title: The usefulness of on-site physical therapy-led triage services for professional orchestral musicians -- a national cohort study.
abstract: BACKGROUND
  Australian professional orchestral musicians reported a lifetime prevalence of musculoskeletal injuries that had interfered with playing at 84%. Physical therapy-led triage clinics may be a practical method to manage the impact of high performance-related musculoskeletal disorders (PRMDs) in professional orchestral musicians. This study aimed to: a) collect information on presenting injuries, b) determine the participant's provisional diagnosis, c) evaluate uptake of an on-site triage service, d) measure participant satisfaction, and e) identify factors influencing attendance.
  
  
  METHODS
  Eight triage sessions were run on a fortnightly basis during a designated lunch break between rehearsal calls in seven premier symphony orchestras in Australia; a total population of 483 musicians. The participants received one or a combination of: a) education and advice relating to their provisional diagnosis, b) basic acute management and/or c) a referral to a suitable medical practitioner or allied health professional for further consultation or treatment. A three-month follow-up questionnaire was completed and a qualitative narrative themes-based analysis was undertaken to summarise participant and physical therapist feedback. Uptake, participant satisfaction and factors influencing attendance were measured.
  
  
  RESULTS
  99 initial consultations (83 individuals) were conducted with more females (61%) utilizing the service than males (49%). The most common injury complaints were in the shoulder (22%), neck (18%), upper back (18%), and hand (8%). 66% of these were diagnosed as PRMDs. Of these injuries, 94% were considered preventable, 93% continued to affect playing, 68% were severe requiring a referral for further management, and 46% were recurrent. The advice at the triage service was rated as helpful or very helpful by 79% of the musicians, whilst 68% responded they were likely or very likely to continue to use the service if it was offered in the future. Of the participants that followed through with the referral advice, 67% reported that the referral advice was helpful or very helpful. Musicians' and physical therapists' written feedback indicated their acknowledgement for the need of this service. The main suggestions for improving attendance were increasing the music-specific physical therapy knowledge of therapists and overcoming competing time demands.
  
  
  CONCLUSIONS
  On-site health services for musicians may facilitate better injury management by providing immediate and specific health advice.
  
  
  BACKGROUND
  ACTRN12612000220864.
authors.affiliation: Discipline of Biomedical Science, Sydney Medical School, P,O, Box 170, Lidcombe, NSW, 1825, Australia. cliffton.chan@sydney.edu.au
authors.forename: Cliffton
authors.initials: C
authors.lastname: Chan
authors.forename: Tim
authors.initials: T
authors.lastname: Driscoll
authors.forename: Bronwen
authors.initials: B
authors.lastname: Ackermann
mesh_terms: D000328:Adult; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D020821:Dystonic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D026201:Musculoskeletal Manipulations / Q000379:methods*; D009146:Music; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D014218:Triage / Q000379:methods*