Karoline V. Kumke

Bio: Karoline V. Kumke is an academic researcher. The author has contributed to research in topics: Mental health & Human factors and ergonomics. The author has an hindex of 1, co-authored 1 publications receiving 27 citations.

A Pilot Study of Occupational Injury and Illness Experienced by Classical Musicians

Abstract: Limited attention is paid to the hazards experienced by orchestra musicians in the occupational health and safety literature. Within that literature, the primary focus has been on noise exposure. A focus on this area is warranted because high sound pressure levels are a product of this work environment. However, in addition to being at risk for noise-induced hearing loss, workers are also at risk for musculoskeletal injury and illness related to stressful body postures held for prolonged work periods. The socio-political forces of employment may place workers at risk for mental health disorders (e.g., depression). The researchers distributed an anonymous survey to classical orchestra musicians in the southwestern United States. The survey inventoried several areas related to occupational health risks. Results suggest low health care-seeking behaviors relative to self-reported signs and symptoms of morbidity. Musicians also reported limited formal training and education regarding occupational health risks. Risk information was provided late in their professional development. This is a particular concern because of the young age at which music training is initiated.

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.

기업지배구조의 합주(Orchestration)

Abstract: 본 연구는 외환위기 이후 급격한 변화를 겪고 있는 국내 기업 풍토에서 대리인 이론의 적용 여부를 검증하고, 장기적인 가치 증진에 도움이 되는 한국적 기업 지배구조 모형을 도출하는 데에 목적이 있다. 이러한 목적의 달성을 위하여 저자는 소유의 집중도, 기관투자가 지분율, 외국인 지분율, 사외이사 비율 등의 기업 지배구조 변수를 도입하고, 이들 변수들이 단독 또는 상호 결합하여 균형투자에 어떠한 영향을 미치는 지를 분석했다. 저자의 중요한 가정 중 하나는 지배구조 구성 요소들은 단독으로 보다는 상호 결합하여 더 큰 효과를 발휘한다는 것이다. 399개 상장 기업을 대상으로 하여 실증 분석한 결과, 외국인 지분율, 사외이사 비율 등은 균형투자에 긍정적인 영향을 미치는 것으로 나타났다. 또한, 외국인 지분율과 사외이사 비율 상호작용 항과 외국인 지분율과 기관투자가 지분율 상호작용 항도 균형투자에 긍정적인 영향을 미치는 것으로 나타났다. 본 연구의 결과는 첫째, 사외이사와 외국인 투자가는 기업이 장기적 성과 향상을 담보하는 투자를 유도하는 역할을 한다는 것과 둘째, 기관투자가, 외국인 투자가, 사외이사 등은 상호 결합하여 경영자의 기회주의적 행동을 보다 효과적으로 억제한다는 것을 시사한다.본 연구의 결과는 경영자의 도덕적 해이 방지에 골몰하고 있는 기관투자가, 외국인 투자가 등의 주주는 물론 기업 지배구조와 관련된 정책 마련에 고심하고 있는 정책 당국, 소액주주 운동을 펼치고 있는 시민단체, 그리고 자신의 투자 행동 방향을 놓고 고민하는 경영자에게 유용한 지침을 제공할 것이다.

Effect of a musicians' exercise intervention on performance-related musculoskeletal disorders.

Abstract: PURPOSE: To evaluate the effect of a purpose-designed exercise program on performance-related musculoskeletal disorders (PRMDs) and associated risk factors in a sample of professional orchestral musicians. METHODS: A 10-week exercise program was made available to full-time musicians employed by the eight premier symphony orchestras of Australia. Questionnaires were administered before, immediately after (T1), and 6 months after interventions (T2) containing questions relating to change in frequency and severity of PRMDs, ratings of perceived exertion (RPE) during rehearsal, private practice, and performance, as well as nine performancerelated factors. Participants were also asked to rate whether these performance-related factors affected their overall playing capacity during different playing situations. A comparative control group of musicians had no intervention and completed a modified questionnaire at the same time points. RESULTS: Exercise participants (n=30) reported a reduction in frequency (p<0.05) and severity (p<0.05) of PRMDs at T1 but not at T2 compared to controls (n=23). The exercise group reported a significant improvement in RPE during private practice at T1 (p<0.01) and T2 (p<0.01), but not during rehearsal and performance. At T1, the intervention was rated to be moderately to highly effective for three performancerelated factors: strengthening muscles that support playing, learning techniques that support playing, and posture. Further, participants reported an intervention effect on overall playing capacity during rehearsal at T1 and T2. CONCLUSIONS: A tailored exercise program for musicians was effective at managing PRMDs, especially in reducing the frequency and severity of PRMDs. Physical therapy exercises should be considered in modifying performance-related factors that have been reported to be predictors of PRMDs. Med Probl Perform Art 2014; 29(4):181–188.

Hearing Loss, Tinnitus, Hyperacusis, and Diplacusis in Professional Musicians: A Systematic Review

Abstract: Professional musicians (PMs) are at high risk of developing hearing loss (HL) and other audiological symptoms such as tinnitus, hyperacusis, and diplacusis. The aim of this systematic review is to (A) assess the risk of developing HL and audiological symptoms in PMs and (B) evaluate if different music genres (Pop/Rock Music—PR; Classical Music—CL) expose PMs to different levels of risk of developing such conditions. Forty-one articles including 4618 PMs were included in the study. HL was found in 38.6% PMs; prevalence was significantly higher among PR (63.5%) than CL (32.8%) PMs; HL mainly affected the high frequencies in the 3000-6000 Hz range and was symmetric in 68% PR PMs and in 44.5% CL PMs. Tinnitus was the most common audiological symptom, followed by hyperacusis and diplacusis. Tinnitus was almost equally distributed between PR and CL PMs; diplacusis was more common in CL than in PR PMs, while prevalence of hyperacusis was higher among PR PMs. Our review showed that PR musicians have a higher risk of developing HL compared to CL PMs; exposure to sounds of high frequency and intensity and absence of ear protection may justify these results. Difference in HL symmetry could be explained by the type of instruments used and consequent single-sided exposure.

Musculoskeletal disorders and complaints in professional musicians: a systematic review of prevalence, risk factors, and clinical treatment effects.

Abstract: Musicians’ practice and performance routines reportedly lead to musculoskeletal complaints and disorders (MCD) that impact their wellbeing and performance abilities. This systematic review aims to assess the prevalence, risk factors, prevention and effectiveness of treatments for MCD in professional musicians and consider the methodological quality of the included studies. A systematic literature search was performed in December 2017 using electronic databases and supplemented by a hand search. Case–control studies, cohort studies, cross-sectional studies, interventional studies and case reports investigating the prevalence, risk factors, prevention or treatment effects of MCD in professional musicians or music students (age ≥ 16 years) were included. Quality assessments of the included studies were performed using an adapted version of the “Study Quality Assessment Tools” from the National Heart, Lung, and Blood Institute. One case–control study, 6 cohort studies, 62 cross-sectional studies, 12 interventional studies and 28 case reports were included and assessed for methodological quality. The study designs, terminology, and outcomes were heterogeneous, as the analyses mostly did not control for major confounders, and the definition of exposure was often vague. Therefore, evidence that being a professional musician is a risk factor for MCD as well as the causal relationship between these factors remains low despite the fact that a large number of studies have been performed. Studies with high internal and external validity regarding the prevalence, risk factors and effectiveness of the prevention or treatment of MCD in professional musicians are still missing. Further high-quality observational and interventional studies are required.