EVALUATION OF PAIN AND FUNCTIONAL DISABILITY BODY PARTS SEEN BETWEEN MUSICIANS PLAYING STRING INSTRUMENTS

Yıl 2018, Cilt: 4 Sayı: 1, 1 - 8, 12.02.2018

Elisa Çalışgan Ünal İmik , Burcu Talu

https://doi.org/10.22252/ijca.393667

Öz

Purpose: The most common
discomforts in musicians are musculoskeletal injuries. Musicians who play
advanced instruments use their musculoskeletal systems for long periods of time
outside their normal position. Conventional treatment, including cold therapy,
passive motion, parafine, contrast and circular bath with additional ESWT
(Extracorporeal Shock Wave Therapy) and High Density Laser therapy are the
treatment methods of wrist and elbow Problems in patients with musician. The
aim of study is evaluated of pain and functional disability body parts seen
between musicians playing string instruments.

Method: Our randomized,
blinded, controlled included 22 in musicans aged 16 to 50 years. Disabilities
of the Arm, Shoulder and Hand Score (DASH) which has minimal 0 and maximal 100
points, Oxford Elbow Scale which has minimal 0 and maximal 48 points, Shoulder
Pain and Disability Index (SPADI) which has minimal 0 and maximal 130 points.
Our the last evaluation form is Functional Situation Scale (FSS) which has
minimal 0 points and maximal 40 points. We compared conclusion of these forms
total points because our main goal was to determine the locations of
inflamation and pain seen substantially in musicians playing string
instruments. We compared our conclusion of questionnare with literatüre.

Result: Many studies have demonstrated in vivo and in vitro evidence of frequence
musicians health problems. The main objective of the our study was to determine
localization of the pain, functional disabilityand evaluate whether consisting
of different reasons can lead to an improvement in activation of finger, wrist,
elbow ability in patients with musician and whether the effects of treatment on
pain and inflamation may persist or not. Also, mean
and standart deviation of FSS was 36,18±1,43.
According to these scores and literatür, problems seen frequently in
musicians playing string instrument are inactivation of finger, wrist, elbow
ability because of pain, functional impairment and epicondilit.

Conclusion: In shortly, playing musical
instruments requires that the stimuli enter a position contrary to the natural
posture of the body according to the variety and cause of physical tension. It
is essential that the tension in the instrument technique is destroyed. According
to OES, FSS, Musicians playing string instrument have suffered from disability
of finger, wrist, elbow because of pain and restriction of functions.

Anahtar Kelimeler

Musicians, Elbow, Wrist, Pain, Function, Rehabilitation

EVALUATION OF PAIN AND FUNCTIONAL DISABILITY BODY PARTS SEEN BETWEEN MUSICIANS PLAYING STRING INSTRUMENTS / YAYLI ÇALGI ÇALAN MÜZİSYENLERDE AĞRILI VE FONKSİYONEL OLARAK YETERSİZ OLAN VÜCUT BÖLGELERİNİN TESPİTİ VE DEĞERLENDİRİLMESİ

Öz

Amaç: Müzisyenlerde en sık görülen rahatsızlıklar kas-iskelet sistemi
yaralanmalarıdır. İleri düzeydeve uzun süre enstrüman çalan müzisyenler kas
iskelet sistemlerini normal pozisyonlarının dışında uzun süre kullanırlar.
Ekstansör Şok Dalga Terapisi ve Ek Yoğunluk Lazer Terapisi, müzisyen hastaların
bilek ve dirsek sorunlarının önlenmesi ile ağrı ve fonksiyonel zorlanmalarda
kullanılır. Bu çalışmanın amacı, yaylı çalgı çalan müzisyenlerin ağrılı ve
fonksiyonel olarak yetersiz olan vücut bölgelerinin tespit edilerek
değerlendirilmesidir.

Yöntem:Araştırmaya, randomize, körleştirilmiş, kontrollü 16-50 yaş arası 22
müzisyen dahil edilmiştir. Minimum 0 ve maksimal skoru 100 olan Kol, Omuz ve El
Skoru (DASH), en az 0 ve en fazla 48 puan olan Oxford Dirsek Ölçeği, Omuz
Ağrısı ve Özürlülük İndeksi (SPADI) en az 0 ve en fazla 130 puan olan. Son
değerlendirme formumuz, en az 0 puan ve en fazla 40 puan içeren Fonksiyonel
Durum Ölçeği (FSS) 'dir. Araştırmada, bu formların toplam puanlarının
sonuçlarını karşılaştırdık, çünkü asıl amacımız yaylı enstrümanlarını çalan
müzisyenlerde görülen enflamasyon ve ağrıların yerlerini belirlemekti. Bu
sebeple, anket sonuçlarını literatür ile karşılaştırdık.

Sonuç: Birçok çalışmada (canlıda ve canlı dışında) ileri düzey müzisyenlerdeki
sağlık sorunları kanıtlamıştır. Çalışmamızın amacı, yaylı çalgı çalan
müzisyenlerdeoluşan ağrıların nedenlerini, lokalizasyonunu saptamak ve
fonksiyonel olarak yetersiz olan vücut bölümünü tespit etmektir. Ayrıca,
DİE'nin ortalama ve standart sapması 36,18 ± 1,43 idi. Bu puanlara ve literatüre
göre, yaylı çalgı çalan müzisyenlerde sık görülen problemler, ağrı, fonksiyonel
yetersizlikve epikondilit nedeniyle parmak, bilek, dirsek
hareketlerininkısıtlanmasıdır.

Anahtar Kelimeler

Müzisyen, Dirsek, El bileği, Ağrı, Fonksiyon, Rehabilitasyon

Kaynakça

• 1) Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE, et al. Gray’s anatomy. 38th ed. Edinburg: Churchill Livingstone; 1995. 2) Morrey BF. The Elbow and its disorders. 3rd ed. Philadelphia: Saunders; 2000. 3) Arıncı K, Elhan A. Anatomi. 1. Cilt. 3. Baskı, Ankara: Güneş Kitabevi; 2001. 4) Morrey BF, An KN. Functional anatomy of the ligaments of the elbow. Clin Orthop Relat Res 1985;201: 84-90. 9. Fuss FK. The ulnar collateral ligament of the human elbow joint. Anatomy, function and biomechanics. J Anat1991;175:203-12. 10. Gurbuz H, Kutoglu T, Mesut R, Gurbuz H. Anatomical dimensions of anterior bundle of ulnar collateral ligament and its role in elbow stability. Folia Med (Plovdiv)2005;47:47-52. 11. O’Driscoll SW, Jaloszynski R, Morrey BF, An KN. Origin of the medial ulnar collateral ligament. J Hand Surg Am1992;17:164-8. 12. Morrey BF, Tanaka S, An KN. Valgus stability of the elbow. A definition of primary and secondary constraints. Clin Orthop Relat Res 1991;265:187-95. 13. SchwabGH, BennettJB, WoodsGW, TullosHS. Biomechanics of elbow instability: the role of the medial collateral ligament. Clin Orthop Relat Res1980;146:42-52. 15. Osborne G. Compression neuritis of the ulnar nerve at the elbow. Hand 1970;2:10-3. 16. Martin BF. The annular ligament of the superior radio-ulnar joint. J Anat1958;92:473-82. 17. Açar Hİ. Dirsek ekleminin kollateral bağlarının anatomisi ve klinik önemi. [Uzmanlık Tezi]. Ankara: Ankara Üniversitesi Tıp Fakültesi Anatomi Anabilim Dalı; 2004. 18. Spinner M, Kaplan EB. The quadrate ligament of the elbowits relationship to the stability of the proximal radio-ulnar joint. Acta Orthop Scand 1970;41:632-47. 19. Martin BF. The oblique cord of the forearm. J Anat 1958; 92:609-15. 20. Bert JM, Linscheid RL, McElfresh EC. Rotatory contracture of the forearm. J Bone Joint Surg [Am] 1980;62:1163-8. 21. Keats TE, Teeslink R, Diamond AE, Williams JH. Normal axial relationships of the major joints. Radiology 1966;87:904-7. 22. Morrey BF, Chao EY. Passive motion of the elbow joint. J Bone Joint Surg [Am] 1976;58:501-8. 23. O’Driscoll SW, Morrey BF, Korinek S, An KN. Elbow subluxation and dislocation. A spectrum of instability. Clin Orthop Relat Res1992;280:186-97. 24. Søjbjerg JO, Ovesen J, Gundorf CE. The stability of the elbow following excision of the radial head and transection of the annular ligament. An experimental study. Arch Orthop Trauma Surg1987;106:248-50. 25. Eren OT, Tezer M, Armağan R, Küçükkaya M, Kuzgun U. Results of excision of the radial head in comminuted fractures. [Article in Turkish] Acta Orthop Traumatol Turc2002;36:12-6. 26. Tyrdal S, Olsen BS. Combined hyperextension and supination of the elbow joint induces lateral ligament lesions. An experimental study of the pathoanatomy and kinematics in elbow ligament injuries. Knee Surg Sports Traumatol Arthrosc 1998;6:36-43. 27. An KN, Morrey BF, Chao EY. The effect of partial removal of proximal ulna on elbow constraint. Clin Orthop Relat Res 1986;209:270-9. 28. Nalbantoğlu U, Gereli A, Kocaoğlu B, Haklar U, Türkmen M. Surgical treatment of acute coronoid process fractures. [Article in Turkish] Acta Orthop Traumatol Turc 2008; 42:112-8. 29. Josefsson PO, Nilsson BE. Incidence of elbow dislocation. Acta Orthop Scand1986;57:537-8. 30. Mehlhoff TL, Noble PC, Bennett JB, Tullos HS. Simple dislocation of the elbow in the adult. Results after closed treatment. J Bone Joint Surg [Am] 1988;70:244-9. 31. O’Driscoll SW. Elbow instability. Hand Clin1994;10:405-15. 32. Lee ML, Rosenwasser MP. Chronic elbow instability. Orthop Clin North Am1999;30:81-9. 33. O’Driscoll SW, Bell DF, Morrey BF. Posterolateral rotatory instability of the elbow. JBone Joint Surg [Am] 1991;73:440-6. 34.Erickson, L., Research Into Tendinosis and Other Chronic Tendon Injuries, Tendinosis.org:Home Page, 2002 35.Jameson, T. “ Repetitive Strain Injuries Continue to Plague Musicians” www.newpage5.htm. 2001. 36.Jameson,T.“Prevention of repetitive strain injuries”.http://www.gbase.com/aricles/med/med 37.Jameson, T. 2000. “Musicians and weight training”www.musicianshealth.com. weight.htm. 38.Jameson, T. 2001. “What makes musicians prone to repetitive strain injuries” www.musicianhealth.com. 39.Jameson, T. “ Trigger Finger”http://eeshop.unl.edu/text/ow. 40.Manchester,R.A. The Incidence of Hand Problems in Music Students, Medical problems of Performing Artists, 1988. 41.Manchester,R.A. And Flieder,D. Further Observations on the epidemiolojy of hand injuries in music students.Medical problems of Performing Artists ,7.1992. 42.Mark,T. Pianist’s Injuries: Movement Retraining is yhe Key to the Recovery, http://www.bodymap.org/aritcles/artpianistnj.html. 2003 43.Marxhausen,P., “Musicians and Injuries” http:// eeshop.unl.edu/text/ow.auhttp. 44.Reubart, D. Anxiety and Musical Performance. Da capo Pres, New York, 1985. 45.Sen, J. “Casulties of the Keyboard” . www.ismennt.is/not/sen/caskeyb.html. 46.Şen, S. Piyano Tekniğinin Biyomekanik Temeli. Pan Yayıncılık, İstanbul, 1999. 47.Williams,P. And V., Tendinitis Problems of MusiciansIdentification Prevention, Treatment, Voyager Recordings & Publ. 2001. 48.Yadeau. W. R. Thought on Medical Problems of Performing Artists, American Music Teacher, 1995. 49.Yağışan, N., Keman Çalmada Etkin Bedensel Yapıların Hareket Analizi ve Fiziksel-Motorik Özelliklerin Geliştirilmesinin Öğrencinin Çalma Performansına Yansıması ( yayınlanmamış doktora tezi) Ankara Eğ. Bil. Ens. 2002. 50. Lockwood, A. H. “Medical Problems of Musicians”, New England Journal of Medicine, (1989) 1, 221–227. 51.Ergin E. Sports &Science Education, International Journal of New Trends inArts - 2016, 5.