| Instrumental musicians may constitute the least recognized and most under-served large occupational group at risk for upper-extremity musculoskeletal disorders (UEMSD). This study investigated the cross-sectional prevalence of UEMSD (as defined by self-reported symptoms) and Carpal Tunnel Syndrome (CTS), within a population of professional musicians belonging to two musicians union(s). Musicians in each union were asked to complete a mailed questionnaire on physical and psychosocial stressors in both primary (music) and secondary jobs, covering both generic ergonomic and music-specific factors, as well as demographics, medical history and UEMSD symptoms. This study assessed the frequency of specific biomechanical and psychosocial exposures in music and other jobs as well as of UEMSD, and the separate and combined contributions of these exposures in the prevalence of UEMSD. The Cox Regression Model was used to perform univariate and multivariate regressions on both symptoms prevalence and CTS. A number of key physical and psychosocial exposures including orchestral playing, playing upper-strings instruments, upper-extremity strain factors, psychosocial strain (JCQ) factors, and music-specific psychosocial factors were significantly associated with UEMSD in musicians (p<0.10). Biomechanical and psychosocial factors were strong predictors of UEMSD both individually and in various combinations, though interactions between them were not particularly strong. An experimental study was also performed to assess actual stress responses that result from specific work organizational factors inherent in the orchestral audition process. A light-weight, portable and non-invasive heart rate monitor was used to record heart rate and heart-rate variability activity before, during and after a natural quartet performance in a non-intimidating and relaxed setting and during a stressful and less stressful audition trial. The magnitude and differences in mean heart rate and heart rate variability values between baseline and task for each performance situation was assessed using the generalized estimating equation (GEE) method. Closed audition trials yielded higher stress responses, i.e., higher heart rate and lower heart-rate variability, than natural performances, and the stressful audition yielded more stressful responses than the less stressful audition, suggesting that the rigors and inherent features of the closed audition process should be investigated for their potential contribution to stress and stress-related diseases. |
