Occurrence and co-existence of localized musculoskeletal symptoms and findings in work-attending orchestra musicians - an exploratory cross-sectional study

Helene M Paarup,Jesper Baelum,Jonas W Holm,Claus Manniche,Niels Wedderkopp

doi:10.1186/1756-0500-5-541

Abstract

BackgroundDue to ergonomic exposure musicians are at risk of work-related musculoskeletal disorders in the neck, back, and upper extremities. The literature confirms musculoskeletal problems in these anatomic regions among orchestra musicians.MethodsAn explorative cross-sectional study among 441 musicians from six Danish symphony orchestras; 216 underwent a clinical examination constructed for the purpose. Prior to the examination the musicians rated their maximally perceived trouble within the last week on a scheme blinded to the examiner. Accessibility to the clinical examination differed between orchestras.The aims were to assess the prevalence of 1) perceived symptoms within the previous week in the neck, back and limbs and of 2) clinical findings in the neck, back, and upper extremities, and 3) to investigate the co-existence of the perceived symptoms and clinical findings.ResultsSymptoms and findings were most common in the neck, back, and shoulders. Due to a poor co-existence between self-reported symptoms and clinical findings musicians experiencing bodily trouble could not be identified through this clinical examination. Free accessibility to the examination was of major importance to participation.ConclusionsIn compliance with the purpose, perceived symptoms within the previous week and present clinical findings were assessed. Although both symptoms and findings were most frequent in the neck, back, and shoulders the co-existence of anatomically localized symptoms and findings was generally quite poor in this study.Discrepancy between symptoms and findings might be caused by the participants currently attending work and therefore being relatively healthy, and the fluctuating nature of musculoskeletal problems. Furthermore from a comparison of different measuring units - self-reported symptoms being period prevalence rates and clinical findings point prevalence rates; a bias which may also be inherent in similar studies combining self-reported questionnaire data and clinical findings.

Highlights

Due to ergonomic exposure musicians are at risk of work-related musculoskeletal disorders in the neck, back, and upper extremities
Main findings Accessibility to be examined appeared to be of major importance for a high participation rate; among musicians who had permission to be examined at any time during a rehearsal about twice as many took part compared to the musicians who only had access to be examined before rehearsals or in breaks
Repeating this study, optimizing the present clinical examination must be recommended: The current study examined the active range of motion and pain of motion in the neck and shoulders, this did not reveal anything about the actual and playingrelated level of function

Summary

Introduction

Due to ergonomic exposure musicians are at risk of work-related musculoskeletal disorders in the neck, back, and upper extremities. The postures are characterized as giving little scope for variation in the neck and trunk, and they comprise repetitive use of the upper extremity, especially with repetitive precision movements in the fingers [1,2,3,4,5] Due to this occupational exposure professional musicians can be considered at risk of work-related musculoskeletal disorders in the neck, back, and upper extremities [6,7,8]. Recent studies of elite musicians playing in professional orchestras have emphasized the extent of the musculoskeletal problems in this occupational group by demonstrating that the majority of the orchestra musicians reported perceived musculoskeletal symptoms These studies revealed that in the elite musicians the most affected anatomic regions were the neck, back, and upper extremities, and that females tended to report more symptoms than males [9,13,14]. Studies of professional orchestra musicians have demonstrated a difference between the instrument groups and have indicated that string players had higher odds ratios for more of the symptoms than (most of ) the wood wind players had [1,13,14]

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