Performance-related musculoskeletal pain, quality of work life and psychosocial aspects in professional violinists and violists in Rio de Janeiro

Abstract

Introduction: The appearance of performance-related musculoskeletal pain in professional violinists and violists is associated with work overload, excessive repetition and posture. Much has been studied about the biomechanics of movement performed by these professionals, pointing to work-related illness and the diagnoses that often mark the discontinuation of their profession due to the occurrence of pain. However, there seems to be a gap in the literature when it comes to understanding the onset of musculoskeletal pain in musicians from a perspective focused on observing the psychosocial aspects and quality of life at work involved in their performance. Objective: The objective of this study was to identify psychosocial aspects of stress, anxiety and depression and quality of life conditions at work as possible predictors for the occurrence of musculoskeletal pain related to the performance of violin and violist musicians. Methods: This cross-sectional quantitative observational study included 122 violinists and violists from 10 orchestras in Rio de Janeiro, of both sexes, aged 18 or over, with at least one year in the profession, and in activity. Sociodemographic data was collected, and questionnaires were applied: Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians- Brazilian version (MPIIQM-BR); Quality of Work Life Questionnaire abbreviated version (QWLQbref);
and Depression, Anxiety and Stress Scale (DASS-21). The normality of the data distribution was verified by the Shapiro-Wilk test and graphical analysis of the histograms. The significance level adopted was 5%. The statistical analysis was processed using SPSS version 26. The outcomes for pain that interferes with the ability to play were the last 12 months, the last 30 days, the last 7 days, and the variable created from the presence of pain in the previous 3 outcomes, which was called the constant pain group. The 4 outcomes were divided, for comparison, into groups with and without pain and their association with the variables (school degree, gender, use of accessories, physiotherapy follow-up, length of professionalization, age, age group, instrumentalists, use of accessories, length of time (years) playing the instrument, length of time playing in an orchestra, length of time (hours) playing in an orchestra, average number of hours playing outside the orchestra, domains of the DASS-21 and QWLQ-bref, answers from the MPIIQM-BR) under study. were analyzed using the Mann-Whitney test for numerical variables; and the chi-square (χ2) or Fisher's exact test for categorical variables. Binary Logistic Regression was performed to identify independent predictors of pain that interferes with the ability to play among the variables under study. Results: A high lifetime prevalence of pain was found in this
group of musicians (95.1%), and the constant pain group accounted for more than 50% of cases (56.6%). The parts of the body with the highest prevalence of musculoskeletal problems reported were the shoulder (44.2%), wrist (36.5%), scapula (21.2%) and
neck (21.2%). It was observed that the group with constant pain had a higher stress score (p = 0.014), years playing the instrument (p = 0.040), years as an orchestra professional (p = 0.020) and average hours playing outside the orchestra (p = 0.016) than the group without constant pain. The results of the QWLQ-bref test showed scores in its domains (physical, psychological, personal and professional) of between 55% and 75%, which is considered satisfactory, with no significant association between groups in the four outcomes. The variable stress was found to be a significant independent predictor of pain in the last 12 months (β=0,153 , RC=1,17, IC= 1,00- 1,35, p = 0,044), in the last 07 days (β= 0,118, RC=1,12, IC=1,01-1,25, p = 0,027), and for the constant pain group (β= 0,140, RC=1,15, IC=1,04-1,27, p = 0.006). Conclusion: Violinists and violists from orchestras in Rio de Janeiro have a high prevalence of pain. The quality of life at work of these musicians does not prove to be a determining factor for the occurrence of pain, however, an important finding is that stress proved to be one of the relevant predictors for this condition.