as Chryseobacterium and Elizabethkingia, may occasionally cause serious infections, especially in people with suppressed immune systems. Likewise, the Mycobacterium group includes a type that causes tuberculosis, and the Streptococcus group also shows pathogenic characteristics. The mouthpiece and leadpipe of the instruments had a much larger microbial load compared to the tuning and valve slides.

Conclusion: According to the findings, brass instruments may harbor a wide variety of bacteria, some of which are potentially hazardous for the musicians' health, especially if their immune systems are compromised. These risks can be minimized by regularly cleaning and disinfecting the instrument, especially the mouthpiece and leadpipe, which are the areas harboring most of the microorganisms.

Background: Repetitive piano movements have been associated with playing-related musculoskeletal disorders (PRMDs) such as forearm myalgia and symptoms of lateral epicondylopathy. Despite the high prevalence of PRMDs among pianists, there is poor understanding regarding the underlying physiological mechanisms. Intramuscular oxygenation may play a role in the development of PRMDs. Therefore, this observational study aimed to explore the effect variability of playing piano repertoire on the oxygenation of the extensor carpi radialis brevis (ECRB).

Methods: Surface electromyography (EMG) activity and intramuscular oxygenation data (using near-infrared spectroscopy, NIRS) of the left and right ECRB were recorded in 13 conservatory piano students (8 female, 5 male, mean age 23.54 ± 3.24 years) while playing piano repertoire (virtuoso piece or études) for 20 minutes. From the oxygenation data, relative changes (in the percentage of the baseline measurements at rest) were calculated.

Results: For all participants, the oxygenated hemoglobin of the left ECRB over the piano play presented an averaged decline to the baseline resting value, with a sample mean for left ECRB of -7.48% and -11.88% for the right ECRB, ranging from -15.53% to -2.00% and -19.12% to -3.93%, respectively. The deoxygenated hemoglobin ranged in the left ECRB from -5.39% to 39.14% and from -9.37% to 54.01% in the right ECRB. The change in total hemoglobin ranged from -5.35% to 16.80% for the left ECRB and -12.10% to 10.37% for the right ECRB. EMG activity (in % maximal voluntary contraction) presented a mean of 16.85% (range 11.86 to 24.43) for the left ECRB and 23.65% (range 14.46 to 37.91) for the right ECRB. This pilot study presented a Pearson's r between the averaged oxygenated hemoglobin and EMG of -0.60 for the right ECRB and -0.48 for the left ECRB.

Conclusion: Piano performance induced an average decline in oxygenated hemoglobin in the left and right ECRB, which differed largely between the specific pieces played. The EMG activity can partially explain these differences. Further research is needed to explore the impact of a 'dynamic index' reflecting the piece's dynamic characteristics and the individual oxygenation characteristics.

The Department of Defense is the largest employer of full-time musicians. In the U.S. military, many musicians experience unique occupational exposures such as extended periods of standing, sitting, and marching for rehearsals and performances, static and non-neutral postures, and a variety of repetitive motions while playing instruments. These exposures are in addition to physical training and fitness standards required of U.S. Army soldiers.

Methods: An electronic survey was administered to active-duty U.S. Army Band musicians. The survey collected demographics, personal characteristics, Army Physical Fitness Test performance, occupational demands, health behaviors, and injuries from October 2017 to December 2018. Survey responses were combined with medical and physical fitness performance records. Descriptive statistics were reported and factors associated with injuries were investigated.

Results: There were 465 Army Band members in this population, with approximately half (49%) completing the survey. Most survey respondents (81%) reported an injury in the past year, which they predominantly attributed to overuse (54%). Leading reported activities resulting in injury included running for physical training (21%), repetitive movements while playing an instrument (11%), and standing while playing (11%). A majority of survey respondents (60%) also had a medical encounter for an injury. Factors significantly associated with injury among men were lower aerobic fitness and higher body fat percentage; additional unadjusted factors associated with injury among all Army Band soldiers included female sex, older age, and longer periods of marching and standing while playing.

Conclusions: Injury prevention initiatives for Army Band musicians should focus on the reduction of overuse and repetitive motion injuries. Suggested prevention strategies include balanced physical training, ergonomic adjustments, rehearsal breaks, and leadership support for injury prevention efforts.

Objective: It is expected that in classical ballet dancers would be able to execute all the techniques symmetrically from the right as well as from the left side of the body. This study aimed to evaluate the symmetry of kinematic parameters of hip joints, knee joints, and foot progression angle of the left and right lower extremities (LE) in five classical ballet positions, as well as the symmetry of active and passive turnout and range of passive hip external rotation.

Methods: The experimental testing involved 12 female pre-professional ballet dancers. Three measurements of range of motion, made using a standard goniometer, were carried out to characterize the study group. Kinematic data of left and right LE in the five classical ballet positions were recorded using a motion capture system.

Results: The comparisons revealed significantly lower (p < 0.01) hip external rotation values by 9.8% (1st position), 5.4% (2nd position), and 8.5-11.8% (3rd position) for the right LE than the left LE. Moreover for 3rd, 4th and 5th positions, there was significantly higher (p < 0.05) hip external rotation values by 7.0%-27.2% in the back LE than the front LE. In 4th position there was asymmetry in foot progression angle with significantly lower values (p < 0.01) by 5.3% in the front LE (left) than the back LE (right). In case of goniometric measurements, the results showed significantly higher (p < 0.05) passive hip external rotation values by 10.8% for the right LE than the left LE.

Conclusion: The perfect ballet symmetry pursued by dancers is not in fact so ideal. The most astonishing result was the existence of statistically significant differences in hip external rotation in the case of the 1st and 2nd positions.

Objective: Low back pain (LBP) is relatively common among the musician population. Few studies have looked at the usefulness of a core stability exercise program in musicians suffering from LBP. The aim of this study was to investigate the effectiveness of a core stability exercise program on pain and improvement of function in musicians with LBP.

Methods: A total of 41 university-level instrumental musicians with nonspecific LBP who played piano, violin, or cello were randomly allocated to one of two groups in a randomized controlled trial. One person from the control group was lost to follow-up. Thus, 40 participants (23 females and 17 males) completed the study. The intervention group received education and a 12-week core stability exercise program. The control group only received an educational brochure. A visual analogue scale (VAS) and the Oswestry Disability Index (ODI) were used to determine the severity of pain and functional status, respectively. Data were collected by an independent, blinded evaluator at baseline and at 12 and 24 weeks after baseline.

Results: The intervention group showed a significant improvement in pain severity on the VAS and functional status on the ODI during all times of follow up, whereas the scores of pain and function worsened in the control group at 24 weeks. Between-group analysis showed significant difference in pain intensity at both weeks 12 and 24 of follow-up. However, for functional status, the difference was only significant after 12 weeks.

Conclusions: A structured core stability exercise program supplemented with an educational brochure was effective to manage LBP in musicians.

Background: Foot and ankle injuries are the most prevalent injuries in dance. The single leg heel-rise (SLHR) test is a simple tool to assess muscular endurance of the plantar flexors of the foot and is an increasingly popular manual muscle test in various areas of dance. Although the SLHR test has shown high reliability and validity in the medical field, no uniform description of this test exists in dance.

Objective: This systematic review aimed to identify parameters, outcome measures, purposes, and existing normative values of the SLHR test in the dance field.

Methods: Following the PRISMA guidelines, the electronic databases Scopus, PubMed, SPORTDiscus, EMBASE, CINAHL, and Cochrane were searched using a predefined search strategy up to June 2022. Studies were included if they reported screening, testing, or evaluation of either muscular endurance or strength of the calf muscle-tendon unit (MUT) in dancers using the SLHR test. The methodological quality of the studies was evaluated using a modified version of the Downs and Black Quality Index.

Results: A total of 180 studies were identified. Twelve studies comprising a total of 427 dancers met the inclusion criteria. Key testing parameters of the SLHR test varied widely or were not reported. The average quality rating of the reviewed studies was 12.9 (range 8 to 17) out of a possible 20 points.

Discussion: Although commonly used in test batteries, there are no standardized parameters of the SLHR test used in the dance field. Therefore, no generally applicable normative values could be established.

Conclusion: Key parameters such as the precise execution of the heel rises should be reported in testing protocols. For the SLHR test to be a useful tool in dance, further research on the influence of dance style, age, and injuries to the calf MTU on this test is needed.

Objective: The purpose of this study was to compare the impact of playing brass and wind instruments in seated versus standing positions on cardiovascular parameters in musicians. We hypothesized that heart rate (HR) and blood pressure (BP) would be higher while playing compared to resting, and would be higher in standing compared to seated positions.

Methods: Ten musicians completed two study visits. In both, resting, supine HR and BP were recorded, followed by 30 minutes of playing. In one visit, participants played seated, and in the other, played while standing. The order of these positions was randomized. BP and HR were recorded every 5 minutes during playing.

Results: Systolic BP was not affected by playing (p = 0.09, eta2 = 0.046) or position (p = 0.35, eta2 = 0.024). Diastolic BP increased while playing (p < 0.0001, eta2 = 0.32), but did not differ between positions (p = 0.21, eta2 = 0.03). Mean arterial pressure (MAP) increased while playing (p < 0.0001, eta2 = 0.25), but did not differ between positions (p = 0.68, eta2 = 0.03). There was a significant time X position interaction for HR (p = 0.0001, eta2 = 0.037). Simple main effects analysis revealed that HR was higher while playing in the standing compared to the seated position at all but one time point.

Conclusion: Playing brass and wind instruments increases diastolic BP and MAP, regardless of playing position, while playing in the standing position induces a higher HR compared to the seated position.