Dr. Barton: Thank you so much for that nice introduction. I have been in practice for 36 years and I initially started working at a hospital. I was there for almost 15 years working in acute care. I specialized in arthritis care and worked very closely with a Rheumatologist that became interested in the area of performing arts medicine. This was back in the 1980's when the Performing Arts Medicine Association, PAMA, came into being and in close association with the Aspen Music Festival. A lot of this work with performing artists began back then. The Performing Arts Medical Association also houses the Medical Problems of Performing Artists Journal, which is a professional journal.
The way I designed this session is to reflect on the occupational therapy process of evaluation and intervention, and to introduce you to the OT Practice Framework and how we can use those guidelines with this special group of patients that are involved in the performing arts. How you can intertwine that and apply that to your everday practice with patients that might be musicians or other types of performing artists?
Above are our session objectives. I really want you to feel comfortable with identifying common health problems that a musician may have. I am probably going to lapse into that musician language even though there are other performing artists that would be applicable in this category. We will look at an occupation-based approach on evaluating musicians dealing with everyday occupations, not just their music making, but all those other things that are important throughout the day and their role as a musician. We will also look at those underlying client factors, that are impacting the person's ability to make music, and the performance skills that are needed to improve those skills so that they can prevent injury or deal with injury. We will also talk about different interventions that will help to improve occupational performance for musicians and other performing artists.
Why Are Musicians at Risk?
It is important for us to have some information about why musicians may be at increased risk for occupational performance issues (Figure 1).
Figure 1. Performing arts studies.
In the first bullet point is a 1988 article, that is pretty old, but it is a pertinent article that upon which a lot of subsequent research has been based. As I said, the Performing Arts Medical Association began in 1980 and it is during this early period of time in the '80s that we were trying to identify how musicians were impacted by playing in terms of injury. In this study, by Fishbein and Middlestadt, of a huge number of symphony musicians, they found that 76% of these musicians reported problems physically that impacted their playing. These were professional musicians.
In another article done about 10 years later, there is a term that starts to emerge called playing-related musculoskeletal disorders, PRMD. You are going see this term throughout the literature with musicians. In the study by Christine Zaza, she found that 39 to 87% in various organizations of adult musicians were complaining about playing-related musculoskeletal disorders.
