title: The occurrence of musculoskeletal complaints among professional musicians: a systematic review.
abstract: OBJECTIVE
  This study gives a systematic overview of the literature on the occurrence of musculoskeletal complaints in professional instrumental musicians.
  
  
  METHODS
  A systematic review. Nine literature databases were searched without time limits on June 25, 2015, also the complete index of the journal Medical Problems of Performing Artists (MPPA) until June 2015 (30;2) was searched, and citation tracking and reference checking of the selected articles were performed. The search consisted of the combination of three groups of keywords: musician (e.g., musician, violin, music student, instrument player) AND musculoskeletal (e.g., musculoskeletal, tendon, shoulder, arthritis) AND epidemiology (e.g., prevalence, incidence, occurrence).
  
  
  RESULTS
  The initial literature search strategy resulted in 1258 potentially relevant articles. Finally, 21 articles describing 5424 musicians were included in this review. Point prevalences of musculoskeletal complaints in professional musicians range between 9 and 68 %; 12-month prevalences range between 41 and 93 %; and lifetime prevalences range between 62 and 93 %. Ten out of 12 studies show a higher prevalence of musculoskeletal complaints among women. Brass instrumentalists are reported to have the lowest prevalence rates of musculoskeletal complaints. The neck and shoulders are the anatomic areas most affected; the elbows are least affected. Although some information is reported concerning age, the high risk of bias in and between these studies makes it impossible to present reliable statements with respect to this.
  
  
  CONCLUSIONS
  Musculoskeletal symptoms are highly prevalent among musicians, especially among women instrumentalists. Future research concerning the epidemiology of musculoskeletal complaints among musicians should focus on associated risk factors and follow the current guidelines to optimize scientific quality.
authors.affiliation: Department of Orthopedics, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. laura.m.kok@gmail.com.|Department of Orthopedics, Spaarne Hospital, Hoofddorp, The Netherlands. laura.m.kok@gmail.com.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Kok
authors.affiliation: Department of Orthopedics, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.|Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Bionka M A
authors.initials: BM
authors.lastname: Huisstede
authors.affiliation: Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Veronique M A
authors.initials: VM
authors.lastname: Voorn
authors.affiliation: Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jan W
authors.initials: JW
authors.lastname: Schoones
authors.affiliation: Department of Orthopedics, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
authors.forename: Rob G H H
authors.initials: RG
authors.lastname: Nelissen
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000209:etiology; D009146:Music; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012307:Risk Factors
keywords: Arts; Epidemiology; Music; Musician; Occupational; PRMD