MÜZİSYENLERİN AĞRI, POSTÜR, ÜST EKSTREMİTE FONKSİYONU VE ANKSİYETE DÜZEYLERİNİN İNCELENMESİ

Öz

Bu çalışma müzisyenlerde ağrı, postür, üst ekstremite fonksiyonları ve anksiyete düzeylerini incelemek amacıyla gerçekleştirildi. Çalışmaya 22 profesyonel müzisyen dahil edildi (ortalama yaş±SS (28,45±5,05 yıl), ortalama vücut kütle indeksi±SS (24,34±3,98 kg/m2)). Müzisyenlerin ağrı şiddeti Vizüel Ağrı Skalası (VAS) ile, postür Iphone uygulaması olan Posture Screen Mobile (PSM) ile, üst ekstremite fonksiyonları Kol-Omuz-El Sorunları Anketi (DASH) ile ve anksiyete düzeyi Beck Anksiyete Ölçeği (BAÖ) ile değerlendirildi. Değişkenler arası ilişki Spearman Korelasyon testi ile incelendi. Müzisyenlerin 20’si (%90,9) performans sırasında rahatsızlık hissettiği ve en çok rahatsızlık hissedilen bölgelerin boyun (%54,5), sırt (%50) ve bel (%40,9) olduğu belirlendi. VAS puanı 4,81±3,16, Anterior PSM derecesi 4,41±3,05, Posterior PSM derecesi 13,9±9,07, Sağ lateral PSM derecesi 21,92±7,43, Sol lateral PSM derecesi 22,5±7,94, DASH puanı 19,31±17,24 ve BAÖ puanı 12,56±9,07’ydi. VAS ile DASH arasında pozitif ve güçlü bir ilişki (r=0,76; p<0,001), VAS ile BAÖ arasında pozitif ve orta düzey bir ilişki (r=0,49; p=0,02) bulundu. VAS ile Anterior, Posterior, Sağ lateral ve Sol lateral PSM derecesi arasında istatistiksel olarak bir ilişki (sırasıyla, r=0,168, r=-0,166, r=0,214, r=0,306; p>0,05) bulunmadı. Müzisyenlerde ağrı şiddetinin üst ekstremite fonksiyonelliği ve anksiyete ile ilişkili olduğu düşünülmektedir. Müzisyenlere daha iyi performans gösterebilmeleri için bütüncül yaklaşımlarla birtakım egzersiz ve pratikler önerilebilir.

Anahtar Kelimeler

• Ağrı
• anksiyete
• müzik
• postür
• üst ekstremite

EXAMINATION OF PAIN, POSTURE, UPPER EXTREMITY FUNCTION AND ANXIETY LEVELS OF MUSICIANS

Abstract

This study was carried out to examine pain, posture, upper extremity functions and anxiety levels in musicians. 22 professional musicians were included in the study (mean age±SD (28.45±5.05 years), mean body mass index±SD (24.34±3.98 kg/m2)). The pain intensity of the musicians was evaluated with the Visual Pain Scale (VPS), the posture was evaluated with the Posture Screen Mobile (PSM) iPhone application, the upper extremity functions were evaluated with The Disabilties of the Arm, Shoulder and Hand (DASH) and the anxiety level was evaluated with the Beck Anxiety Inventory (BAI). The relationship between the variables was examined with the Spearman Correlation test. It was determined that 20 (90.9%) of the musicians felt discomfort during the performance and the areas where they felt the most discomfort were the neck (54.5%), back (50%) and low back (40.9%). VPS score 4.81±3.16, Anterior PSM grade 4.41±3.05, Posterior PSM grade 13.9±9.07, Right lateral PSM grade 21.92±7.43, Left lateral PSM grade 22,5±7,94, the DASH score was 19.31±17.24, and the BAI score was 12.56±9.07. A positive and strong correlation was found between VAS and DASH (r=0.76; p<0.001), and a positive and moderate relationship between VAS and BAI (r=0.49; p=0.02). There was no statistical correlation between VAS and Anterior, Posterior, Right lateral and Left lateral PSM grades (respectively, r=0.168, r=-0.166, r=0.214, r=0.306; p>0.05). It is thought that the severity of pain in musicians is related to upper extremity functionality and anxiety. Some exercises and practices can be offered to musicians with holistic approaches so that they can perform better.

Keywords

• Pain
• anxiety
• music
• posture
• upper extremty

Kaynakça

1. Chan C, Ackermann B. Evidence-informed physical therapy management of performance-related musculoskeletal disorders in musicians. Front Psychol. 2014; 5:706.
2. Wilke C, Priebus J, Biallas B, Froböse I. Motor activity as a way of preventing musculoskeletal problems in string musicians. Med Probl Perform Art. 2011; 26(1): 24-9.
3. Raymond III DM, Romeo JH, Kumke KV. A pilot study of occupational injury and illness experienced by classical musicians. Workplace Health Saf. 2012;60(1):19-24.
4. Zuskin E, Schachter EN, Kolcic I, Polasek O, Mustajbegovic J, Arumugam U. Health problems in musicians-a review. Acta Dermatovenerol Croat. 2005;13(4):247-51.
5. Newmark J. Musicians' dystonia: the case of Gary Graffman. Semin Neurol. 1999;19:41-45.
6. Johnson D. Classical Guitar and Playing-Related Musculoskeletal Problems A Systematic Review. Malmö Academy of Music. 2009. Schuppert M, Altenmüller E. Occupation-specific illnesses in musicians. Versicherungsmedizin. 1999;51(4):173-9.
7. Genç A, Altuntaşoğlu B, Özcan A. Comparison of hand functions in musicians and non-musicians [Turkish]. Fizyoter Rehabil. 2002;13(3):124-128.
8. Lederman RJ. Neuromuscular and musculoskeletal problems in instrumental musicians. Muscle Nerve. 2003;27(5):549-61.

9. Larsson LG, Baum J, Mudholkar GS. Hypermobility: features and differential incidence between the sexes. Arthritis Rheum. 1987;30(12):1426-30.
10. Kok LM, Huisstede BM, Voorn VM, Schoones JW, Nelissen RG. The occurrence of musculoskeletal complaints among professional musicians: a systematic review. Int Arch Occup Environ Health. 2016;89(3):373-96.
11. Kenny D, Ackermann B. Performance-related musculoskeletal pain, depression and music performance anxiety in professional orchestral musicians: a population study. Psychol Music. 2015;43(1):43-60.
12. Bejjani FJ, Kaye GM, Benham M. Musculoskeletal and neuromuscular conditions of instrumental musicians. Arch Phys Med Rehabil. 1996;77(4):406-13.
13. Winspur I. Controversies surrounding “misuse,” “overuse,” and “repetition” in musicians. Hand Clin. 2003;19(2):325-9.
14. Pitner MA. Pathophysiology of overuse injuries in the hand and wrist. Hand Clin. 1990;6(3):355-64.
15. Heming MJE. Occupational injuries suffered by classical musicians through overuse. Clin Chiropract. 2004;7(2):55-66.
16. Toledo SD, Nadler SF, Norris RN, Akuthota V, Drake DF, Chou LH. Sports and performing arts medicine. 5. issues relating to musicians. Arch Phys Med Rehabil. 2004;85(3 Suppl 1):72-4.
17. Amadio PC. Management of nerve compression syndrome in musicians. Hand Clin. 2003;19(2):279-86.
18. Heinan M. A review of the unique injuries sustained by musicians. JAAPA. 2008;21(4):45-6.
19. Chamagne P. Functional dystonia in musicians: rehabilitation. Hand Clin. 2003;19(2):309-16.
20. Butler K, Rosenkranz K. Focal hand dystonia affecting musicians. Part I: An overview of epidemiology, pathophysiology and medical treatments. Hand Therapy. 2006;11(3):72-8.
21. Butler K. Focal Hand Dystonia Affecting Musicians. In: Rose FC editor. Neurology of Music, Imperial College Press, London 2010 p:402.
22. Butler K, Rosenkranz K. Focal hand dystonia affecting musicians. Part II: An overview of current rehabilitative treatment techniques. Hand Therapy. 2006;11(3):79-87.
23. Byl NN, Archer ES, McKenzie A. Focal hand dystonia: effectiveness of a home program of fitness and learning-based sensorimotor and memory training. J Hand Ther. 2009;22(2):183-97.
24. Chen YC, Yang ZR, Hsu ML, Hwang IS. Differences in cross modulation of physiological tremor in pianists and nonmusicians. Med Sci Sports Exerc. 2011;43(9):1707-15.
25. Lederman RJ. Focal peripheral neuropathies in instrumental musicians. Phys Med Rehabil Clin N Am. 2006;17(4):761-79.
26. Jabusch HC, Müller SV, Altenmüller E. Anxiety in musicians with focal dystonia and those with chronic pain. Mov Disord. 2004;19(10)1169-75.
27. Önder M, Cosar B, Öztas MO, Candansayar S. Stress and skin diseases in musicians: Evaluation of the Beck Depression Scale, General Psychologic Profile (The Brief Symptom Inventory [BSI]), Beck Anxiety Scale and stressful life events in musicians. Biomed Pharmacother. 2000;54(5):258-62.
28. Kenny DT, Osborne M. Music performance anxiety: New insights from young musicians. Adv Cogn Psychol. 2006;2(2):103-12.
29. Kenny DT, Davis P, Oates J. Music performance anxiety and occupational stress amongst opera chorus artists and their relationship with state and trait anxiety and perfectionism. J Anxiety Disord. 2004;18(6):757-77.
30. Finnoff JT, Willick S, Akau CK, Harrast MA, Storm SA. Sports and performing arts medicine: 6. Tendinopathy. PM R. 2009;1(3 Suppl):S83-7.
31. Hansen PA, Reed K. Common musculoskeletal problems in the performing artist. Phys Med Rehabil Clin N Am. 2006;17(4):789-801.
32. Bragge P, Bialocerkowski A, McMeeken J. A systematic review of prevalence and risk factors associated with playing-related musculoskeletal disorders in pianists. Occup Med (Lond). 2006;56(1):28-38.
33. Lockwood AH. Medical problems in secondary school-aged musicians. Med Probl Perform Art. 1988;3:129-32.
34. Allsop L, Ackland T. The prevalence of playing related musculoskeletal disorders in relation to piano players’ playing techniques and practising strategies. Music Performance Research. 2010;3(1):61-78.
35. Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP. Validity of four pain intensity rating scales. Pain. 2011;152(10):2399-2404.
36. Hopkins BCB. Validity of PostureScreen Mobile in the measurement of standing posture. Provo: Brigham Young University; 2014.
37. Cosma G, Ilinca I, Rusu L, Nanu C, Burileanu A. Physical Exercise And Its Role In A Corect Postural Alignment. Discobolul Physcal Educ Sport Kinetother J. 2015;11(1):58-64.
38. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29(6):602-8.
39. Düger T, Yakut E, Öksüz Ç, Yörükan S, Akel S, Ayhan Ç ve ark. Omuz ve El Sorunları (Disabilities of the Arm, Shoulder and Hand - DASH) Anketi Türkçe uyarlamasının güvenirliği ve geçerliği. Fizyoter Rehabil. 2006;17(3):99-107.
40. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(6):893-7.
41. Ulusoy M, Şahin N, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. J Cogn Psychother. 1998;12(2):163-72.
42. Cohen J. Statistical power analysis for the behavioral sciences. 2th ed. ed. New York: Academic Press; 2013.
43. Blanco-Piñeiro P, Díaz-Pereira MP, Martinez A. Musicians, postural quality and musculoskeletal health: A literature's review. J Bodyw Mov Ther. 2017;21(1):157-72.
44. Blanco-Piñeiro P, Díaz-Pereira MP, Vidal AM. Variation in posture quality across musical instruments and its impact during performances. Int J Occup Saf Ergon. 2018;24(2):316-23.
45. Baadjou VAE, Verbunt JAMCF, van Eijsden-Besseling MDF, Huysmans SMD, Smeets RJEM. The Musician as (In)Active Athlete? Exploring the Association Between Physical Activity and Musculoskeletal Complaints in Music Students. Med Probl Perform Art. 2015;30(4):231-37.
46. Matei R, Ginsborg J. Physical Activity, Sedentary Behavior, Anxiety, and Pain Among Musicians in the United Kingdom. Front Psychol. 2020;11:560026.
47. Davies J, Mangion S. Predictors of Pain and Other Musculoskeletal Symptoms among Professional Instrumental Musicians: Elucidating Specific Effects. Med Probl Perform Art. 2002;17(4):155-68.