Prolonged and incorrect postures are one of the main risk factors for the development of musculoskeletal pathologies. The aims of this study were to study the prevalence of incorrect postures among conservatory students; to identify if the use of an asymmetric instrument represents a risk factor for developing postural disorders; and to investigate whether a correlation exists between years of study, physical activity, and prevalence of postural disorders. METHODS: The subjects were recruited among students of the Giuseppe Verdi Conservatory of Milano. All musical instruments were investigated and classified as asymmetric and symmetrical. The observed student posture was classified without instrument as “correct posture” or “postural disorder” and with an with instrument as “optimal posture” or “non-optimal posture.” While playing, the postural disorder was classified as “unchanged” or “increased.” The data were analyzed with chi-square and linear regression methods. RESULTS: Of the 148 conservatory students entered into the study, 66.2% had a postural disorder; 73.4% had a non-optimal posture, and playing an asymmetric instrument was the only variable associated (p=0.01). While playing, the postural disorder was increased in 59.2%; playing an asymmetric instrument (p=0.01) and years of practice (p=0.007) were the significantly associated variables. CONCLUSIONS: To play an asymmetric instrument exposes musicians to an increased risk of non-optimal postures and to a worsened postural disorder when present. Considering that the years of practice have an additional negative impact on postural disorders, further studies are needed to clarify the role of non-optimal postures in the development of musculoskeletal complaints among students and professional musicians.
Powered wheelchairs are complex and expensive assistive devices that must be selected and configured on the basis of individual user needs, lifestyle, motivation, driving ability, and environment. Providing agencies often require evidence that their financial investment will lead to a successful outcome. The authors surveyed a sample of 79 users who had obtained powered wheelchairs from a Regional Health Service in Italy in the period 2008-2013. Follow-up interviews were conducted at the users' homes in order to collect information about wheelchair use, and its effectiveness, usefulness, and economic impact. The instruments used in the interviews included an introductory questionnaire, QUEST (Quebec User Evaluation of Satisfaction with Assistive Technology), PIADS (Psychosocial Impact of Assistive Devices Scale), FABS/M (Facilitators and Barriers Survey/Mobility), and SCAI (Siva Cost Analysis Instrument). The results indicated positive outcomes, especially in relation to user satisfaction and psychosocial impact. A number of barriers were identified in various settings that sometimes restrict user mobility, and suggest corrective actions. The provision of a powered wheelchair generated considerable savings in social costs for most users: an average of about $38,000 per person over a projected 5-year period was estimated by comparing the cost of the intervention with that of non-intervention.
Playing a musical instrument is a constrained motor activity; the instrument has a fixed geometry and playing technique that the performer must accommodate. Although the performer progressively adapts to the instrument during years of education, few options are available for adapting the instrument to the performer. The present work is intended to quantitatively describe the effects of using different setups of the violin shoulder rest during performance. Three conditions were considered, the maximum and minimum heights allowed by the shoulder rest and the absence of the shoulder rest. The setups allowed a height variation of <40 mm. Fifteen skilled violin players performed a three-octave scale in G with the three rest setups. An optoelectronic motion capture system measured the positions of passive markers placed on the player's body and on the violin and bow, in order to compute, by means of mathematical models, the kinematics of the body, violin, and bow. The increase in rest height was significantly related to a reduction in head rotation (–7.0°), left shoulder rotation (–8.5°), and left acromion elevation (–17.2 mm) and to an increase in left shoulder flexion (+8.2°) and left forearm pronation (+8.8°). In general, the results demonstrate that a skilled player is able to adapt to any shoulder rest setup and can maintain the quality of sound, and that the adaptations are primarily those of the anatomical systems involved in holding the violin and not in holding the bow. Moreover, adjustment of the shoulder rest setup appears to be the individual's search for a tradeoff position, which possibly may be alleviated by adopting objective assessment and innovative shoulder rests.
PURPOSE: This study aimed to assess the effectiveness of the “modified graded motor imagery” (mGMI) protocol as a rehabilitative treatment of musician’s focal dystonia (MFD). METHODS: Six musicians with MFD (age 43.83±17.24 yrs) performed the home-based mGMI protocol (laterality training, imagined hand movements and visual mirror feedback) once a day for 4 weeks. The mMGI protocol was designed to sequentially activate cortical motor networks and improve cortical organization. Subjects were evaluated before and after treatment with the dystonia evaluation scale (DES), arm dystonia disability scale (ADDS), Tubiana-Chamagne scale (TCS), and performing scale (PS). RESULTS: All participants were compliant with the mGMI treatment protocol without any adverse events. A significant improvement was measured in ADDS (p=0.047) and TCS scores (p=0.014) but not in DES (p=0.157). The severity of MFD decreased from moderate to mild in four patients. After mGMI treatment, all musicians were able to play easy pieces (TCS: median 3.5, IR 3.5–4). CONCLUSION: The findings from this pilot study suggest that home-based mGMI treatment is a feasible and promising rehabilitative approach for patients with mild to moderate MFD.
The World Health Organization has defined assistive technologies (AT) as the fourth pillar of global health and supported identifying AT outcomes among the five top priorities in AT research. In this framework, the research study OMAT (Outcomes of Mobility Assistive Technology in rehabilitation pathways) was developed by Fondazione Don Carlo Gnocchi. The OMAT study aims to develop and test the applicability of a model of rehabilitation pathway related to prosthetic interventions in the field of mobility: a multidisciplinary assessment of patients’ needs and expectations was made at baseline and after an adequate period of use of the prescribed assistive devices in everyday settings. To date, the study is ongoing. The present work aims to show the preliminary results of the OMAT research study, in particular its primary outcomes. Specifically, OMAT AT outcome assessment consists of 1) perceived effectiveness of assistive mobility products, 2) satisfaction of the intervention and 3) possible changes in quality of life. Among the recruited subjects (N = 32), most patients (87.5%) received only one mobility assistive product, especially bimanual self-propelled wheelchairs. Patients used the received mobility assistive products for 3–6 months, with a good frequency (few-days/ week) and moderate support. Preliminary results showed a positive impact of assistive mobility products in terms of perceived effectiveness, intervention satisfaction, and quality of life. Interestingly, patients showed improved quality of life, showing a significant decrease of the severity degree in problems identified at baseline evaluation. Further studies will be conducted to replicate these promising results in a larger sample.
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