Prevalence and associated factors of playing-related musculoskeletal disorders in violin players

Abstract

Introduction: Music can bring out emotions associated with leisure and well-being. However, it is difficult for the audience to imagine that the musicians are subject to occupational risks during their musical practice. A professional musical career requires development of complex tasks and high productivity. Moreover, musicians are subjected to 1300 hours per year of strenuous musical practice in non-ergonomic instruments. For these reasons, instrumental musicians are subject to a high risk of developing musculoskeletal diseases, especially violinists. Objective: This study aimed investigates the prevalence of Playing-related Musculoskeletal Disorders (PRMD) in musicians living and working in the state of Rio de Janeiro. Methods: This study consisted of a systematic review and a cross-sectional study. The systematic review aimed to assess the methodological quality of cross-sectional studies on the prevalence of PRMD among string players. To achieve this goal the Loney Scale was used. The cross-sectional study included 106 violinists from eight cities of the State of Rio de Janeiro. Sociodemographic and musical characteristics data, pain symptoms and upper limbs functionality were collected using the DASH and the Standardized Nordic Questionnaire. The associations between musculoskeletal complaints and possible predictors were analyzed by binary logistic regression. Results: Systematic review showed that the prevalence of PRMD in string players is alarming high, ranged from 64.1% to 90%. However, only eight of 34 selected studies had achieved satisfactory methodological quality score. The cross-sectional study showed that 86.8% of violinists reported at least one painful area in the last 12 months and 77.4% in the last week. These symptoms were responsible for the momentary interruption of musical activity in 8.1% of musicians. More than 50% of violinists showed dysfunctional upper limbs according to the DASH optional module. Women were more likely to develop musculoskeletal disorders (OR 4.4, CI 1.9 - 10.0, p <0.001). In addition, older musicians were more likely to refer pain in the last seven days (OR 3.3, CI 5.1 - 10.97; p = 0:04) and also had higher scores on the DASH (OR 1.8, CI 1.1 - 3.1; p = 0.01). Other associated factors were BMI, artistic practice in hours per week and the final score of the DASH questionnaire. Conclusion: Violinists living and working in the state of Rio de Janeiro have a high prevalence of PRMD, especially women and older musicians. For this reason, these professionals were forced temporarily to interrupt his artistic activities due to pain. Although studies have shown the alarming prevalence of PRMD all over the world, the Performing Arts Medicine still lacks studies of good methodological quality.