Arts Medicine journal N°89 music students

The High Prevalence of Playing-related Musculoskeletal Disorders (PRMDs) and its Associated Factors in Amateur Musicians Playing in Student Orchestras

Despite the high number of amateur musicians in the general population, little is known about the musculoskeletal health of amateur musicians. Playing a musical instrument is supposed to be a risk factor for the development of musculoskeletal complaints. This cross-sectional study aimed to evaluate playing-related musculoskeletal disorders (PRMDs) among amateur musicians playing in student orchestras.

357 members of eleven Dutch student orchestras across the Netherlands were included in this study. A paper-based questionnaire on PRMDs was used. Sociodemographic characteristics and PRMDs were evaluated using an adaptation of the Nordic Musculoskeletal Questionnaire (NMQ) and the music module of the Disabilities of Shoulder and Hand (DASH) questionnaire.

The year prevalence of PRMDs among amateur musicians was 67.8%. Female gender, younger age, higher BMI (Body mass index) and playing a string instrument were independently associated with a higher prevalence of PRMDs. The left shoulder was affected more frequently in violinists and violists, whereas the right hand and wrist were more frequently affected in wood-wind instrumentalists. Of the subjects with PRMDs during the last week, the score of the music module of the DASH was 18.8 (6.3-31.2)

This study is the first to report on PRMDs and its associated factors in a large group of amateur musicians. The prevalence of PRMDs in amateur musicians is high, however the DASH scores reflect a confined impact of these PRMDs on their functioning as a musician. Preventive measures are needed aiming at reducing PRMDs among amateur musicians.

Musical performance requires the ability to master a complex integration of highly specialized motor, cognitive, and perceptual skills developed over years of practice. It often means also being able to deal with considerable pressure within dynamic environments. Consequently, many musicians suffer from health-related problems and report a large number of physical and psychological complaints.

Our research aimed to evaluate and analyze the wellbeing of two distinct groups of musicians, college music students and amateur performers in the French-speaking part of Switzerland. A total sample of 126 musicians was recruited for the study (mean age ± SD = 22.4 ± 4.5 years, 71 male). Wellbeing was assessed through the World Health Organization Quality of Life-BREF questionnaire evaluating two general measures, quality of life (QoL) and general health, and four specific dimensions: physical health, psychological health, social relationships, and environment. For both groups, respondents’ QoL was high on each measure: median scores were higher than 4 for the two general measures and higher than 70 for the four specific dimensions. Among the dimensions, respondents had the highest mean score for environment (75.0), then social relationships and physical health (74.0 and 73.8, respectively), and finally, psychological health (70.3). Differences between groups of musicians emerged in terms of overall QoL and general health, as well as the physical health dimension, where college music students scored lower than the amateur musicians; conversely, college music students scored higher than the amateurs on social relationships.

Our overview of musicians’ wellbeing in Western Switzerland demonstrates that, while music making can offer some health protective effects, there is a need for greater health awareness and promotion among advanced music students. This research offers insight into musicians’ wellbeing and points to the importance of involving different actors (teachers, administrators, support staff) in facilitating healthy music making.

Clarinetists close and open multiple tone holes to alter the pitch of the tones.Their fingering technique must be fast, precise, and coordinated with the tongue articulation.

In this empirical study, finger force profiles and tongue techniques of clarinet students (N = 17) and professional clarinetists (N = 6) were investigated under controlled performance conditions.
First, in an expressive-performance task, eight selected excerpts from the first Weber Concerto were performed. These excerpts were chosen to fit in a 2 × 2 × 2 design (register: low-high; tempo: slow-fast; dynamics: soft-loud). There was an additional condition controlled by the experimenter, which determined the expression levels (low-high) of the performers.
Second, a technical-exercise task, an isochronous 23-tone melody was designed that required different effectors to produce the sequence (finger-only, tongue-only, combined tongue-finger actions). The melody was performed in three tempo conditions (slow, medium, fast) in a synchronization-continuation paradigm. Participants played on a sensor-equipped Viennese clarinet, which tracked finger forces and reed oscillations simultaneously. From the data, average finger force (Fmean) and peakforce (Fmax) were calculated. The overall finger forces were low (Fmean = 1.17 N, Fmax = 3.05 N) compared to those on other musical instruments (e.g., guitar). Participants applied the largest finger forces during the high expression level performance conditions (Fmean = 1.21 N). For the technical exercise task, timing and articulation information were extracted from the reed signal.

Here, the timing precision of the fingers deteriorated the timing precision of the tongue for combined tongue-finger actions, especially for faster tempi. Although individual finger force profiles were overlapping, the group of professional players applied less finger force overall (Fmean = 0.54 N). Such sensor instruments provide useful insights into player-instrument interactions and can also be used in the future to give feedback to students in various learning and practising situations.

Is There a Link between the Health of an Artist, Membership in a Family of Artists, and Self-positioning with respect to One’s Artistic Ideal?

Do artists whose family circle lives in an artistic environment have a relationship with health and the artistic ideal that is different from artists not belonging to an artistic family environment?

A 80-item questionnaire was distributed to 131 artists with a higher education in art in Belgium, 119 of whom answered the entire questionnaire. We established five categories: no artists in the immediate family; artists who were brothers, sisters, or cousins; artists who were uncles, aunts, or a godfather or godmother; artists who were their parents or grandparents; artists from different branches of the family (more than one of the previous categories). We then chose three items and compared this classification with how long the artists had been away from artistic work for health reasons (no interruption, less than three weeks, more than three weeks, and more than three months) as well as with the artists’ self-positioning with respect to their personal artistic ideal. We also analyzed the link between this self-positioning and the length of time away from artistic work for health reasons.

Fifty percent of the young artists belonging to a family of parents and grandparents who were not artists themselves but whose siblings or cousins were, had never had to interrupt their artistic work for health reasons. More than half of every other category had had to interrupt their artistic work for health reasons. Among the artists having never had to do so for health reasons, 70.73% had a very high artistic ideal. Among the artists with a very high ideal, 47.14% did not have artists in their family and 21.43% belonged to a family containing numerous artists. For these two categories, more than 60% set their artistic ideal very high. This was also true of 75% of the artists with uncles, aunts, or a godfather or godmother who were artists.

Membership in a family of numerous artists does not seem to be correlated to a possible advantage or disadvantage from the standpoint of interruptions of artistic work for health reasons, nor of having a higher artistic ideal, as compared to those with no artists in their family circle. On the contrary, having artists among one’s siblings or cousins seemed to be more tightly linked to the lack of a health problem that has repercussions on artistic work. The absence of a long interruption of artistic work for health reasons was often statistically linked to a high ideal, but certain artists with a high ideal had to stop for more than three months while others who felt they had attained their ideal never had to interrupt their artistic work.

Descriptive statistics are given on the similarities and differences between different individual past histories but will never replace the kind of individual dialogue that would be necessary for gaining an in-depth understanding of each individual’s personal trajectory.

Key words: artist; artistic work; medical problem; family; artistic ideal.