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Effect of a rehabilitation program on performance-related musculoskeletal disorders in student and professional orchestral musicians: a randomized controlled trial [with consumer summary]
Roos M, Roy JS
Clinical Rehabilitation 2018 Dec;32(12):1656-1665
clinical trial
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To explore the feasibility of a rehabilitation program and its effect on the performance-related musculoskeletal symptoms and functional limitations of orchestral musicians. DESIGN: Single-blind pilot randomized controlled trial with exercise group and control group. SETTING: Workplace of professional symphony orchestra and tertiary-level conservatory orchestral musicians. PARTICIPANTS: Professional and student orchestral musicians with or without performance-related musculoskeletal disorders. INTERVENTIONS: A rehabilitation program including an educational presentation, an 11-week home exercise program and three supervised exercise sessions, versus no intervention. MEASURES: Feasibility measures included adherence and drop-out rate. The Musculoskeletal Pain Intensity and Interference Questionnaire for professional orchestra Musicians (MPIIQM) measured symptom intensity and functional limitations, while the Nordic Musculoskeletal Questionnaire (NMQ) measured symptom prevalence and frequency. RESULTS: A total of 30 participants were recruited (n = 15 per group). Exercise group adherence was 97.7% for the supervised sessions and 89% for the home exercise program. There were no drop-outs. Significant group-time interactions were obtained for both the pain intensity (partial eta2 = 0.166; p = 0.025) and pain interference (partial eta2 0.186; p = 0.017) sections of the MPIIQM. Mean (standard deviation) pain intensity score changes from baseline to 11 weeks were control group 0.40 (5.04); p = 0.763; partial eta2 =0.007; and exercise group -4.07 (5.31); p = 0.010; partial eta2 = 0.386. For pain interference, mean score changes were control group 0.20 (9.10); p = 0.933; partial eta2 = 0.001; and exercise group -9.00 (10.73); p = 0.006; partial eta2 = 0.430. NMQ analyses revealed no significant interaction (p > 0.05). CONCLUSION: Results suggest that the studied program is feasible and effective in decreasing the intensity and functional impact of musicians' symptoms. However, no significant medium-term effect on the prevalence and frequency of symptoms was shown.

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