Medical problems of performing artists最新文献

Objective: There are no universally accepted requirements or uniform protocols to determine when dancers can safely commence dancing en pointe (shod relevé). The purpose of this study was to examine dancer-specific biomechanics of adolescent pointe dancers and explore factors that may help determine pointe readiness.

Methods: Dancers (n=26; median age 14 yrs [IQR=13-16]) were stratified into two groups based on the ability to stand on the pointe shoe box as per a plumb line (Group 1: on the box; Group 2: not on the box) during parallel, shod relevé. Measurements included unshod weight-bearing range of motion (ROM) of ankle plantarflexion (PF) and first metatarsophalangeal (MTP) extension and shod posture assessment during first position elevé (rising into relevé with turned out, straight legs). Qualisys 3D motion capture and AMTITM force plates recorded dancers performing 10-15 repetitions of first position elevé. Comparison of three kinematic and three kinetic variables aimed to describe group differences during unshod and shod conditions. Wilcoxon signed-rank test assumed no difference between groups with a Bonferroni correction (p<0.0083).

Results: During unshod parallel relevé, ROM was different between groups for first MTP extension (deg; MedGroup1: 90°, IQR 80°-90°; MedGroup 2: 70°, IQR: 70°-80°, p<0.0001) but no statistical difference in ankle PF (deg; p=0.0098). There were no differences in C7 displacement (m; p=0.5055), ankle PF moment (p=0.1484), or hip mediolateral and anteroposterior moments (p=0.8785 and 0.8785, respectively) during shod first position relevé, indicating that both groups tend to engage the same dominant muscle groups (trunk extensors, ankle dorsiflexors, hip flexors, and hip abductors) during elevé.

Conclusion: Dancers in Group 1 demonstrated greater first MTP extension during unshod relevé compared to dancers in Group 2. Weight-bearing ROM could be a valuable tool in predicting pointe readiness of adolescent ballet dancers.

Objective: In professional dance, the injury rate is extremely high and dancers have a great chance to experience at least one injury during their careers. Since the #metoo campaign, many abuse cases showed up in the dance industry, resulting in media coverage. Results indicate that dancers had a significantly higher distribution of post-traumatic stress disorder (PTSD) compared to the broad population. In this study, we investigate pathological dissociation, quantify chronic musculoskeletal conditions and evaluate abusive experiences.

Methods: Questionnaire-based dataset filled out online by Hungarian professional dancers (n = 168). The statistical analysis contains descriptive results, risk assessment, Kaplan Meier curve, and hazard ratios.

Result: Dancers scored in the pathological dissociation values, reported several cases of emotional and physical abuse, and were represented by elevated chronic musculoskeletal conditions. We found a statistically significant relationship between abusive experiences and musculoskeletal conditions, so as with dissociation.

Conclusion: We conclude that emotional abuse might be one of the factors in a multifactorial model that plays a role in the pathomechanism of chronic pain, inflammation, and tendinopathy. It is important to raise awareness about the importance of emotional factors of pedagogy and the working atmosphere among professional dancers since it might have a role in higher injury rates.

Aims: In classical ballet, dancers may wear flat shoes and pointe shoes. To consider the kinematic changes between flat shoes and pointe shoes to prevent injuries, it is essential to focus on the fundamental ballet movement of standing on pointe. This study aimed to clarify the differences in the center of pressure (COP) displacement and lower limb muscle activity during the descending phase of a relevé when wearing pointe shoes versus flat shoes.

Methods: Ten amateur ballet dancers volunteered for this study and performed a reléve wearing flat shoes and pointe shoes. We measured the COP displacement by using a footplate and electromyographies of the tibialis anterior, soleus, lateral gastrocnemius, and peroneus longus muscles during the relevé descending phase. These data were compared using a paired t-test or Wilcoxon signed-rank sum test.

Results: The COP significantly shifted to the lateral side when dancers were wearing pointe shoes compared to wearing flat shoes (p<0.05). The muscle activity of the tibialis anterior and soleus muscles was significantly higher by 5.7% and 5.3%, respectively, when ballet dancers were wearing pointe shoes compared to flat shoes (p<0.05). However, there were no differences in both lateral gastrocnemius and peroneus longus.

Conclusion: Greater muscle activities in the tibialis anterior and soleus muscles when wearing pointe shoes than when wearing flat shoes were associated with a larger lateral displacement of the COP. To control the COP displacement during the descending phase of a relevé, the muscle activity of the peroneus longus, which is antagonist of tibialis anterior muscle, and soleus muscles should be increased.

Purpose: Musicians are labelled 'fine motor athletes' due to the significant demands of practice and performance. In response, sports medical concepts and expertise have been adapted and mobilized to address musicians' health considerations. However, understanding distinct differences between the sports and performing arts medical contexts is critical. Mismanagement of fatigue and acute fatigability are identified as key risk factors for deleterious symptoms and injuries in musicians. Acute fatigability in athletes and musicians have been assumed to occur similarly, although this has yet to be empirically demonstrated. This study aimed to evaluate acute muscular performance fatigability during piano performance of varied intensities.

Methods: Fourteen university pianists attended a single experimental session and performed three pieces of randomly ordered repertoire for 10 minutes each. Repertoire were self-selected to be physically easy (rating of perceived exertion [RPE] 9/20), somewhat hard (RPE 13/20), or hard (RPE 17/20). At baseline, after each repertoire performance, and following a concluding 10-minute silent sitting period, participants completed maximum voluntary contraction (MVC) grip and shoulder strength tests. Surface electromyographic (EMG) data were obtained from bilateral upper trapezius and forearm flexor and extensor muscles. Data were analyzed using uni- and multivariate repeated measures analyses of variance (ANOVAs).

Results: No evidence of muscular performance fatigability was found in study pianists at any intensity. Mean EMG amplitude and average median EMG frequency did not significantly vary during any repertoire performances or MVC tests (F≤1.72; p>0.09). Additionally, no changes in force or EMG parameters were found during any MVC tests (F≤1.19; p>0.31).

Conclusions: The absence of muscular performance fatigability during even the most intense piano performances suggests substantially differing mechanisms of fatigability and perceived exertion in pianists versus those commonly seen in sport athletes. Further research is needed to understand the mechanisms of acute fatigability in musicians and develop musician-specific management strategies.

Aims: Pain catastrophizing is characterized by a set of negative emotional and cognitive processes in response to pain, with a tendency to focus inordinately on the painful sensation, exaggerate the damage, and perceive feelings of helplessness. It is a psychological factor that can be treated to help people more effectively cope with pain. In this cross-sectional study, we explored the relationship between self-reported injuries, resilient behavior, and pain catastrophizing in dance students, with more than 3 years of study in public conservatories or private academies.

Methods: A sample of 147 dance students participated, 75.5% of whom were female with a mean age of 28.34 yrs (SD 11.42). Pain catastrophizing was assessed using the Pain Catastrophizing Scale, and resilience was assessed using the Resilience Scale.

Results: Students in the high resilience category reported lower scores on rumination and magnification, with a marginal difference in total catastrophizing and no difference in helplessness. Those who reported having suffered injuries during the last 3 years showed higher scores in total catastrophizing, rumination, and magnification, but not in helplessness. Those who reported mild injuries showed differences in pain catastrophizing, rumination, and magnification, while those with moderate and severe/very severe injuries only showed differences in magnification.

Conclusion: The individual nature of pain perception and coping strategies suggests that pain catastrophizing may be considered before dance performance and in those dancers who do not recover as expected after injury.

Background: Disordered eating (DE) behaviors are relatively common among high-level dancers, especially in classical ballet. At the same time, interventions aimed at reducing DE behaviors in this population are scarce.

Methods: An 8-week exploratory preventive intervention for DE behaviors was carried out in a high-level ballet school for 40 teenagers aged 12-15 years (77.5% female). Both risk factors (perfectionism) and potentially protective factors (self-esteem, self-compassion) for the development of DE behaviors were considered. The intervention was created specifically for this study and consisted of five cognitive behavior therapy (CBT) workshops and four nutrition workshops. Additional components included newsletters for pupils and educational sessions and social media interactions with staff and parents. The intervention comprised two phases (control and intervention periods), with students acting as their own controls. Standardized questionnaires were completed before and after both phases.

Results: Questionnaire results did not indicate any changes in reported perfectionism, self-esteem, or self-compassion, nor were symptoms of DE affected during either the control or intervention periods.

Conclusions: The intervention did not yield any discernible impact. However, it was affected by the onset of the COVID-19 pandemic, which limits our ability to draw conclusions about intervention effectiveness. Evaluations with pupils offer several considerations for future improvements.

Aims: To analyze headache and pain in the mandibular region as well as the self-perception of fatigue, difficulty and level of performance during instrumental practice when using a face mask. To analyze their influence in relation to the duration of practice.

Methods: Observational study through the completion of an online questionnaire among students and teachers in public conservatories in Spain.

Results: In 552 respondents (435 students, 117 teachers), the incidence of headache was 28.6%, being higher in musicians who used the face mask. Regarding jaw pain, 12.5% indicated that their pain increased since its use. However, the differences of pain in both regions and face mask use were not statistically significant. Nearly 40% of the participants indicated an increase in fatigue, tiredness and lowering of performance than before using the mask. Moreover, this percentage was between 66-74% when we analyzed the musicians who use it when playing, obtaining p<0.001 in all 3 variables. As for the duration of rehearsals, the only difference found is between jaw pain and hours/week of practice (p=0.036).

Conclusion: The use of the face mask significantly affected the self-perception of fatigue, as well as the difficulty and performance of instrumental practice, but was not related to the occurrence of headache and jaw pain in the musicians.

Aims: The COVID-19 pandemic negatively affected the performing arts sector by temporarily closing venues. As venues reopened, COVID-19 symptom self-reporting and monitoring were one tool to identify potentially symptomatic cast and crew, who would then undergo contact tracing, testing, or isolation to prevent spreading COVID-19. However, the compliance rates for submitting a COVID-19 self-monitoring checklist among undergraduate performing art majors remain unknown.

Methods: This retrospective medical chart review investigated 282 cast and crew (68 males and 214 females) regarding their daily COVID-19 symptom report documents across the genres of dance, musical theater, and vocal performance throughout the production runs of 11 performances at a midwestern United States university's integrated performing arts campus. Compliance regarding the completion of the COVID-19 symptom checklist was compared between gender identity, performance semester, and performance type throughout the 2020-2021 academic year.

Results: There was no statistically significant difference on masking compliance when comparing males (mean 73.6%) and females (73.8%). The completion of the symptom self-reporting during the fall 2020 semester was statistically significantly higher than in the spring 2021 semester (F = 6.065, t = 4.485, df = 229.661, p = 0.014, d = 0.52). Additionally, those participating in musical theater were more compliant than those in vocal performance (F(2,280) = 4.410, p = 0.013, d = 0.031). There was no statistically significant difference between dance and musical theater or vocal performance and dance genres regarding overall compliance.

Conclusions: These findings can help understand the groups of performing artists who would comply with the public health measure of completing a daily symptom checklist for COVID-19 or similar communicable diseases.

Background: The Musculoskeletal Pain Intensity and Interference Questionnaire for Professional Orchestra Musicians (MPIIQM) is a prominent patient-reported outcome measure (PROM) in the musicians' health literature. It has been published in at least four languages, but not in French.

Aims: To cross-culturally adapt the MPIIQM into French and establish the preliminary psychometric properties (validity, reliability, and responsiveness) of the MPIIQM-F.

Methods: Standardized cross-cultural adaptation methods included forward translations, an expert committee, and verbal field tests in the target population. Psychometric properties were assessed in a population of French-speaking professional orchestra musicians who participated in three evaluation sessions. Evaluated properties include content, face, structural and construct validity, reliability (internal consistency, test-retest reliability, minimal detectable change [MDC], measurement error), and responsiveness (effect size and standardized response means [SRM]).

Results: Sixty-one French-speaking orchestra musicians participated in the psychometric validation. Exploratory factor analysis revealed a two-factor solution equivalent to previous versions, confirming the Pain Intensity and Interference subscales. Spearman correlations for construct validity were as hypothesized for four of six hypotheses (minor deviances for the other two hypotheses) using the Brief Pain Inventory, Disability of the Arm, Shoulder and Hand Performing Arts Module, and PROMIS Global Health Scale as comparators. Reliability results demonstrated high internal consistency (Cronbach's a=0.84-0.89), excellent test-retest reliability (intraclass correlation coefficient = 0.91-0.97), and small measurement error with MDC for the overall scale <10%. Responsiveness resulted in moderate to large effect sizes and SRM (0.54-0.87).

Conclusions: Preliminary validation of the MPIIQM-F suggests good validity, reliability, and responsiveness, indicating its suitability for use in French-speaking orchestra musicians.

Objective: This study aimed to investigate the vocal health literacy level and attitudes of professional and amateur performing artists in Greece and identify possible gaps and limitations that should be addressed in the future.

Methods: This mixed-methods study took place in two successive stages. The first stage involved 4 focus groups with professional and amateur actors and singers. The focused discussions of this stage, which were moderated by one otolaryngologist and one speech and language therapist, provided necessary information for the design of the structured questionnaire used during the second stage of the study (online survey). The online questionnaire included questions about responders' knowledge and attitudes of vocal health. Although not compulsory, the Greek version of the Singing Voice Handicap Index (SVHI) was also part of the online survey.

Results: The online questionnaire was validly answered by 305 respondents during a 10-month period (May 2020 to March 2021). Considerable knowledge gaps were observed regarding anatomy, physiology, and vocal disorders management. The vast majority of participants (94.1%) had at some point experienced problems with their voice. Gastroesophageal reflux (21.6%), vocal nodules (12.5%), and vocal polyps (3.9%) were the most frequently mentioned diagnoses in our sample. A small proportion of participants (9.5%) stated that they have never visited an ENT, while 84.3% have never seen a speech and language therapist. The total scores on the SVHI in our sample were compatible to the ones in previous studies targeting healthy professional and amateur artists (range 0-116, mean 32, SD 24.7).

Conclusions: This study provides insights into Greek performing artists' knowledge and attitudes regarding vocal health and may pave the way towards improving vocal health awareness among performing artists.