Injured Professional Musicians and the Complex Relationship between Occupation and Health
TL;DR: This mixed format (research and discussion) article addresses the relationship between occupation and health by including findings from a phenomenological study of the lived experience of professional musicians with playing-related injuries.
Abstract: This mixed format (research and discussion) article addresses the relationship between occupation and health. The conceptual discussion is deepened by including findings from a phenomenological study of the lived experience of professional musicians with playing-related injuries. Participants described decreased awareness of time and of their bodies when they were healthy, particularly when experiencing flow. Participants described flow as detrimental to their health, and used strategies to disrupt flow in order to continue in their chosen occupation. This choice can be seen as unhealthy, particularly in cases where the musician has been advised to decrease or stop playing for health reasons. However, occupational science theories favour individual choice in occupations. This apparent contradiction can be resolved if the definition of health is broad and includes justice and freedom to choose.
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01 Jan 2007
2,163 citations
TL;DR: 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 favorable outcomes.
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.
66 citations
Cites background from "Injured Professional Musicians and ..."
...Negative connotations of inferior technical competency are commonly directed at musicians suffering performance-related injuries by their peers (Guptill, 2011, 2012; Raymond et al., 2012)....
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TL;DR: A tailored exercise program for musicians was effective at managing PR MDs, especially in reducing the frequency and severity of PRMDs.
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.
51 citations
Journal Article•
TL;DR: A critical review of research examining the relationship between occupation and health and well-being found moderate to strong evidence that occupation has an important influence on health andWell-being for persons who experience a disability which affects their daily occupations.
Abstract: Occupational therapists believe that there is a relationship between occupation, health and well-being but there is little evidence in the occupational therapy literature to support this belief. This paper describes the results of a critical review of research examining the relationship between occupation and health and well-being. Twenty-two studies from the health and social sciences literature were reviewed using specific methodological review criteria. The findings of these studies provide moderate to strong evidence that occupation has an important influence on health and well-being. Because most of this research has been completed with persons without disabilities, further research is required to explain the nature of the relationship between occupation and health and well-being for persons who experience a disability which affects their daily occupations
49 citations
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Book•
26 May 2000
TL;DR: This chapter discusses how to start fieldwork, analyze the data, and write the results to reduce bias.
Abstract: Introduction - Marlene Z Cohen Writing the Proposal - Marlene Z Cohen How to Start Fieldwork - Richard H Steeves Ethical Issues and Ethical Approval - Marlene Z Cohen Sampling - Richard H Steeves How to Conduct Research - David L Kahn How to Analyze the Data - Marlene Z Cohen et al Reducing Bias - David L Kahn Writing the Results - Richard H Steeves
769 citations
"Injured Professional Musicians and ..." refers background in this paper
...I also met with an experienced qualitative researcher who was a member of my dissertation committee, in order to determine whether the analysis was plausible (Cohen et al., 2000; van Manen, 1997)....
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TL;DR: Significant benefits for the OT preventive treatment group were found across various health, function, and quality-of-life domains, and suggest that preventive health programs based on OT may mitigate against the health risks of older adulthood.
Abstract: Context. —Preventive health programs may mitigate against the health risks of older adulthood. Objective. —To evaluate the effectiveness of preventive occupational therapy (OT) services specifically tailored for multiethnic, independent-living older adults. Design. —A randomized controlled trial. Setting. —Two government subsidized apartment complexes for independentliving older adults. Subjects. —A total of 361 culturally diverse volunteers aged 60 years or older. Intervention. —An OT group, a social activity control group, and a nontreatment control group. The period of treatment was 9 months. Main Outcome Measures. —A battery of self-administered questionnaires designed to measure physical and social function, self-rated health, life satisfaction, and depressive symptoms. Results. —Benefit attributable to OT treatment was found for the quality of interaction scale on the Functional Status Questionnaire (P=.03), Life Satisfaction Index-Z (P=.03), Medical Outcomes Study Health Perception Survey (P=.05), and for 7 of 8 scales on the RAND 36-Item Health Status Survey, Short Form: bodily pain (P=.03), physical functioning (P=.008), role limitations attributable to health problems (P=.02), vitality (P=.004), social functioning (P=.05), role limitations attributable to emotional problems (P=.05), and general mental health (P=.02). Conclusions. —Significant benefits for the OT preventive treatment group were found across various health, function, and quality-of-life domains. Because the control groups tended to decline over the study interval, our results suggest that preventive health programs based on OT may mitigate against the health risks of older adulthood.
566 citations
"Injured Professional Musicians and ..." refers background or methods in this paper
...This is most powerfully illustrated by a paper informally known as the ‘well-elderly study’ (Clark et al., 1997), as discussed by Jackson et al. (1998) in a follow-up publication in the American Occupational Therapy Journal....
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...This is most powerfully illustrated by a paper informally known as the ‘well-elderly study’ (Clark et al., 1997), as discussed by Jackson et al....
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TL;DR: How a dynamic balance between doing and being is central to healthy living and wellness, and how becoming whatever a person, or a community, is best fitted to become is dependent on both is reflected.
Abstract: Occupation, and its relationship with health and well-being, is very complex. It can be described in many different ways by the profession within which it is so central that it provides its name. A simple way to talk about occupation that appears to appeal to a wide range of people is as a synthesis of doing, being and becoming. In the present paper I reflect on how a dynamic balance between doing and being is central to healthy living and wellness, and how becoming whatever a person, or a community, is best fitted to become is dependent on both. Doing is often used as a synonym for occupation within our profession and is so important that it is impossible to envisage the world of humans without it. Being encapsulates such notions as nature and essence, about being true to ourselves, to our individual capacities and in all that we do. Becoming adds to the idea of being a sense of future and holds the notions of transformation and self actualization. It is a concept that sits well with enabling occupation and with ideas about human development, growth and potential. Occupational therapists are in the business of helping people to transform their lives through enabling them to do and to be and through the process of becoming. In combination doing, being and becoming are integral to occupational therapy philosophy, process and outcomes, and some attention is given as to how we may best utilize these in self growth, professional practice, student teaching and learning, or towards social and global change for healthier lifestyles.
487 citations
Additional excerpts
...Indeed, occupational science as a discipline, and occupational therapy as a practice, were founded on this concept (Jackson, Carlson, Mandel, Zemke, & Clark, 1998; Law, Steinwender, & Leclerc, 1998; Molineux, 2004; Wilcock, 1998, 2005; Yerxa, 1998)....
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TL;DR: An ongoing, international dialogue about the relationship between occupation, justice, and client-centred practice, prompted by the question: How do occupational therapists work for justice is described, encouraging occupational therapists to develop their own dialogue about occupational injustices.
Abstract: Background. This paper describes an ongoing, international dialogue about the relationship between occupation, justice, and client-centred practice, prompted by the question: How do occupational therapists work for justice? Methods. The authors critically reflect on their own dialogue and culturally situated interests, dialogues with workshop participants, and a literature review. Results. Four cases of occupational injustice are proposed: occupational alienation, occupational deprivation, occupational marginalization, and occupational imbalance. The naming of these occupational injustices suggests four occupational rights: to experience meaning and enrichment in one's occupations; to participate in a range of occupations for health and social inclusion; to make choices and share decision-making power in daily life; and to receive equal privileges for diverse participation in occupations. Practice Implications. Since silence implies compliance with the status quo, the authors encourage occupational therap...
476 citations
"Injured Professional Musicians and ..." refers background in this paper
...Musicians in this study also experienced occupational marginalization, which ‘‘operates invisibly, a major force of injustice being normative standardization of expectations about how, when, and where people ‘should’ participate’’ (Townsend & Wilcock, 2004, p. 81)....
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