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

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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...

This research is the first known large-scale, instrument-specific, epidemiological study on the occupational health problems of violists. An online survey was developed based on a biopsychosocial framework to assess demographics, pain, musculoskeletal and non-musculoskeletal problems, music performance anxiety, and musician identity. Additionally, this is the first study known to investigate violists' perceptions and attitudes regarding viola jokes and negative stereotypes associated with viola players and their effects on violists' occupational health. Validated tools used to measure violists' health problems included the short-form McGill Pain Questionnaire (SF-MPQ) and the Musician's Identity Measurement Scale (MIMS). Results: This survey yielded a cohort N = 324 that was diverse in age, education, and professional involvement. The overall prevalence for violists that experienced musculoskeletal pain in the past year was 79%. For violists in pain, 51% reported being reluctant to inform others of their playing-related pain. In the past year, 89% of violists experienced music performance anxiety. 49% of violists reported having negative thoughts about viola jokes, with 23% indicating they experience music performance anxiety because of viola jokes. The prevalence rates for non-musculoskeletal problems, perceived factors that influence pain, and the influence of viola jokes suggest that high levels of biopsychosocial stressors are often associated with the classical music genre and playing the viola. The results from this research can be used to enhance music teacher-training programs, inform performance practice and viola pedagogy, and educate clinicians about the health risks of playing the viola.