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Abstract

Playing-related musculoskeletal problems (PRMP) are common in adult musicians. The limited available evidence suggests PRMP are common in children and adolescents and that risk factors may be similar. The aim of this study was to determine the prevalence of PRMP in children and adolescents and their associations with female gender, age and instrument exposure. The study surveyed 731 children learning musical instruments (460 females) ranging in age from 7—17 years. Lifetime symptoms, monthly symptoms and monthly disorders (the inability to play an instrument as usual) were examined. Logistic regression evaluated the independent association of these potential risk factors with PRMP prevalences. A total of 67% students reported PRM symptoms at some point, 56% reported PRM symptoms within the last month and 30% reported an inability to play as usual within the last month. Female gender was significantly associated with PRMP (OR 1.38—1.56, p = 0.004—0.046), as was age (OR 1.19—0.23, p < 0.001). After adjustment for gender and age, type of instrument (upper and lower strings, woodwind and brass) were significantly associated with all PRMP (p < 0.005) and playing three instruments was protective against monthly symptoms (OR 0.43, p = 0.05).

The study concludes that the high prevalence and disabling impact of playing-related musculoskeletal problems is clearly an important issue for child and adolescent health with gender, age and instrument exposure important factors for risk management.

Troubles musculo-squelettiques (TMS) associés à la pratique musicale chez les enfants: l’influence du genre, de l’âge et de l’instrument

Troubles musculo-squelettiques (TMS) sont communs chez les musiciens adultes. L’evidence limitée disponible suggère que les TMS soient aussi commun chez les enfants et les adolescents et que les facteurs de risque doivent être similaire. Le but de cette étude est de déterminer la prévalence du TMS chez les enfants et les adolescents et leurs associations avec du genre féminin, de l’âge et de l’instrument. L’étude a investigué 731 enfants qui apprenaient un instrument (460 jeune filles) entre l’âge du 7 au 17 ans. Symptômes de longue durée, symptômes de courte durée (mensuelle) et des desordres mensualles (incapacité de jouer un instrument) ont été examinés. Régression logistique a evalué l’association indépendente parmi ces facteurs de risque avec les prévalences de TMS. Parmi les étudiants, 67% ont rapporté des symptômes de TMS pendant le dernier mois et 30 % ont raporté une incapacité de jouer de façon usuelle aussi pendants le dernier mois. Le genre féminin a montré une association significative avec TMS (OR 1,38—1,56, p = 0,004—0,046), ainsi que avec l’âge (OR 1,19—0,23, p < 0,001). Aprés avoir ajustés genre et l’âge, le type d’instrument (cordes, à vent et cuivres) a demonstré une association significative avec TMS (p < 0,005) et jouer trois instruments était protecteur vis-à-vis les symptômes mensuels (OR 0,43, p = 0,05).

La haute prévalence et l’impact incapacitant des troubles musculo-squelettiques liès à la pratique musicale sont des sujets importants pour la santé de l’enfant et de l’adolescent en ayant du genre, de l’âge et l’instrument comme des facteurs de risque à gérer.

Spielbezogene Probleme des Bewegungsapparats bei kindlichen Instrumentalisten: der Einfluss von Geschlecht, Alter und instrumentaler Belastung

Spielbezogene Erkrankungen des Bewegungsapparats (SEB) sind bei erwachsenen Musikern bekannt. Die begrenzt zugänglichen Erfahrungen legen nahe, dass SEB auch bei Kindern und Jugendlichen vorkommen und dass die Risikofaktoren ähnlich sind. Ziel der Untersuchung war es daher, die Verbreitung von SEB bei Kindern und Jugendlichen nachzuweisen und deren Verbindung mit dem weiblichen Geschlecht, mit Alter und instrumentaler Belastung zu bestimmen. Die Studie begutachtete 731 Kinder, die ein Instrument erlernen (460 weibliche Personen) im Alter von 7 bis 17 Jahren. Langzeit Symptome, monatliche Symptome und monatliche Erkrankungen (die Unfähigkeit, das Instrument wie üblich zu spielen) wurden untersucht. Logistische Regressionsanalyse bewertete die unabhängige Verbindung dieser potentiellen Risikofaktoren mit der Verbreitung von SEB.

Ergebnisse: 67% berichteten über gelegentliche SEB Symptome, 56% nannten Symptome innerhalb des letzten Monats, und 30% konnten ihr Instrument im letzten Monat nicht wie sonst spielen. Weibliches Geschlecht stand signifikant mit SEB in Verbindung (OR 1.38—1.56, p = 0.004—0.046) wie ebenso das Alter (OR 1.19—0.23, p < 0.001). Nach der Eichung für Geschlecht und Alter zeigte auch die Instrumentengruppe (obere und tiefere Streicher, Holzund Blechbläser) signifikante Zusammenhänge mit SEB (p < 0.005), während das Spielen von drei Instrumenten die Spieler vor monatlichen Symptomen bewahrte (OR 0.43, p = 0.05).

Die große Verbreitung und Beeinträchtigung des Instrumentalspiels durch SEB ist eindeutig ein wichtiger Punkt für die Gesundheit von Kindern und Jugendlichen, wobei Geschlecht, Alter und instrumentale Belastung wichtige Faktoren bei der Risikobehandlung darstellen.

Trastornos Músculo-esqueléticos Relacionados con la Interpretación en Niños Instrumentistas: Influencias del Género, Edad y Contacto con el Instrumento

Los trastornos músculo-esqueléticos relacionados con la interpretación (TMRI) son comunes entre los músicos adultos. Las evidencias limitadas de que disponemos sugieren que los TMRI son también comunes entre niños y adolescentes y los factores de riesgo pueden ser similares a los de los adultos. El propósito de este estudio fue determinar el predominio de los TMRI en niños y adolescentes y su relación con el género femenino, la edad, y el contacto con el instrumento. El trabajo encuestó a 271 niños y 460 niñas (n = 731) de entre 7 y 17 años aprendiendo a tocar un instrumento musical. Se estudiaron síntomas crónicos, síntomas mensuales y trastornos también mensuales (es decir, la incapacidad para tocar normalmente un instrumento). Mediante regresión logística se valoraron las asociaciones independientes de estos factores de riesgo potenciales con el predominio de los TMRI.

Resultados: Un 67% del alumnado dijo tener algún síntoma MRI en mayor o menor medida, un 56% dijo haber padecido algún síntoma en el último mes y un 30% informó de la imposibilidad de tocar normalmente durante el último mes. El género femenino estuvo significativamente asociado con TMRI (OR 1’38—1’56, p = 0’004—0’046), así como la edad (OR 1’19—0’23, p < 0’001). Tras realizar ajustes por género y edad, el tipo de instrumento (cuerdas superiores e inferiores, viento madera y metal) se asociaba significativamente con todos los TMRI (p < 0’005). Se encontró además que tocar tres instrumentos protegía contra los síntomas mensuales (OR 0’43, p = 0’05). El alto predominio de los trastornos músculo-esqueléticos relacionados con la interpretación musical y su impacto incapacitante es claramente una cuestión importante para la salud de los niños y los adolescentes en donde el género, la edad y el contacto con el instrumento son factores importantes que influyen en la gestión del riesgo.

Keywords

age child/adolescent instrumentalists gender instrument exposure playing-related musculoskeletal problems risk factors

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Playing-related musculoskeletal problems in child instrumentalists: The influence of gender,age and instrument exposure

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