Assel Carolin, Nugraha Boya, Kallusky Nicolas, Faßnacht-Lenz Stephan, Altenmüller Eckart, Gutenbrunner Christoph, Sturm Christian
Department of Rehabilitation Medicine, Hanover Medical School, Hanover, Germany.
Institute of Music Physiology and Musicians' Medicine, Hanover University of Music, Drama and Media, Hanover, Germany.
Front Pain Res (Lausanne). 2023 Jun 28;4:1151886. doi: 10.3389/fpain.2023.1151886. eCollection 2023.
Playing Related Musculoskeletal Disorders (PRMD) belong to the most prevalent medical ailments affecting musicians' health and career. This study documents the effect of a physiotherapeutic treatment as well as functional impairments of PRMD on the musculoskeletal system. In total, 32 music students suffering from PRMD were examined in Hanover Medical School (MHH) before and after they received twelve physiotherapeutic treatments, which were carried out over 20 min each over 6 weeks. Additionally, 32 healthy music students, matched by age and gender, were examined at one time point in the MHH to explore which musculoskeletal restrictions are associated with PRMD. The examination included the evaluation of the pain on the Visual Analogue Scale for pain (VAS), a body composition, and body posture measurement, the finger-to-floor distance, the range of motion of the cervical spine, the pressure pain and muscular hypertension examination, the temporomandibular joint-test, the Beighton score screening test, and the testing of the widespread pain score (WSP). After analyzing the data of the patient group (PG) a significant reduction of pain level on the VAS from an average pain of 6.31 to 3.53 was found (large effect). Additionally, a significant reduction of the pressure pain of the M. levator scapulae, the M. rhomboideus, the M. sternocleidomastoideus on the left side and the paravertebral muscles of the cervical spine on the right side after the treatment of the patients could be detected. Regarding the WSP, the positive testing significantly differed, showing a 28% positive testing in the patient group vs. a positive testing of 9% in the control group (CG). As hypermobility is a common phenomenon in musicians, the percentage of those being diagnosed with generalized hypermobility by using the Beighton score in both groups (PG: 37.5%; CG: 25%) was remarkably higher compared to previous studies. In this study, a short course of manual therapy, client tailored for each musician's specific problem, was shown to reduce pain levels in musicians with PRMD.
与演奏相关的肌肉骨骼疾病（PRMD）是影响音乐家健康和职业生涯的最常见疾病之一。本研究记录了物理治疗的效果以及PRMD对肌肉骨骼系统的功能损害。共有32名患有PRMD的音乐专业学生在汉诺威医学院（MHH）接受了12次物理治疗前后接受了检查，这些治疗在6周内每周进行一次，每次20分钟。此外，32名年龄和性别匹配的健康音乐专业学生在MHH的一个时间点接受了检查，以探究哪些肌肉骨骼限制与PRMD有关。检查包括视觉模拟疼痛量表（VAS）上的疼痛评估、身体成分和身体姿势测量、手指触地距离、颈椎活动范围、压痛和肌肉紧张度检查、颞下颌关节测试、Beighton评分筛查测试以及广泛性疼痛评分（WSP）测试。在分析患者组（PG）的数据后，发现VAS上的疼痛水平从平均6.31显著降低到3.53（效果显著）。此外，在对患者进行治疗后，可以检测到左侧肩胛提肌、菱形肌、胸锁乳突肌以及右侧颈椎椎旁肌肉的压痛显著降低。关于WSP，阳性测试结果有显著差异，患者组的阳性测试率为28%，而对照组（CG）为9%。由于关节活动过度在音乐家中是一种常见现象，与之前的研究相比，两组中使用Beighton评分被诊断为全身性关节活动过度的比例（PG：37.5%；CG：25%）明显更高。在本研究中，为每位音乐家的特定问题量身定制的短期手法治疗课程被证明可以降低患有PRMD的音乐家的疼痛水平。
