Magister Scientiae (Physiotherapy) - MSc(Physio) / Playing related musculoskeletal disorder (PRMD) is common among instrumentalists, professionals, amateurs and music students with a prevalence ranging from 39-47% with an impact on playing and performance. This is synonymous to the prevalence of musculoskeletal disorders among other work population. Risk factors such as lack of warm ups, awkward posture, long playing hours and bad techniques has been consistently indicated as risk factors influencing the incidence of PRMDs among instrumentalists. The aim of this study is to design a warm up programme for instrumentalists. The study population and sample are instrumentalists at the Centre for Performing Arts, University of the Western Cape. A cross sectional study design with a quantitative approach was utilized in this study to determine the prevalence, severity, distribution of PRMDs and its association with quality of life. All the instrumentalists learning or playing a musical instrument of the Centre for Performing Arts was approached to participate in this study. In the first phase of the study, a self administered questionnaire was used to collect data regarding prevalence, distribution and the severity of PRMDs and health related quality of life. The instruments for this study are the standard NORDIC questionnaire for musculoskeletal disorders to determine pain distribution and prevalence, the visual analogue scale to determine the pain severity and the WHOQOL –BREF, a quality of life questionnaire and an adapted questionnaire to determine the knowledge of instrumentalists about injury prevention strategies. The second phase of the study, a systematic review of evidence was done on the pattern of warm up and practice habits of instrumentalists. The third phase of the study to design the content of the study was done using a Delphi study. The Statistical Package for Social Sciences (SPSS) was used for descriptive and inferential statistics. Chi square was used to determine the association of prevalence, distribution and severity on quality of life. Alpha level was set at 0.05. Ethical clearance and permission to conduct study was sought, written informed consents from participants was sought clearly stating the right to participate and withdraw from study was respected and anonymity and confidentiality was be ensured. The results of the study show that 82.4 % lifetime prevalence and current prevalence of 23.5 % among instrumental musicians in a Centre for Performing Arts. The shoulder (41.2 %), neck (29.4 %) and the wrists and hands (29.4%) are the mostly affected region on the body. The most common symptoms are tightness and soreness. However, the results of the systematic review shows that there is a lack of operational term for warm up in the performing arts and this therefore could be responsible for the variations in the influence of warm up on the prevention of PRMDs. The content of the warm up programme was designed using a Delphi study and stretching and postural awareness were included with musical warm up as part of a regular warm up exercise, although, consensus was not reached on the duration of the warm up programme. Strengthening and conditioning were included to in a different exercise program done three times per week. Education on injury prevention strategies were also included in the programme and the mode of instruction agreed on was active learning and group instruction in classroom. The role of warm up exercise in the prevention of PRMDs using this model could reduce the incidence of PRMDs. However, it is important to note that the programme should be tested in order to determine the overall effect it has on PRMDs. / South Africa

Title The prevalence of musculoskeletal disorders among wind instrument players Objectives The aim of this thesis is to determine the prevalence of playing-related musculoskeletal disorders (PRMD) in players on wind instruments in the Czech Republic, to determine their consequences and to identify related factors. Methods This thesis has the character of a cross-sectional study with a questionnaire survey. The study included 308 players on wind musical instruments. Outcomes The prevalence of PRMD was 55 % for the whole music group and 62 % for professional players. The higher prevalence of PRMD was statistically significantly associated with the student status (p=0.001), female sex (p=0.026), playing time on the dominant instrument weekly (p=0.001), and earlier incidence of PRMD (p=0.000). 31 % of players confirmed wrist/hand problems, 31 % confirmed problems in the neck area and 28 % confirmed problems in the upper back area. Because of PRMD, participants most frequently visited a health specialist such as a physical therapist and when dealing with their difficulties alone, most often they did some kind of physical activity. Conclusion The prevalence of PRMD in professional players was at a lower level than in foreign literature. Students, women, players playing more hours per week and players...

Playing a musical instrument requires hours of exposure to a fixed position and a performance of greatly repeated movements. This excessive physical load in combination with other factors can often result in playing-related musculoskeletal disorders (PRMD). This thesis specifies the definition of PRMD, clarifies the idea of musician's medicine as a fairly new specialization, titles the most commonly occurring medical conditions and risk factors in musicians with an emphasis on guitarists (classical and electric guitar players) and pianists. It also offers recommendations on how to play these instruments with respect to the ergonomics. The aim of practical part of the thesis was to find the possible relation between PRMD and instrument playing among guitarists and pianists in the last 12 months. It was composed of three parts: questionnaire of musculoskeletal disorders, clinical examination and video-analysis of instrument playing. The study surveyed 401 guitarists and pianists without specified instrumental level. 19 of these participated in the clinical examination. The analysis of questionnaire data revealed PRMD in 55,6 % musicians mainly localized in neck (19,8 %); more specifically, in pianists in neck and both hands (equally 27,4 %); however, in guitarists in left hand (18,6 %). Asymmetry has...

Playing‐related pain is a common and serious problem among pianists. Information on cause and prevention is extremely limited due to a lack of scientific research. The purpose of this study was to (1) review and describe risk factors for piano‐related pain among college students and piano teachers that were reported in my previous two research studies, (2) justify the use of an ergonomically modified keyboard as a potential solution for reducing playing‐related pain, and (3) test and evaluate the effectiveness of an ergonomically modified keyboard for alleviating pianists' pain. Both study populations reported high prevalence rates for playing‐related pain: 86 % for college students (n = 35), 91 % for piano teachers (n = 47). For both populations, statistical analyses confirmed that pianists with small physical size (hand size) were more prone to pain. This finding helped rationalize the use of an ergonomically modified keyboard (the key width is 1/16 narrower than the standard) for small‐handed pianists as an ergonomic intervention. To test the effectiveness of an ergonomically modified keyboard, 35 college students played identical music on both the reduced-sized keyboard and the standard keyboard. Observations of video‐recorded performances revealed that small-handed pianists can avoid extreme stretching of their hands when playing on the modified keyboard. Statistical analysis of questionnaire data confirmed that the modified keyboard helped small‐handed pianists to play with less pain and tension. These results warrant the serious consideration of adopting ergonomic principals into the world of piano.