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- Fakultät WiSo (17)
background: Musculoskeletal problems (MP) are widespread in performing artists and are due to the special demands of instrument playing, singing or dancing. Additionally, various other factors might contribute to performance-related MP. To provide a specific physiotherapeutic management for performing artists it is important to gain information about the performing art, the individual demands and contributing factors. The subjective examination (SE) is the basis of the clinical reasoning process and the hypothesis forming for further clinical examination and biomechanical analysis. In the present protocol, the SE consists of a questionnaire-based section and an interview-based section and is part of the evaluation process of the neuromusculoskeletal examination of a performing artist specific reference laboratory.
purpose: To develop a standardized SE protocol divided into a questionnaire-based section (Part 1) via web application and an interview-based SE (Part 2) to address MP of performing artists.
methods: The questionnaires for part 1 were selected based on the expertise of the research group and the psychometric properties of each possible questionnaire. A common physiotherapeutic recording of findings which addresses the relevant questions of the SE of MP was used. To adapt the anamnesis to performing-associated MP questions specific to instrument playing, singing and dancing were selected on the basis of a literature search and the expertise of the research group.
summary of content/results: Part 1 consists of three topics. (1) information about the performing art, professional level and sociodemographic data, (2) information about pain and pain processing, and (3) the anatomical location of the main MP including a body region-specific questionnaire. Part 2 is based on the five aspects of clinical practice described by Maitland and the Musculoskeletal Clinical Translation Framework by Mitchell et al. The performing arts specific part is particularly focused on performing art specific considerations, physical and psychosocial contributing factors and art-specific activities.
significance: This standardized SE protocol should help clinicians evaluating the musculoskeletal health of performing artists in a standardized and specific way.
Background: Musculoskeletal problems (MP) are widespread in performing artists and are due to the special demands of instrument playing, singing or dancing. In order to specifically evaluate these problems, a reference laboratory is under development. The evaluation covers 4 steps: a subjective examination (SE) including (1) a questionnaire-based online survey and (2) an interview-based anamnesis. On the basis of the results of the SE, hypotheses are formed for (3) an individual musculoskeletal clinical examination and a (4) biomechanical analysis. Here, the focus is on the clinical examination.
Purpose: to develop a standardized protocol for a clinical examination addressing especially musculoskeletal problems in performing artists.
Methods: A common physiotherapeutic clinical examination should be supplemented with techniques, which are specific to performance-related musculoskeletal problems and/or their risk factors. The development was based on a literature search and the clinical expertise of the physiotherapeutic research group.
Summary of content/Results: The performing arts specific clinical examination includes the common analysis of posture as well as passive/active movement capacities and specific differentiating tests in relation to the signs and symptoms of the individual artist. The examination is supplemented by a functional demonstration focusing on the special demands of playing the respective instrument, while singing or dancing. Common overuse risk factors like hypermobility, special anthropometric data or an examination of the motor control of different body regions are addressed. Optional, the various parts of the examination process could be skipped, if not relevant for the individual artist.
Significance: This clinical examination protocol should help clinicians evaluating the musculoskeletal health of performing artists in a standardized and specific way.
Rationale:
Performing artists are exposed to high strains during their performance. These strains are similar to the ones of professional athletes, but in contrast to athletes there is a comprehensive undersupply of care regarding preventive and rehabilitative therapy offers.
Purpose:
The purpose of RefLabPerform is to develop a reference laboratory for the assessment of neuromusculoskeletal disorders using physiotherapeutic assessment methods in combination with biomechanical motion analysis. This includes the automatized integration of the physiotherapeutic assessments with the technical biomechanical analysis for an individual treatment recommendation with decentralized health care recommendations for a home-based therapy based on evidence-based prevention and rehabilitation strategies.
Methods:
Several work packages are processed systematically, whereby according to the requirements in the course of the project an overlapping of work packages occurs. First, the component planning of the innovative reference laboratory structure is carried out, on which the clinical and technical development of the reference laboratory is based. The next steps are the development of individual clinical assessment protocols, prevention and rehabilitation strategies as well as the setup of the laboratory and the development of technical routines. Parallel to this, various analysis tools are being developed for biomechanical data as well as for physiotherapeutic diagnostics and merged at the end of this work package for individual results for different groups of performing artists. Overlapping with the previous work packages, the reference laboratory will be tested for application and manageability. Clinical and technical data are brought together and checked by means of individual case trials on various groups of artists. In terms of an agile software development process, the results flow back into the previous work packages in order to optimize them and then test them again.
Results:
At the end of the project a functional and proven reference laboratory for the comprehensive analysis of performing artists will be developed.
Conclusions:
This reference laboratory is specialized to the diagnosis and treatment of playing- and performance-related dysfunctions with a focus on clinical findings and biomechanical movement analysis.
Educational Objectives:
At the end of the presentation, the participants will be able to…
1. describe the innovative content of the project RefLabPerform
2. understand the advantages of merged analysis strategies by physiotherapeutic and biomechanical examinations
3. understand the complex interdisciplinary process to develop a reference laboratory for performing artists
Rationale:
Performing artists are exposed to high strains during their performance. These strains are similar to the ones of professional athletes, but in contrast to athletes there is a comprehensive undersupply of care regarding preventive and rehabilitative therapy offers.
Purpose:
The purpose of RefLabPerform is to develop a reference laboratory for the assessment of neuromusculoskeletal disorders using physiotherapeutic assessment methods in combination with biomechanical motion analysis. This includes the automatized integration of the physiotherapeutic assessments with the technical biomechanical analysis for an individual treatment recommendation with decentralized health care recommendations for a home-based therapy based on evidence-based prevention and rehabilitation strategies.
Methods:
Several work packages are processed systematically, whereby according to the requirements in the course of the project an overlapping of work packages occurs. First, the component planning of the innovative reference laboratory structure is carried out, on which the clinical and technical development of the reference laboratory is based. The next steps are the development of individual clinical assessment protocols, prevention and rehabilitation strategies as well as the setup of the laboratory and the development of technical routines. Parallel to this, various analysis tools are being developed for biomechanical data as well as for physiotherapeutic diagnostics and merged at the end of this work package for individual results for different groups of performing artists. Overlapping with the previous work packages, the reference laboratory will be tested for application and manageability. Clinical and technical data are brought together and checked by means of individual case trials on various groups of artists. In terms of an agile software development process, the results flow back into the previous work packages in order to optimize them and then test them again.
Results:
At the end of the project a functional and proven reference laboratory for the comprehensive analysis of performing artists will be developed.
Conclusions:
This reference laboratory is specialized to the diagnosis and treatment of playing- and performance-related dysfunctions with a focus on clinical findings and biomechanical movement analysis.
Educational Objectives:
At the end of the presentation, the participants will be able to…
1. describe the innovative content of the project RefLabPerform
2. understand the advantages of merged analysis strategies by physiotherapeutic and biomechanical examinations
3. understand the complex interdisciplinary process to develop a reference laboratory for performing artists
Background: Muscle fatigue has been reported as a risk factor for the
development of performance-related musculoskeletal disorders (PRMD) in
musicians. However, little research exists to support this claim. The aim of
this study was to investigate whether changes occur in muscle activity
patterns during high string performance over a prolonged playing period, and
whether this is influenced by PRMD.
Methods: High string musicians were divided into a PRMD and a non-PRMD
group. They played a chromatic scale pre and post and a self-chosen “hard”
(Borg scale 16-17) piece of music for one hour. Electromyography data
recorded from arm, shoulder and trunk muscles was analyzed: the amplitude
to measure muscle activity characteristics and the lower frequency to
measure muscle fatigue. Differences between and within groups and the
frequency spectrum were analyzed using linear mixed models.
Results: Fifteen musicians participated (7 PRMD: 22.8 years, 2 male/5 female
and 8 non-PRMD: 34.3 years, 2 male/6 female). Changes in muscle activation
patterns were observed between and within both groups, however changes
varied significantly depending on group affiliation. Significant low frequency
spectrum changes between groups were observed in overall muscles of the
right arm (p=0.04) and left forearm flexors (p=0.05) following one hour of
playing.
Conclusions: Muscle activity and frequency spectrum shifts differ in high
string musicians with and without PRMD, suggesting possible differential
muscle fatigue effects between the groups.
Rationale:
Dance as an intense kind of performance is associated with high loads on the musculoskeletal system. In particular, the lower limb is exposed to these high loads, which is reported by a high prevalence. Most dancers are affected by injuries during their careers, most in the lower limb. Typical risk factors for dancers include the compensatory turnout, hypermobility, and core stability. The correlation between these factors and lower limb injuries is not fully understood.
Purpose:
The aim of this study was to evaluate the correlation between lower limb injuries and the risk factors compensated turnout, hypermobility and core stability. Based on these results, hypotheses can be generated for further studies.
Methods:
This explorative pilot study was conducted at Osnabrück University of Applied Sciences. All eligible participants were scheduled for a single research appointment if they fulfilled the inclusion criteria of dance experience (ballet, modern, contemporary or jazz) at least one year with dance lessons of at least 5 hours per week. Parameters for the correlation analysis were (1) core stability, measured by the motor control tests battery proposed by Luomajoki, (2) hypermobility, measured by the Beighton Score (3) compensated turnout, measured by the difference between functional turnout and external rotation of both hips, (4) dance hours per week, (5) dance experience in years, (6) professional dance experience in years and (7) dance style (ballet, modern, contemporary, jazz). These parameters were correlated with the numbers of lower limb injuries. Significance level was set at 90% because of the explorative character of the study with the purpose to generate hypotheses.
Results:
Sixteen female dancers with different levels of dance experience (mean 11.3 years) and dance lessons per week (mean 17.6 hours) fulfilled the inclusion criteria and participated in this study. Significant correlations with the numbers of lower limb injuries were found at core stability (rs=0.489, p=0.034, medium effect), dance hours per week (rs=0.459, p=0.048, medium effect) and professional dance experience in years (rs=0.396, p=0.093, medium effect). Two dance styles (modern dance: rs=0.388, p=0.101 and contemporary dance: rs=0.385, p=0.104) were close to the significance level.
Conclusions:
These results show correlations between core stability, dance hours per week, professional dance experience in years and lower limb injuries in dancers.
Due to the limitations of a small and heterogeneous sample size as well as the medium effects, these results should be interpreted with caution, but may provide a basis for further research to this topic in the field of dance research and can be helpful in generating research hypotheses.
Rationale
Playing the trombone can lead to playing-related musculoskeletal disorders (PRMD). Previous research suggests that professional trombonists predominantly struggle with PRMD on the left body side. An increasing volume leads to an increasing contact pressure on the mouthpiece of the trombone, but it is still unclear how the muscle activity relates to this and whether it differs in musicians with PRMD from those without PRMD.
Purpose
The purpose of this study was to investigate the relationship between the activity of different muscles of the left body side, the contact pressure on the mouthpiece and the volume level in healthy trombonists.
Methods
Six male healthy tenor trombonists were included in this study and run through a standardized protocol which consisted of playing a b-flat major scale with three different volume levels (pianissimo, mezzoforte, fortissimo). Analyzed parameters were (1) the activity of several muscles of the left body side (measured with surface electromyography), (2) the contact pressure on the mouthpiece (measured with a force sensor) and (3) the different volume levels.
Results
Analysis of variance reveals significant differences of the muscle activity for the three volume levels. Depending on the volume level and the selected muscle, results show very weak to moderate correlations between contact pressure on the mouthpiece and muscle activity (Spearman´s rho between .11 and .58). The strongest correlation across all muscles occurs during fortissimo playing.
Conclusions
These results show a relationship in healthy trombonists between volume level, contact pressure on the mouthpiece and muscle activity when playing a b-flat major scale. Future research should include trombonists with PRMD to enable comparison between PRMD and non-PRMD musicians.
Educational Objectives:
At the end of the presentation, the participants will be able to…
1. understand the relationship between muscle activity, contact pressure on the mouthpiece and volume when playing the trombone
2. recognize that there are different muscle activity patterns on the left body side when playing the trombone
3. understand that a comprehensive functional diagnosis is important in the management of musicians