Simetrik ve Asimetrik Pozlarda Çalan Müzisyenlerde Kas-İskelet Sistemi Sorunlarının Araştırılması

Yıl 2025, Cilt: 16 Sayı: 3, 287 - 297, 22.12.2025

Neriman Temel Aksu , Alime Büyük , Nihan Yağışan , Levent Sarıkçıoğlu

https://doi.org/10.22312/sdusbed.1548294

Öz

Enstrüman çalarken tekrarlayan hareketler ve enstrümanların omurgada oluşturduğu asimetrik duruşlar kas-iskelet sistemi rahatsızlıklarına neden olmaktadır. Enstrümanın türü de kas-iskelet sistemi sorunlarının sıklığını etkileyen bir diğer faktördür. Bu çalışmada, erken yaşlardan itibaren simetrik duruşlarda (klarnet, obua, fagot, trompet, piyano, perküsyon vb.) ve asimetrik duruşlarda (keman, viyolonsel, flüt, gitar, bağlama, kontrbas vb.) çalan müzisyenlerin kas-iskelet sistemi ağrıları üzerine enstrümanların etkilerinin araştırılması amaçlanmıştır. Çalışmaya en az 10 yıldır enstrüman çalan 50 müzisyen dahil edilmiştir. Müzisyenler ağrı ve duruş açısından değerlendirilmiştir. Ağrı sorunları The Extended Version of the Nordic Musculoskeletal Questionnaire adı verilen özel bir anket ile değerlendirilmiş ve duruş değerlendirmesi gözlem tabanlı duruş değerlendirmesi kullanılarak yapılmıştır. Mevcut çalışma, asimetrik duruşlarda çalan müzisyenler ile simetrik duruşlarda çalan müzisyenler arasında duruşlarda önemli farklılıklar tespit edildiğini buldu. (p<0,05). Bu çalışma, asimetrik duruşlarda çalan müzisyenlerin duruşlarının, simetrik duruşlarda çalan müzisyenlerin duruşlarından daha fazla etkilendiğini ortaya koydu. Dahası, mevcut çalışma, asimetrik duruşlarda çalan müzisyenlerin, simetrik duruşlarda çalanlara kıyasla alt sırt, eller, üst sırt ve pelviste daha şiddetli ağrıya sahip olduğunu gösterdi.

Anahtar Kelimeler

kas iskelet sistemi bozuklukları , müzisyenler , ağrı , postür , işle ilgilili problemler

Investigation of Musculoskeletal Problems in Musicians Playing in Symmetrical and Asymmetrical Postures

Öz

Repetitive movements while playing instruments, and the asymmetrical postures of the spine created by the instruments, cause musculoskeletal disorders. The type of the instrument is likely to be another factor affecting the frequency of musculoskeletal problems. This study aimed to investigate the effects of instruments on musicians’ musculoskeletal pain which have been played from an early age in symmetrical postures (clarinet, oboe, bassoon, trumpet, piano, percussion, etc.) and asymmetrical postures (violin, cello, flute, guitar, baglama [Turkish lute], double bass, etc.). This study included 50 musicians who played instrument for at least 10 years. Musicians were assessed about pain and posture. Pain problems was evatulated by special questionnaire called The Extended Version of the Nordic Musculoskeletal Questionnaire and posture assesment were evaluated using observation-based posture assessment. The current study found that a significant differences were detected in postures between musicians playing in asymmetrical postures and musicians playing in symmetrical postures. (p<0.05). This study revealed that postures of musicians playing in asymmetrical postures were affected more than those of the musicians playing in symmetrical postures. Moreover, the present study showed that musicians playing in asymmetrical postures had more severe pain in the lower back, hands, upper back, and pelvis compared to those playing in symmetrical postures.

Anahtar Kelimeler

musculo-skeletal disorders , musicians , pain , posture , working related problems

Kaynakça

• 1. Rotter G, Noeres K, Fernholz I, Willich SN, Schmidt A, Berghöfer A. Musculoskeletal disorders and complaints in professional musicians: a systematic review of prevalence, risk factors, and clinical treatment effects. Int Arch Occup Environ Health. 2020;93(2):149-187. doi:10.1007/s00420-019-01467-8.
• 2. Mizrahi J. Neuro-mechanical aspects of playing-related mobility disorders in orchestra violinists and upper strings players: a review. Eur J Transl Myol. 2020;30(3):9095. doi:10.4081/ejtm.2020.9095.
• 3. Rousseau C, Taha L, Barton G, Garden P, Baltzopoulos V. Assessing posture while playing in musicians - A systematic review. Appl Ergon. 2023;106:103883. doi:10.1016/j.apergo.2022.103883.
• 4. Yang N, Fufa DT, Wolff AL. A musician-centered approach to management of performance-related upper musculoskeletal injuries. J Hand Ther. 2021;34(2):208-216. doi:10.1016/j.jht.2021.04.006.
• 5. 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):373-396. doi:10.1007/s00420-015-1090-6.
• 6. Iglesias-Carrasco C, de-la-Casa-Almeida M, Suárez-Serrano C, Benítez-Lugo ML, Medrano-Sánchez EM. Efficacy of Therapeutic Exercise in Reducing Pain in Instrumental Musicians: Systematic Review and Meta-Analysis. Healthcare (Basel). 2024;12(13):1340. Published 2024 Jul 5. doi:10.3390/healthcare12131340.
• 7. Blanco-Piñeiro P, Díaz-Pereira MP, Martínez Vidal A. Variation in posture quality across musical instruments and its impact during performances. Int J Occup Saf Ergon. 2018;24(2):316-323. doi:10.1080/10803548.2017.1298277.
• 8. Zão A, Altenmüller E, Azevedo L. Performance-Related Pain Among Musicians Questionnaire (PPAM): Multicenter Validation of the First Questionnaire to Evaluate Performance-Related Pain Among Musicians With Different Musical Backgrounds. J Pain. 2024;25(2):393-406. doi:10.1016/j.jpain.2023.09.003.
• 9. Dommerholt J. Performing arts medicine - instrumentalist musicians: part III - case histories. J Bodyw Mov Ther. 2010;14(2):127-138. doi:10.1016/j.jbmt.2009.02.005.
• 10. Fjellman-Wiklund A, Brulin C, Sundelin G. Physical and psychosocial work-related risk factors associated with neck-shoulder discomfort in male and female music teachers. Med Probl Perform Art. 2003;18(1):33-41. doi: 10.21091/mppa.2003.1007.
• 11. Olszewska AM, Gaca M, Herman AM, Jednoróg K, Marchewka A. How Musical Training Shapes the Adult Brain: Predispositions and Neuroplasticity. Front Neurosci. 2021;15:630829. doi:10.3389/fnins.2021.630829.
• 12. Ziane C, Goubault E, Michaud B, Begon M, Dal Maso F. Muscle fatigue during assisted violin performance. Ergonomics. 2024;67(3):275-287. doi:10.1080/00140139.2023.2221416
• 13. Kok LM, Huisstede BM, Douglas TJ, Nelissen RG. Association of Arm Position and Playing Time with Prevalence of Complaints of the Arm, Neck, and/or Shoulder (CANS) in Amateur Musicians: A Cross-Sectional Pilot Study Among University Students. Med Probl Perform Art. 2017;32(1):8-12. doi:10.21091/mppa.2017.1003.
• 14. Edling CW, Fjellman-Wiklund A. Musculoskeletal disorders and asymmetric playing postures of the upper extremity and back in music teachers: a pilot study. Med Probl Perform Art. 2009.;24(3):113-118.doi: 10.21091/mppa.2009.3025.
• 15. Bağrı G, Güngörer K. Akıllı telefonlarda bulunan postür düzeltme uygulamalarının boyun ağrısı ve fonksiyonuna etkileri. SDÜ Sağlık Bilimleri Dergisi. 2022;13(2):161-170. doi: 10.22312/sdusbed.1117215
• 16. Ranelli S, Straker L, Smith A. Playing-related musculoskeletal problems in children learning instrumental music: the association between problem location and gender, age, and music exposure factors. Med Probl Perform Art. 2011;26(3):123-139.
• 17. Büyük A, Aksu NT, Demir E, Yağışan N, Sarıkçıoğlu L. Comparison of Spinal Mobility in Professional Musicians With and Without Pelvic Girdle Pain. Med Probl Perform Art. 2023;38(1):9-15. doi:10.21091/mppa.2023.1002.
• 18. Blanco-Piñeiro P, Díaz-Pereira MP, Martínez A. Musicians, postural quality and musculoskeletal health: A literature's review. J Bodyw Mov Ther. 2017;21(1):157-172. doi:10.1016/j.jbmt.2016.06.018.
• 19. Ciurana Moñino MR, Rosset-Llobet J, Cibanal Juan L, García Manzanares MD, Ramos-Pichardo JD. Musculoskeletal Problems in Pianists and Their Influence on Professional Activity. Med Probl Perform Art. 2017;32(2):118-122. doi:10.21091/mppa.2017.2019.
• 20. Kuorinka I, Jonsson B, Kilbom A, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233-237. doi:10.1016/0003-6870(87)90010-x.
• 21. Dickinson CE, Campion K, Foster AF, Newman SJ, O’Rourke AM, Thomas PG. Questionnaire development: an examination of the Nordic Musculoskeletal Questionnaire. Appl Ergon. 1992;23:197-201. doi:10.1016/0003-6870(92)90225-k.
• 22. Dommerholt J. Performing arts medicine - instrumentalist musicians part I - general considerations. J Bodyw Mov Ther. 2009;13(4):311-319. doi:10.1016/j.jbmt.2009.02.003.
• 23. Shoebridge A, Shields N, Webster KE. Minding the body: An interdisciplinary theory of optimal posture for musicians. Psychol Music. 2017;45(1):821-838. doi: 10.1177/0305735617691593.
• 24. Yang N, Fufa DT, Wolff AL. A musician-centered approach to management of performance-related upper musculoskeletal injuries. J Hand Ther. 2021;34(2):208-216. doi:10.1016/j.jht.2021.04.006.
• 25. Lonsdale K, Laakso EL, Tomlinson V. Contributing factors, prevention, and management of playing-related musculoskeletal disorders among flute players internationally. Med Probl Perform Art. 2014;29(3):155-162. doi:10.21091/mppa.2014.3032.
• 26. Berque P, Gray H, McFadyen A. Playing-Related Musculoskeletal Problems Among Professional Orchestra Musicians in Scotland: A Prevalence Study Using a Validated Instrument, the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM). Med Probl Perform Art. 2016;31(2):78-86. doi:10.21091/mppa.2016.2015.
• 27. Panuccio F, Marcellini G, Berardi A, Tofani M, Uboldi M, Galeoto G. Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians-Italian Version (MPIIQM-IT): Multicenter Validation, Translation and Cultural Adaptation. Med Probl Perform Art. 2024;39(1):38-48. doi:10.21091/mppa.2024.1005.
• 28. Sousa CM, Machado JP, Greten HJ, Coimbra D. Playing-Related Musculoskeletal Disorders of Professional Orchestra Musicians from the North of Portugal: Comparing String and Wind Musicians. Acta Med Port. 2017;30(4):302-306. doi:10.20344/amp.7568.
• 29. Soares CO, Pereira BF, Pereira Gomes MV, Marcondes LP, de Campos Gomes F, de Melo-Neto JS. Preventive factors against work-related musculoskeletal disorders: narrative review. Rev Bras Med Trab. 2020;17(3):415-430. doi:10.5327/Z1679443520190360.
• 30. Rotter G, Noeres K, Fernholz I, Willich SN, Schmidt A, Berghöfer A. Musculoskeletal disorders and complaints in professional musicians: a systematic review of prevalence, risk factors, and clinical treatment effects. Int Arch Occup Environ Health. 2020;93(2):149-187. doi:10.1007/s00420-019-01467-8.