Muscular effort and musculo-skeletal disorders in piano students: electromyographic, clinical and preventive aspects.

An investigation was made on the relationship between music practice and musculo-skeletal disorders among piano students, with the main aim of developing health education programmes that would improve the performance and health of the students. The investigation covered three areas: (a) Analysis of study organization and main musculo-skeletal complaints achieved by a questionnaire distributed to all piano students at the Milan Conservatory. (b) Vocational electromyographic analysis of the effort exerted by the various muscle groups of the trunk, of the shoulder and shoulder blade girdle, and of the arm during performance of a standard set of piano exercises, an unseen passage and a passage of maximum difficulty. This analysis was made on a sample of six subjects. (c) A series of preventive measures was developed on the basis of a critical assessment of the results (38% of the students practised for excessively long periods without breaks; 62% had from 1 to 5 complaints, the most affected sites being the spine and the trapezius muscles). These consisted largely of a health education programme aimed at helping the students to suitably organize practice and rest periods and in instructing them in appropriate exercises for relaxation and stretching of overused muscle groups and strengthening the supporting muscle groups. Changes in lifestyle were also suggested.