MEDICAL PROBLEMS OF PERFORMING ARTISTS

Developing a Screening Tool for Psychological Stress in Musicians: The Lübeck Inventory on Musicians' Psychological Stress (LIMIT)
Sickert C, Alpheis S, Obleser J and Scholz DS
Psychological stress concerns many musicians and poses a risk for their mental and physical health. However, there are thus far no instruments that measure psychological stress of musicians in particular. We aimed to fill this gap by developing a questionnaire designed specifically to detect components that increase psychological strain in musicians.
Diagnostic Ultrasound Findings and Treatments in Cellists with Performance-Related Musculoskeletal Disorders: A Retrospective Study
Lin TK, Lam SK, Yeh MC, Dai LW and Su DC
Performance-related musculoskeletal disorders (PRMDs) are common among orchestral musicians, with string players, including cellists, at high risk due to their unique playing posture and forceful movements. Despite frequent reports of pain, especially in the upper back, shoulders, and hands, specific tissue pathologies in cellists remain underexplored. This study investigates ultrasound findings in cellists with PRMDs and their clinical implications.
Relationship Between Musculoskeletal Pain, Psychosocial Aspects, and Quality of Work Life in Violinists and Violists: A Cross-Sectional Study in Rio de Janeiro, Brazil
Cesar Santos A, Kochem FB and Crepaldi Lunkes L
Violinists and violists are prone to musculoskeletal pain due to repetitive movements, sustained postures, and long hours of practice. While performance-related musculoskeletal disorders are well documented internationally, little is known about their prevalence and psychosocial correlates among Brazilian professional musicians.
Craniocervical Characteristics of Wind Musicians: An Observational Study in Spanish Conservatory Students
Rodríguez-Gude C, Taboada-Iglesias Y and Pino-Juste M
Playing wind instruments may promote neck, arm, or shoulder pain, as well as temporomandibular pain. The cervical and orofacial regions are associated, due to their proximity and the influence they both have on body posture. In wind musicians, the mouth is responsible for producing the sound. Any alteration in the characteristics of the orofacial system can affect the embouchure when playing a wind instrument.
Ballet-Trained Individuals Demonstrate Reduced Postural Sway and Less Variation of Spinopelvic Kinematics Compared with an Age-Matched Untrained Group During Demi-Pointe Standing
Fujii E, Yoshida Y, Kuno-Mizumura M, Maeda N, Sasadai J and Urabe Y
The aesthetic demands require adaptations in posture that serve both functional efficiency and artistic purposes, but the relationship between spinopelvic alignment and center of pressure (COP) displacement in ballet dancers is understudied. Exploring the differences in these parameters between ballet-trained and untrained individuals could help determine whether the posture of dancers, adapted to aesthetic demands, is also efficient from a kinematic perspective. In this study, we compared postural sway characteristics and segmental kinematics between ballet dancers and non-dancers during three different standing positions with progressively increasing heel elevation (normal, 1/4 pointe, and demi-pointe). Additionally, this study sought to clarify the relationship between the spinopelvic and lower limb kinematics and the oscillations in the COP of the body.
Intra- and Inter-Rater Reliability of Pointe-Readiness Tests
Karim A, Patterson C and Wong M
To investigate via video review the intra-rater and inter-rater reliability of three pointe-readiness tests: the topple test, airplane test, and sauté test.
College Marching Band Artists' Access to and Satisfaction with Healthcare Providers
Merrill AL, Winkelmann ZK, Uriegas NA and Eberman LE
Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered care (PCC). The purpose of this study was to explore healthcare providers (HCPs) who MB artists have access to and the artists' perceptions of PCC.
Biomechanical Validation of a Dance-specific Heel Raise to Jump Progression
Haber C and Schärli A
In ballet, a single movement can be developed into multiple variations by changing factors such as direction or magnitude. Similarly, the Dance-Specific Graded Rehabilitation Program (DSGRP) is built on the progression of three factors: (1) movement (relevés, heel raises; explosive relevés [EXrelevé], heel raises with the intention to jump but not actually jumping; and sautés, small jumps), (2) leg support (double-leg and single-leg), and (3) barre support (two hands, one hand, and no hands). However, these factors are yet to be fully analyzed biomechanically.
Death Drop and Not Drop Dead: A Preliminary Examination of Drag Queen Health
Davenport KL, Yang JM, Mojica W, Padilla E and Viana JN
The health concerns of drag queens remain understudied. This paper examines the physical health and healthcare access of drag queens and reflects on ways to holistically promote their well-being.
The Footwear Gap in Marching Performance Artists: The Need for Research
Vanderkolff S and Riley ZA
Marching performers spend a significant amount of time on their feet practicing precise movements. Presumably, individuals choose footwear to practice in that is comfortable and suits their individual needs. However, when it comes to competition, there are a limited number of footwear options available, and they are not specialized to the individual. The purpose of this letter is to advocate for more research and the continued evolution of competitive footwear design for marching arts.
Cross-Cultural Adaptation and Validation of the Dance Functional Outcome Survey for Turkish Dancers (DFOS-TR)
Tekin D, Agopyan A, Okur Dündar Ş and Bronner S
In dance, injuries are significant factors that can bring an active dance career to an end. A patient-reported outcomes questionnaire with established validity and reliability is useful for determining and evaluating the functional status of dancers before or after injuries. However, no valid and reliable survey is available in Turkish to assess dancers' functionality levels. The objective of this study was to translate, culturally adapt, and validate the characteristics of the Turkish version of the Dance Functional Outcome Survey (DFOS-TR) in adult dancers.
Music Majors' Exercise Behavior and Motivations Relative to Other College Majors
Ruggieri J and Levy JJ
A comparative approach was used to determine, relative to a broader college student population, 1) the differences in music majors' exercise behaviors and 2) motivation to engage in regular exercise. Participants consisted of 115 non-music and 99 music college majors. Music majors reported engaging in significantly less global (work and leisure) physical activity, leisure physical activity, and moderate intensity exercise. There were no significant differences between music and non-music majors' weekly exercise frequency and engagement in light- and strenuous-intensity exercise. Regarding motivation, music majors endorsed stronger amotivation towards exercise, while non-music majors made stronger endorsements of three more self-determined motivations: identified regulation, integrated regulation, and intrinsic motivation to experience pleasurable sensations. No differences were observed for intrinsic motivation to learn or to accomplish. All participants failed to exceed the threshold for recommended physical activity, but music majors were even less engaged in moderate exertion exercise and overall leisure activities. Future studies are needed to assess how best to increase music majors' exercise engagement.
Quantification of Auditory-Motor Coordination as a Potential Return-to-Dance Criterion After Anterior Cruciate Ligament Reconstruction: A Case Report
Miura A, Ito S, Etani T, Okano M, Hoshiba T and Katakura M
For dancers who undergo anterior cruciate ligament (ACL) reconstruction, it is crucial to establish criteria for safely returning to dance without risking reinjury. Given the specific demands of dance, this case study aims to quantify the ability to coordinate knee movements with sounds and to analyze kinematics during the rehabilitation period. A female recreational street dancer participated in this study while undergoing rehabilitation after ACL reconstruction surgery. She performed knee flexion and extension movements to the beat of a metronome while standing, with both the movements and timing of the metronome beats recorded. Findings indicate that the muscle strength of her injured leg approached that of the uninjured side, suggesting steady rehabilitation progress. Although the range of knee joint angles did not differ between the injured and uninjured legs during the task, the injured knee exhibited less flexion and more extension. The participant was unaware of this increased extension in the injured leg. Additionally, the phase relationship between her rhythmic knee movements and the metronome beat changed unintentionally over the course of rehabilitation. Quantifying these unintentional changes in kinematics and their relationship to auditory beats can help establish appropriate criteria for a safe return to dance.
Musician Identity Measurement Scale: A Validation Study
Zuhdi N, Neumann C and Chesky K
Developing occupational identity is crucial for college students as it influences their career trajectories, mental health, and well-being. Music students, particularly, may experience challenges consistent with behaviors derived from their musician identity, such as prioritizing musical peruse over academic obligations and experiencing identity shifts during transitions in their musical training. However, existing research lacks consistency in defining musician identity. The lack of a well-defined conceptual framework for musician identity hinders the assessment of its changeability and the comparison of research findings. To address this issue, the present study aims to establish a conceptualization of musician identity through the validation of the Musician Identity Measurement Scale (MIMS) and the assessment of its factor structure. The study utilizes data from previous studies encompassing responses from 1,440 musicians (1,028 music majors and 412 non-music majors). The validation process included examining the MIMS' psychometric properties through exploratory structural equation modeling with robust weighted least squares estimation and evaluating measurement invariance by comparing configural and scalar models across sex and musician groups. Results support the MIMS as a valid 3-factor, reliable measure of musician identity and provide evidence for strong measurement invariance. The identified factor structure provides a foundation for future research exploring the musician identity, including how the three MIMS domains relate to various external correlates.
Influence of Stance Configuration on Postural Control While Performing Ballet Turns (Pirouette) in Novices and Experienced Dancers
Lin CW, Wu HW, Su FC and Lin CF
Pirouettes are often first taught from the "fourth position," which is a preparatory distance generally close to 100% of the dancer's foot length. However, the optimal preparation distance has not yet been studied. This study investigated the impact of stance configurations (preparatory distances) on postural control in ballet turns (pirouettes) between both experienced and novice dancers.
Injury Rates in Youth Street Dancers
Tran LM, Critchley ML, Shill IJ, Madrid A, George A, Emery CA and Kenny SJ
An increased concern for injury risk is associated with the rising popularity in street dance. Stunting movements in street dance are comparable to movements in aesthetic sports with documented high risks of concussions (e.g., cheerleading and gymnastics). Limited literature comments on street dance-related injuries and concussions in youth.
From Yesterday Until Today: To Celebrate a New Journal
Brandfonbrener AG
There are few opportunities in life to participate in a truly pioneering venture. Certainly the appearance of a new medical journal in itself is not startling news. However, a new journal that pertains to a new medical specialty with unique subject matter provides a potentially innovative and exciting experience. The purpose of Medical Problems of Performing Artists is to promote interest in the medical problems of performing artists, to help in the search for and dissemination of information, and by these means to promote the well-being of this vulnerable and valuable segment of our society. [This Editorial is reprinted from MPPA, March 1986, vol. 1, issue 1, page 1].
Perceptions and Prevalence of Anxiolytic Medication Usage for Performance Enhancement Among Musicians
Kuwabara A, Miller Olson E and Stanek JL
While anecdotal reports of the use of performance-enhancing medications to curb anxiety in performing artists abound, there has been no research to date assessing the prevalence of usage and attitudes towards use amongst the artists themselves. The objective of this study was to evaluate the perceptions, acquisition, and use of potentially performance-enhancing medications (benzodiazepines, beta-blockers, and cannabinoids) in the performing artist community to clarify the use of these medications to improve patient counseling and patient safety.
Association Between Bone Maturation, Menstrual Cycle, Hypermobility, Scoliosis, and Low Back Pain in Pre-Professional Female Adolescent Dancers
Everaert J, Fierens B, Steinberg N, Mahaudens P, Balagué F, Gielen P, Gielen J, van Breda E and Roussel N
Many adult dancers suffer from low back pain (LBP), which interferes with their movement strategies. A group that merits further attention are adolescent dancers as high levels of physical activity are associated with a higher risk to develop LBP.
A Descriptive Comparison of Oral Cavity Movements Between Brass Instrumentalists Performing Large Interval Slurs
Iltis PW, Frahm J, Voit D, Wright A and Dever A
We have previously described patterns of oral cavity movement in advanced French horn players during the performance of large interval slurs. The current study expands upon that work by reporting comparisons between horn, trumpet, and trombone players performing similar large interval exercises.
Enhancing Physiotherapy Care for Touring Performing Arts Companies: A Model for Quality and Continuity
Schaeffer M and Harary J
Touring presents significant physical and logistical challenges for performing artists, often leading companies to seek healthcare support. This paper outlines a physiotherapy care model developed by a performing arts clinic for a touring puppet company during a 38-city US tour. The model addressed common issues, such as lack of continuity of care, by establishing standard operating procedures (SOPs), pre-tour assessments, and the use of a unified electronic medical records (EMR) system. This ensured efficient communication among healthcare providers and improved the quality of care. Post-tour exit interviews revealed that the continuity and structure of care positively impacted both physical and mental well-being, leading to more effective treatment sessions. The absence of time-loss injuries throughout the tour further underscored the model's success. The paper concludes by recommending further research to explore the long-term effects of such care models and their potential to become standard practice for touring productions.