title: Correlation between risk factors and musculoskeletal disorders among classical musicians.
abstract: BACKGROUND
  Musculoskeletal disorders in humans may originate from biomechanical, environmental, psychosocial and personal risk factors encountered in the working environment. These disorders in musicians are designated as playing related musculoskeletal disorders (PRMD).
  
  
  OBJECTIVE
  To investigate the correlation between biomechanical, environmental, psychosocial and personal risk factors and potential incidence of PRMD arising in professional classical musicians.
  
  
  METHODS
  Fifty-nine orchestral classical musicians were observed: They also filled out questionnaires providing information regarding musculoskeletal symptoms, psychosocial factors and demography.
  
  
  RESULTS
  Clinical observation using the Rapid Upper Limb Assessment (RULA) showed significantly higher scores in string musicians compared with woodwind and brass players (right RULA score F = 4.77, P < 0.05; left RULA score, F = 3.90, P < 0.05). A multivariate regression model showed statistical significance for five of the six dependent variables regarding prevalence of painful joints, severity of musculoskeletal symptoms and functional limitation. The regression analysis revealed that biomechanical risk factors, perceived physical environment risk factors, instrument weight and average playing hours per week, were the main predictors of PRMD.
  
  
  CONCLUSIONS
  The biomechanical risk factors that predict PRMD are mainly associated with the upper limbs. A high association between PRMD and clinical observation emphasizes the need for further investigation of these risk factors and to study possible implementations in order to define 'prevention strategies' for musical routines and patterns, as used by classical musicians.
authors.affiliation: Department of Occupational Therapy, Tel Aviv University, PO Box 39040 Ramat Aviv, Tel Aviv 69978, Israel. yaelkauf@post.tau.ac.il
authors.forename: Y
authors.initials: Y
authors.lastname: Kaufman-Cohen
authors.forename: N Z
authors.initials: NZ
authors.lastname: Ratzon
mesh_terms: D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009135:Muscular Diseases / Q000453:epidemiology*; D009146:Music; D009784:Occupational Diseases / Q000453:epidemiology*; D010146:Pain / Q000453:epidemiology*; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology