Chan Cliffton, Driscoll Tim, Ackermann Bronwen J
Discipline of Biomedical Science, Sydney Medical School, University of Sydney, PO Box 170, Lidcombe, NSW 1825, Australia. Tel +61-2-9351 9244. cliffton.chan@ sydney.edu.au.
Med Probl Perform Art. 2014 Dec;29(4):181-8. doi: 10.21091/mppa.2014.4038.
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.
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 performance-related 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.
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 performance-related 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.
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.
评估一项专门设计的锻炼计划对职业管弦乐音乐家样本中与演奏相关的肌肉骨骼疾病（PRMDs）及相关风险因素的影响。
为澳大利亚八大顶级交响乐团雇佣的全职音乐家提供为期10周的锻炼计划。在干预前、干预刚结束后（T1）以及干预6个月后（T2）进行问卷调查，问卷包含与PRMDs频率和严重程度变化、排练、个人练习及演出期间的主观用力程度（RPE）评分，以及九个与演奏相关的因素。还要求参与者对这些与演奏相关的因素在不同演奏场景下是否影响其整体演奏能力进行评分。一个对照音乐家组未接受干预，并在相同时间点完成一份修改后的问卷。
与对照组（n = 23）相比，锻炼参与者（n = 30）在T1时报告PRMDs的频率（p < 0.05）和严重程度（p < 0.05）有所降低，但在T2时未降低。锻炼组报告在T1（p < 0.01）和T2（p < 0.01）个人练习期间RPE有显著改善，但在排练和演出期间没有。在T1时，该干预对三个与演奏相关的因素被评为中度至高度有效：增强支持演奏的肌肉、学习支持演奏的技巧和姿势。此外，参与者报告在T1和T2排练期间干预对整体演奏能力有影响。
为音乐家量身定制的锻炼计划在管理PRMDs方面是有效的，特别是在降低PRMDs的频率和严重程度方面。在改变已被报道为PRMDs预测因素的与演奏相关因素时应考虑物理治疗锻炼。
