Jonas W Holm

Bio: Jonas W Holm is an academic researcher. The author has contributed to research in topics: Risk assessment & Phone. The author has an hindex of 2, co-authored 2 publications receiving 153 citations.

Prevalence and consequences of musculoskeletal symptoms in symphony orchestra musicians vary by gender: a cross-sectional study

Abstract: Musculoskeletal symptoms are common in the neck, back, and upper limbs amongst musicians. Playing-related musculoskeletal disorders have been found to range from 32% to 87% with a tendency for female musicians to have more problems than males. Studies of musculoskeletal problems in instrumentalists have generally involved pre-professional musicians or populations comprising musicians of different levels. The objective of this study was therefore to investigate the prevalence, duration and consequences of musculoskeletal symptoms in professional symphony orchestra musicians. A cross-sectional questionnaire study. The study population comprised of 441 musicians from six Danish symphony orchestras; 342 (78%) completed the questionnaire. During the last year 97% of the women and 83% of the men experienced symptoms in at least one of nine anatomic regions (neck, upper and lower back, shoulders, elbows, and hands and wrists). 86% of the women and 67% of the men experienced symptoms for more than seven days, while 63% of the women and 49% of the men had symptoms for more than 30 days. Woodwind players had a lower risk for musculoskeletal symptoms and a lower risk for the consequences. Among consequences were changed way of playing, reported by 73% of the musicians, difficulty in daily activities at home, reported by 55%, and difficulty in sleeping, reported by 49%. Their health behaviour included taking paracetamol as the most used analgesic, while physiotherapists and general practitioners were reported as the most consulted health care professionals concerning musculoskeletal problems. Results regarding symptoms in six anatomic regions were compared to results for a sample of the general Danish workforce. Symptoms were more frequent in musicians and lasted longer than in the general workforce. This applied to both genders. Within the last year most symphony orchestra musicians experienced musculoskeletal symptoms in the neck, back or upper extremities. The symptoms impacted on their level of function in and outside work and were reflected in their health behaviour. Generally women had a higher risk than men and woodwind players a lower risk than other instrumentalists. Finally, symptoms were more frequent and lasted longer in the musicians than in the general workforce.

Occurrence and co-existence of localized musculoskeletal symptoms and findings in work-attending orchestra musicians - an exploratory cross-sectional study

Abstract: Background Due to ergonomic exposure musicians are at risk of work-related musculoskeletal disorders in the neck, back, and upper extremities. The literature confirms musculoskeletal problems in these anatomic regions among orchestra musicians.

Perspectives in risk communication due to the PFOS pollution case in Korsoer, Denmark

Abstract: Background In spring 2021 Denmark identified the first PFOS-pollution case deriving from a firefighting school. Through the last 20 years, members of a local cow grazing association had consumed veal having grazed on the contaminated area. The department of Occupational Medicine in Holbaek was contacted by the chairman of the regional council, and asked to investigate the members. In August 2021 118 of the members were found to have elevated blood levels of PFOS. Aim To present our risk communication strategy on individual, group and community level. Methods We gathered knowledge about PFAS by searching the literature and establishing collaboration with experts, research institutions and authorities to be able to perform adequate risk communication based on a risk assessment to the members of the cow grazing association, the Danish authorities and the media. Results We provided risk communication at different levels. (1) Individual level on medical consultations and by availability through the phone as needed; (2) group level by oral and written information with members of the cow grazing association; and (3) community level by contact with the media, and participation on an expert group set up by the National Board of Health. Conclusion Understanding the different ‘senders and receivers’ in risk communication is important to avoid unnecessary concerns and costs. Preliminary assessments is required before a proper exposure and risk assessment is done. It is important to consider how to present scientific uncertainties. Risk perception influences behavior in both individuals, group and public health level often regardless laws, regulations and expert evaluations as risks always are interpreted politically or value-related. Cooperation across professional groups and sectors is essential to be able to handle these types of cases constructively. Keywords Risk communication, PFOS, PFAS, food contamination

The occurrence of musculoskeletal complaints among professional musicians: a systematic review

Abstract: Purpose This study gives a systematic overview of the literature on the occurrence of musculoskeletal complaints in professional instrumental musicians.

Frequency, severity and predictors of playing-related musculoskeletal pain in professional orchestral musicians in Germany.

Abstract: Playing-related musculoskeletal disorders (PRMD) in professional musicians are common. Existing literature demonstrates that up to 86 % of musicians are affected. The aim of the study was to evaluate the frequency of musculoskeletal pain in professional orchestral musicians with regard to their instrument affiliation. Of special interest were pain intensity and its association with predictors such as gender, instrument group, age or stage fright. Professional orchestra players completed a self-report questionnaire to assess playing-related musculoskeletal pain and its frequency and intensity in various body regions on a numeric rating scale (NRS). Relative frequencies and prevalence ratios for different instrument groups were estimated. Out of 720 approached musicians, 408 were included in the sample (response rate 57 %); overall, 89.5 % had been affected by current or past playing-related musculoskeletal pain, 62.7 % reported pain in the previous 3 months, and 8.6 % reported current pain. Pain distribution and frequency varied between instrument groups. For all instrument groups, the neck was the most common pain region. About 43 % of musicians presented more than five pain regions, in particular violin players. Approximately 40 % of musicians indicated frequent or permanent pain. Average pain intensities increased from NRS 3.8 up to a range of 5.9 and 7.4 for frequent and permanent pain, respectively. Female gender and stage fright were proven to be predictors for musculoskeletal pain. Professional orchestral musicians are greatly affected by PRMD, often experiencing frequent or permanent pain, high pain levels and pain in various body regions. As PRMD might contribute considerably to performance disability, sick leave and the possibility of premature termination of a musicians' career, this study highlights the necessity for tailored therapeutic and preventive strategies in performing arts medicine.

A comparative study on the prevalence of musculoskeletal complaints among musicians and non-musicians.

Abstract: Research comparing the frequency of musculoskeletal complaints between musicians and non-musicians is scarce. The aim of this study was to compare the prevalence of musculoskeletal complaints between musicians and non-musicians. A cross-sectional study in 3215 students from three music academies (n = 345) and one medical school (n = 2870) in The Netherlands was performed, using an electronic questionnaire. The questionnaire included socio-demographic characteristics, use of music instruments and the occurrence of musculoskeletal complaints in six body regions. Questions were related to musculoskeletal complaints over the last twelve months and at the time of the questionnaire. Chi-square, t-tests and Kruskal-Wallis tests were used for comparison between the two groups. The association between musculoskeletal complaints and possible predictors was analyzed using a logistic and Poisson regression. Eighty-seven music academy students and 503 medical students returned the questionnaire, of which respectively eighty-three and 494 were included in the study. Seventy-four music academy students (89.2%) reported one or more musculoskeletal complaints during the last twelve months, compared to 384 (77.9%) medical students (p = 0.019). Moreover 52 music academy students (62.7%) and 211 medical students (42.7%) reported current musculoskeletal complaints (p = 0.001). The Odds ratio (OR) for the development of musculoskeletal complaints during the last twelve months in music academy students versus medical students is 2.33 (95% CI 1.61–3.05, p = 0.022). The OR at the time of the questionnaire is 2.25 (95% CI 1.77–2.73, p = 0.001). The total number of complaints have been modeled by employing a Poisson regression; the results show that non-musicians have on average less complaints than musicians (p = 0.01). The adjusted means are 2.90 (95% CI 2.18–3.63) and 1.83 (95% CI 1.63–2.04) respectively for musicians and non-musicians. Regarding the localization of complaints, music academy students reported more complaints concerning the right hand, wrists, left elbow, shoulders, neck, jaw and mouth in contrast to medical students. Musculoskeletal complaints are significantly more common among musicians compared to non-musicians, mainly due to a higher number of upper extremity complaints.

Symptoms of anxiety and depression among Norwegian musicians compared to the general workforce

Abstract: In order to investigate mental health problems among professional musicians, we estimate the prevalence of symptoms of anxiety and depression (psychological distress) among musicians compared to the general workforce. A total sample of 1,607 musicians from the Norwegian Musicians Union answered an online questionnaire about demographic characteristics, lifestyle and symptoms of anxiety and depression. They were compared to a sample of the Norwegian workforce (n = 2,550) drawn from the Norwegian survey of level of living 2012. Based on logistic regression analysis adjusting for age, sex, education level, smoking status, alcohol usage, use of drugs, physical exercise and financial status, we compared anxiety and depression symptom levels in musicians to a variety of professions. Psychological distress was more prevalent among musicians than in the total workforce sample. Solo/lead performers, vocalists, keyboard instrument players and musicians playing within the traditional music genre reported the highest prevalence. Further research needs to map the psychosocial and personal factors contributing to the higher degree of depression and anxiety symptoms among musicians, as well as establishing evidence-based preventative measures.

Evidence-informed physical therapy management of performance-related musculoskeletal disorders in musicians.

Abstract: Playing a musical instrument at an elite level is a highly complex motor skill. The regular daily training loads resulting from practice, rehearsals and performances place great demands on the neuromusculoskeletal systems of the body. As a consequence, performance-related musculoskeletal disorders (PRMDs) are globally recognized as common phenomena amongst professional orchestral musicians. These disorders create a significant financial burden to individuals and orchestras as well as lead to serious consequences to the musicians’ performance and ultimately their career. Physical therapists are experts in treating musculoskeletal injuries and are ideally placed to apply their skills to manage PRMDs in this hyper functioning population, but there is little available evidence to guide specific injury management approaches. An Australia-wide survey of professional orchestral musicians revealed that the musicians attributed excessively high or sudden increase in playing-load as major contributors to their PRMDs. Therefore, facilitating musicians to better manage these loads should be a cornerstone of physical therapy management. The Sound Practice orchestral musicians work health and safety project used formative and process evaluation approaches to develop evidence-informed and clinically applicable physical therapy interventions, ultimately resulting in favourable outcomes. After these methodologies were employed, the intervention studies were conducted with a national cohort of professional musicians including: health education, onsite injury management, cross-training exercise regimes, performance postural analysis, and music performance biomechanics feedback. The outcomes of all these interventions will be discussed alongside a focussed review on the existing literature of these management strategies. Finally, a framework for best-practice physical therapy management of PRMDs in musicians will be provided.