Musculoskeletal pain & dysfunction in musicians

In the Netherlands more than 2 million people are actively making music. Unfortunately, thousands of these musicians experience pain in their muscles and/or tendons that limits them in practicing their hobby or profession. For professional musicians, these complaints can lead to temporary incapacity for work or even early termination of their career. It is not clear exactly what causes these complaints. The PhD thesis of rehabilitation physician Kees Hein Woldendorp focused on this type of complaints among musicians. Since professional musicians are engaged in intensive and long-term physical activities, it is obvious that physical factors play an important role in the development of complaints. Many health care providers assume that highly tensed muscles, insufficient relaxation, poor posture and/or little variation in workload leads to pain complaints. The first goal of the PhD project was therefore to examine these assumptions. The results did not confirm the assumptions. To enable further research, it is important to measure posture and motor function accurately. This is only possible to a limited extent for musicians, because not enough measuring instruments are available or applicable. This is why the second part of the thesis discusses research to gain more knowledge about practical and usable measuring instruments. The studies focused on the measurement of embouchure in wind instruments (how the flow of air through the mouth ensures the right sound), hand characteristics and posture.The insights and results from this PhD research will be used for further research and improving the rehabilitation of musicians with musculoskeletal complaints

Variation in occupational exposure associated with musculoskeletal complaints:a cross-sectional study among professional bassists

Variation in occupational exposure is assumed to have a protective effect against the development of musculoskeletal complaints (MSC), but this common assumption is not strongly supported by the literature. Among musicians, who have a high prevalence of MSC, many play more than one type of instrument (multi-instrumentalism) for many hours a day. Since multi-instrumentalism implies greater variation in ergonomic load of specific musculoskeletal areas than mono-instrumentalism, musicians are a suitable study population to test whether the above assumption is true. To investigate in a sample of professional bass players whether multi-instrumentalists are less likely to have MSC than mono-instrumentalists. Participants were 141 professional and professional student double bassists and bass guitarists. Demographic, MSC and exposure characteristics were collected online with self-constructed and existing questionnaires. Logistic regression analysis was used to test the association between multi- versus mono-instrumentalism and MSC, adjusted for confounders. The prevalence of having MSC in the neck, back, right shoulder area and both wrist areas did not differ significantly between the two groups. Further analysis revealed that the likelihood of having MSC in the left shoulder area was higher in multi-instrumentalists compared to mono-instrumentalists (Odds ratio 0.30, 95% CI 0.119-0.753, p = 0.010). In this sample of professional bass players, no protective effect of multi-instrumentalism against MSC was found. Multi-instrumentalism was associated with a higher prevalence of MSC in the left shoulder. This result challenges theoretical and clinical assumptions in occupational and pain medicine

Quality and usability of clinical assessments of static standing and sitting posture:A systematic review

BACKGROUND: A validated method to assess sitting and standing posture in a clinical setting is needed to guide diagnosis, treatment and evaluation of these postures. At present, no systematic overview of assessment methods, their clinimetric properties, and usability is available. OBJECTIVE: The objective of this study was to provide such an overview and to interpret the results for clinical practice. METHODS: A systematic literature review was performed according to international guidelines. Two independent reviewers assessed risk of bias, clinimetric values of the assessment methods, and their usability. Quality of evidence and strength of recommendations were determined according to the Grading of Recommendations Assessment, Development and Evaluation working group (GRADE). RESULTS: Out of 27,680 records, 41 eligible studies were included. Thirty-two assessment instruments were identified, clustered into five categories. The methodological quality of 27 (66%) of the articles was moderate to good. Reliability was most frequently studied. Little information was found about validity and none about responsiveness. CONCLUSIONS: Based on a moderate level of evidence, a tentative recommendation can be made to use a direct visual observation method with global posture recorded by a trained observer applying a rating scale

Appraisals and coping mediate the relationship between resilience and distress among significant others of persons with spinal cord injury or acquired brain injury: a cross-sectional study

Background: Many significant others of persons with serious conditions like spinal cord injury (SCI) and acquired brain injury (ABI) report high levels of psychological distress. In line with the stress-coping model, the aim of the present study was to investigate the relationship between personal resource resilience and psychological distress, and whether appraisals of threat and loss, and passive coping mediate this relationship. Methods: Significant others (n = 228) of persons with SCI or ABI completed questionnaires shortly after admission to first inpatient rehabilitation after onset of the condition. The questionnaire included measures to assess psychological distress (Hospital Anxiety and Depression Scale), resilience (Connor-Davidson Resilience Scale-10), appraisals (Appraisals of Life Events scale, threat and loss) and passive coping (Utrecht Coping List). The PROCESS tool was used to test the presence of mediation. Confounding and differences between SCI and ABI were investigated. Results: High levels of psychological distress among significant others were found (34-41%). Fifty-five percent of the variance in psychological distress was explained by the relationship between resilience and psychological distress. This relationship was mediated by appraisals of threat and loss, and passive coping. The relationship between resilience and psychological distress was similar in the SCI and ABI groups. Conclusions: The results of our study indicate that appraisals of threat and loss and passive coping are mediating factors in the relationship between resilience and psychological distress. It seems useful to investigate if interventions focussing on psychological factors like resilience, appraisal and coping are effective to prevent or reduce psychological distress among significant others of persons with SCI or ABI

Appraisals and coping mediate the relationship between resilience and distress among significant others of persons with spinal cord injury or acquired brain injury: A cross-sectional study

Background: Many significant others of persons with serious conditions like spinal cord injury (SCI) and acquired brain injury (ABI) report high levels of psychological distress. In line with the stress-coping model, the aim of the present study was to investigate the relationship between personal resource resilience and psychological distress, and whether appraisals of threat and loss, and passive coping mediate this relationship. Methods: Significant others (n = 228) of persons with SCI or ABI completed questionnaires shortly after admission to first inpatient rehabilitation after onset of the condition. The questionnaire included measures to assess psychological distress (Hospital Anxiety and Depression Scale), resilience (Connor-Davidson Resilience Scale-10), appraisals (Appraisals of Life Events scale, threat and loss) and passive coping (Utrecht Coping List). The PROCESS tool was used to test the presence of mediation. Confounding and differences between SCI and ABI were investigated. Results: High levels of psychological distress among significant others were found (34-41%). Fifty-five percent of the variance in psychological distress was explained by the relationship between resilience and psychological distress. This relationship was mediated by appraisals of threat and loss, and passive coping. The relationship between resilience and psychological distress was similar in the SCI and ABI groups. Conclusions: The results of our study indicate that appraisals of threat and loss and passive coping are mediating factors in the relationship between resilience and psychological distress. It seems useful to investigate if interventions focussing on psychological factors like resilience, appraisal and coping are effective to prevent or reduce psychological distress among significant others of persons with SCI or ABI

Musculoskeletal pain & dysfunction in musicians

In the Netherlands more than 2 million people are actively making music. Unfortunately, thousands of these musicians experience pain in their muscles and/or tendons that limits them in practicing their hobby or profession. For professional musicians, these complaints can lead to temporary incapacity for work or even early termination of their career. It is not clear exactly what causes these complaints. The PhD thesis of rehabilitation physician Kees Hein Woldendorp focused on this type of complaints among musicians. Since professional musicians are engaged in intensive and long-term physical activities, it is obvious that physical factors play an important role in the development of complaints. Many health care providers assume that highly tensed muscles, insufficient relaxation, poor posture and/or little variation in workload leads to pain complaints. The first goal of the PhD project was therefore to examine these assumptions. The results did not confirm the assumptions. To enable further research, it is important to measure posture and motor function accurately. This is only possible to a limited extent for musicians, because not enough measuring instruments are available or applicable. This is why the second part of the thesis discusses research to gain more knowledge about practical and usable measuring instruments. The studies focused on the measurement of embouchure in wind instruments (how the flow of air through the mouth ensures the right sound), hand characteristics and posture. The insights and results from this PhD research will be used for further research and improving the rehabilitation of musicians with musculoskeletal complaints