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Journal ArticleDOI

Injured Professional Musicians and the Complex Relationship between Occupation and Health

05 Jul 2012-Journal of Occupational Science (Taylor & Francis Group)-Vol. 19, Iss: 3, pp 258-270
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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Journal ArticleDOI

2,629 citations

Journal ArticleDOI
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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Journal ArticleDOI
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

References
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Journal ArticleDOI
TL;DR: The minimum prevalence of the condition was found to be 9.3% in seven Australian performing music schools and in two music schools where the study was more controlled the incidences were 13% and 21% as mentioned in this paper.
Abstract: Overuse (injury) syndrome, common in musicians, is characterised by persisting pain and tenderness in the muscles and joint ligaments of the upper limb due to excessive use and in more advanced instances by weakness and loss of response and control in the affected muscle groups. This occurs typically in tertiary music students when their practice load is raised. In seven Australian performing music schools the minimum prevalence of the condition was found to be 9.3%. In two music schools where the study was more controlled the incidences were 13% and 21%. The factors leading to overuse (injury) syndrome may be identified as follows: the genetic factor of vulnerability which cannot be altered; the student's technique which may be influenced by teaching and application so that it is more "energy efficient"; and the time X intensity of practice which is totally within the student's control. Prevention involves education of staff and students about the overuse process, rationalisation of practice habits and repertoire, abolition or reduction of static loading of the weight of the instruments, and earlier reporting when the problem is most easily corrected. Psychological problems arising in this syndrome appeared to occur as a reaction to the condition rather than as a causal factor.

117 citations


"Injured Professional Musicians and ..." refers background in this paper

  • ...Mitigating factors include taking breaks and performing a physical warm-up (Lockwood, 1989), and teaching students more efficient practice techniques (Fry, 1987)....

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  • ...Mitigating factors include taking breaks and performing a physical warm-up (Lockwood, 1989 ), and teaching students more efficient practice techniques (Fry, 1987 )....

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Journal ArticleDOI
TL;DR: An investigation into the occupational world of a group of inmates in one of New Zealand's largest maximum security prisons and an assessment of the occupational needs of the inmates is outlined.
Abstract: occupational deprivation is a concept which we are in the early stages of conceptualising and defining. However, that does not make it any less real to those who have experienced extended periods of occupational deprivation. This paper outlines an investigation into the occupational world of a group of inmates in one of New Zealand's largest maximum security prisons. These inmates were part of a special unit as they were identified as having special needs. The project started in response to a request from the prison to establish an occupational therapy programme in the unit. Through further dialogue it became clear that there were more basic questions that needed to be addressed. What was required was an assessment of the occupational needs of the inmates and this was subsequently agreed to and contracted for.. Occupational Needs Assessment Process The process of investigation included a time use survey, a review of current levels of occupational engagement of all inmates and an assessment of ind...

116 citations


"Injured Professional Musicians and ..." refers background in this paper

  • ...These include occupational disruption, which has been defined as ‘‘deprivation from access to occupation’’ (Whiteford, 1997, p. 126) within a relatively short timeframe (as distinguished from deprivation, which takes place over an extended period of time)....

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Journal ArticleDOI
S. Kay Toombs1
TL;DR: This essay argues that, while much has been gained by medicine's focus on the spatial aspects of disease in light of developments in modern pathology, too little attention has been given to the temporal experience of illness at the subjective level of the patient.
Abstract: This essay argues that, while much has been gained by medicine's focus on the spatial aspects of disease in light of developments in modern pathology, too little attention has been given to the temporal experience of illness at the subjective level of the patient. In particular, it is noted that there is a radical distinction between subjective and objective time. Whereas the patient experiences his immediate illness in terms of the ongoing flux of subjective time, the physician conceptualizes the illness as a disease state according to the measurements of objective time. A greater understanding of this disparity in temporal experiencing provides insights into the lived experience of illness and can preclude difficulties in communication between physician and patient.

101 citations


"Injured Professional Musicians and ..." refers background in this paper

  • ...Similarly, Toombs (1990) reported that people who are in ill health experience time as moving more slowly....

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Book ChapterDOI
S. Kay Toombs1
01 Jan 2001
TL;DR: In this paper, the authors discuss the phenomenology of illness and disability and their own experience living with multiple sclerosis, an incurable, progressively disabling disease of the central nervous system.
Abstract: My interest in the phenomenology of illness and disability has grown out of my own experience as a person living with multiple sclerosis, an incurable, progressively disabling disease of the central nervous system. Over the past twenty-eight years (since the age of 30) my physical capacities have altered in a startling number of ways. At one time or another my illness has affected my ability to see, to feel, to move, to hear, to stand up, to sit up, to walk, to control my bowels and my bladder, and to maintain my balance. Some abilities, such as sensing the position of a limb, I have lost abruptly and then slowly regained. Some, such as clear vision in one or the other eye, I have lost and regained numerous times. Other physical capacities have disappeared and never returned. I can, for example, no longer walk because I am unable to lift my legs. This latter change has, however, been gradual. For a number of years, although the muscles in my legs gradually weakened, I was able to get around “on my own two feet” using first a cane, then crutches, and finally a walker for support. Several years ago I was forced to give up the walker and begin full-time use of a wheelchair for mobility.

88 citations


"Injured Professional Musicians and ..." refers background in this paper

  • ...In healthcare, phenomenology often answers questions about how individuals experience particular health concerns (Doherty & Scannell-Desch, 2008; Goldberg, 2008; Ingadottir & Halldorsdottir, 2008; Parsons-Suhl, Johnson, McCann, & Solberg, 2008; Russell, Thille, Hogg, & Lemelin, 2008; Toombs, 2001)....

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  • ...This observation has also been noted by Toombs (1995, 2001) and Leder (1990)....

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Journal ArticleDOI
TL;DR: In this paper, the authors analyse balance of everyday occupations from a novel experiential viewpoint, using an alternative model in which the eight channels are condensed into three dimensions; High Matched Experiences, High Not matched Experiences and Low Challenge Experiences.
Abstract: The Experience Sampling Methodology (ESM) being elaborated within flow theory provides a unique opportunity to collect data about occupational experiences. Both four‐ and eight‐channel models have been developed, to capture various dimensions of people's lived experience. However neither of these models seems suitable for analysis and discussion of balance within everyday life and its relationship to other factors such as well‐being. The purpose of this study was to analyse balance of everyday occupations from a novel experiential viewpoint, using an alternative model in which the eight channels are condensed into three dimensions; High Matched Experiences, High Not Matched Experiences and Low Challenge Experiences. A secondary analysis of published data from four cross‐cultural ESM‐studies with a total of 159 participants from three countries was conducted. The results show a similar pattern in all samples, with Low Challenge Experiences comprising barely half of the pattern and the other two di...

87 citations


"Injured Professional Musicians and ..." refers background in this paper

  • ...Jonsson and Persson (2006) also explored the negative consequences of flow, specifically mentioning a study by Ware and Kleiman (1992) who examined flow experiences in information technology, as the Internet evolved at the beginning of the 1990s....

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