OPErA Orchestral Posture Egonomic Assessment
- Conditions
- Abnormal Posture
- Registration Number
- NCT06758349
- Lead Sponsor
- Fondazione Don Carlo Gnocchi Onlus
- Brief Summary
This is an observational study that will allow to understand if and how posture at the instrument can affect musician health and ability to work.
The study will last 3 years during which the investigators will evaluate 250 orchestral players: all musical instruments will be included. Postural assessments will be performed in the various venues of the participating orchestras.
The study participant, would initially answer a questionnaire that will investigate lifestyle habits (physical activity), professional activity (e.g. instrument played, hours of study/work, study methods) and general health (e.g. presence of pain with functional limitation at the present time or in the past, diagnosis of scoliosis).
The subsequent postural assessment will consist of two phases: phase 1 without an instrument in a sitting position, phase 2 with the musical instrument .
Disposable ECG electrodes will be applied to the skin and will serve as landmarks and will be removed at the end of the assessment.
In both phases, the Physical Analyzer Portable system will be used, which allows the acquisition of calibrated photographs and the subsequent processing of the data obtained through special software, calculating with numerical values the postural asymmetries between the right and left sides and the degrees of inclination of the trunk.
The execution of the planned assessments will take place in the constant presence and under the guidance and control of suitable and qualified personnel who will provide instructions on the activity to be carried out and assistance in case of any need.
The data obtained in this way will be correlated with the information collected with the questionnaire.
Improving musician posture awareness with the musical instrument could prevent the onset of pain and limitations in work activity.
In fact, the identification of risk factors for musculoskeletal pathologies in professional musicians (PRMDs) would allow the development of specific prevention and treatment programs and the development of a network of territorial services dedicated to the musicians themselves.
- Detailed Description
For musicians, movement takes on a particular significance as it allows them to express their creativity through their instrument. The sensation they convey to the audience is one of a body in perfect harmony and symbiosis with their instrument, seemingly free of muscular tension and pain. However, numerous musculoskeletal and neurological disorders afflict musicians, limiting their performance and sometimes forcing them to cease their professional activity. Musicians often tend to underestimate their problems, ignoring pain and symptoms that require care or rest.
In 1713, Bernardino Ramazzini was the first to describe an overview of occupational diseases affecting musicians. Zaza, on the other hand, was the first to introduce the term Playing-Related Musculoskeletal Disorder (PRMD) to define musculoskeletal afflictions as \"chronic, disabling personal health problems that affect the entire person physically, emotionally, and in terms of work and social aspects\".
Recent systematic reviews report a prevalence of musculoskeletal disorders among musicians ranging from 57% to 68%, PRMDs from 9% to 68%, and one-time PRMDs from 62% to 93%. Fishbein highlighted that approximately 76% of members of the International Conference of Symphony and Opera Musicians (ICSOM) experienced at least one medical issue in their career that compromised their performance.
To find effective solutions for preventing the development of PRMDs or minimizing their impact, it is essential to first identify the main risk factors. The most frequently cited factors in the development of PRMDs include gender, age, professional status and years of experience, type of instrument, repertoire, individual technique, long hours of practice with insufficient breaks, poor physical condition, muscle fatigue, lack of preventive behaviours, and previous injuries. Additionally, several studies have revealed a correlation between the presence of musculoskeletal disorders and psychological stress factors (anxiety and stress, depression, and perfectionism). The weight of the instrument and the imposed posture may also influence the prevalence of musculoskeletal injuries among musicians.
Many researchers confirm that prolonged adoption of forced body positions required to play a specific instrument increases the likelihood of overloading the osteo-artro-neuromuscular system. However, few researchers have attempted to clarify the influence of playing classical musical instruments on posture. On average, a musician plays 1300 hours per year in an ergonomically unfavourable position. Instruments that require different positions and playing techniques are associated with varying prevalence of musculoskeletal disorders. A study conducted among conservatory students highlighted a high prevalence of postural alterations without the instrument (66.2%) and a non-optimal posture with the instrument in 73.4% of cases. Instruments that impose asymmetrical postures, such as the violin, viola, and flute, were found to be the main risk factors for incongruent postures.
Musicians who play with their arms above the scapulo-humeral plane are also more prone to suffer from PRMDs in the upper limb compared to those who play in a neutral position. Correcting these conditions, which represent one of the main risk factors for the development of musculoskeletal disorders in workers, depends on understanding the influencing factors and implementing an appropriate therapeutic and preventive approach.
Regarding the ergonomic risk assessment in orchestra musicians, recent reviews have highlighted that there are few publications on this subject. There is more information available on questionnaires used to assess symptoms reported by musicians due to inflammatory processes and musculoskeletal disorders, such as the \"Standardized Nordic Questionnaire\"; the DASH (Disabilities of the Arm, Shoulder, and Hand), and the MPIIQM (Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians).
The objectives of the study on a sample of orchestra musicians are:
* To study the prevalence of abnormal posture with and without instruments and describe them quantitatively.
* To investigate whether and which abnormal posture are associated with pain and PRMDs.
* To identify any risk factors for the development of abnormal posture, pain, and PRMDs.
* To study the impact of abnormal posture and PRMDs on professional life. If the study hypothesis is confirmed, it would demonstrate the high prevalence of abnormal posture among professional musicians and the significant impact on their performance and professional activity. Another effect would be raising awareness among professional musicians about the physical stresses they are exposed to and the disorders they may develop, which are still often misunderstood and underestimated by the musicians themselves.
Confirming our hypothesis would concurrently lead to an enhancement of the ongoing activities.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 250
- Professional musicians from major Italian orchestras
- Pain associated with acute trauma
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Pain, Limitation and Posture last week the week prior to the assessment The investigators will evaluate if there is a correlation between pain with and without functional limitation with the following measure: trunk inclination, cervical inclination, dorsal curve, lumbar curve , right shoulder position, right shoulder height, right scapulae, left shoulder position, left shoulder height, left scapulae last week before the assessment
Pain, Limitation and Posture last six months the six months prior to the assessment The investigators will evaluate if there is a correlation between pain with and without functional limitation with the following measure: trunk inclination, cervical inclination, dorsal curve, lumbar curve , right shoulder position, right shoulder height, right scapulae, left shoulder position, left shoulder height, left scapulae during the last 6 months before the assessment
- Secondary Outcome Measures
Name Time Method Degrees of Trunk Rotation (TR) at the assessment time The investigators will calculate in degrees the difference between trunk rotation with and without musical instrument measured by the Physical Analyzer Portable .
Prevalance of pain without functional limitation during last week the week prior to the assessment The investigators will calculate the prevalance of pain without functional limitation for the week prior to the assessment using questionnaire data
Prevalence of pain without functional limitation during last six months the six months prior to the assessment The investigators will calculate the prevalance of pain without functional limitation for the six months prior to the assessment using questionnaire data.
Prevalance of pain with functional limitation during last week the week prior to the assessment The investigators will calculate the prevalance of pain with functional limitation for the week prior to the assessment using questionnaire data
Prevalence of pain with functional limitation during last six months the six months prior to the assessment The investigators will calculate the prevalance of pain with functional limitation for the six months prior to the assessment using questionnaire data.
Pain with o without functional limitation during last week and personal and playing habit the week prior to the assessment The investigators will evaluate if there is a correlation between the "prevalance of pain with and without functional limitation during last week" with the personal and playing habits collected with the questionnaire.
Pain with o without functional limitation during last six months week and personal and playing habit the six months prior to the assessment The investigators will evaluate if there is a correlation between the "prevalance of pain with and without functional limitation during last six months" with the personal and playing habits collected with the questionnaire.
Degrees of Trunk Inclination (TI) at the assessment time The investigators will calculate in degrees the difference between trunk inclination with and without musical instrument measured by the Physical Analyzer Portable .
Degrees of Cervical Inclination (CI) at the assessment time The investigators will calculate in degrees the difference between cervical inclination with and without musical instrument measured by the Physical Analyzer Portable .
Right shoulder vertical shift at the assessment time The investigators will calculate in millimeters the difference between right shoulder height with and without musical instrument measured by the Physical Analyzer Portable .
Left shoulder vertical shift at the assessment time The investigators will calculate in millimeters the difference between left shoulder height with and without musical instrument measured by the Physical Analyzer Portable .
Right shoulder sagittal shift at the assessment time The investigators will calculate in millimeters the difference between right shoulder position on sagittal plane with and without musical instrument measured by the Physical Analyzer Portable .
Left shoulder sagittal shift at the assessment time The investigators will calculate in millimeters the difference between left shoulder position on sagittal plane with and without musical instrument measured by the Physical Analyzer Portable .
Right Scapula lateral shift at the assessment time The investigators will calculate in millimeters the difference between right scapula position with and without musical instrument measured by the Physical Analyzer Portable .
Left scapula lateral shift at the assessment time The investigators will calculate in millimeters the difference between left scapula position with and without musical instrument measured by the Physical Analyzer Portable .
Dorsal curve change at the assessment time The investigators will calculate in millimeters the difference between dorsal curve with and without musical instrument measured by the Physical Analyzer Portable .
Lumbar curve change at the assessment time The investigators will calculate in millimeters the difference between lombar curve with and without musical instrument measured by the Physical Analyzer Portable .
Trial Locations
- Locations (1)
IRCCS Santa Maria Nascente Fondazione Don Carlo Gnocchi
🇮🇹Milano, MI, Italy