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"Musician"

Original Articles
Electrodiagnostic Study on Neuropathies in String Players.
Kwon, Yong Wook , Kim, Jong Min
J Korean Acad Rehabil Med 1999;23(2):316-324.

Objective: To determine the frequency, involved nerves and sites of entrapment neuropathy in string players.

Method: The subjects were 24 string playing musicians and age matched 24 normal controls. Questionnaire, physical examination were taken in the musicians and the electrodiagnostic study was performed in both the musician and the control groups. Electrodiagnostic study included nerve conduction study of median and ulnar nerves. The distal motor latency, segmental motor conduction velocity, distal sensory latency, and amplitude of sensory nerve action potentials were measured. Each parameter of nerve conduction study was compared in two groups and was correlated to the string playing duration.

Results: Three musicians (12.5%) were diagnosed as entrapment neuropathy: One, left ulnar neuropathy at the elbow and the wrist and left median neuropathy at the wrist; Two, left ulnar neuropathy at the elbow. Ulnar motor conduction velocity of right forearm segment and left elbow segment were significantly reduced in the musicians compared to those of the controls (P<0.05). The distal sensory latency of left ulnar nerve was significantly prolonged in musicians compared to that of the controls (P<0.05). The string playing duration significantly correlated with the distal motor latency of right median nerve (R=0.632, P<0.05) and the distal sensory latency of left median nerve (R=0.518, P<0.05).

Conclusions: These results suggest that some entrapment neuropathies could be developed due to cumulative trauma in string players. Elbow and wrist segment of left ulnar nerve, forearm segment of right ulnar nerve are possible sites of entrapment neuropathy in string players.

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Clinical Manifestations of Overuse Injury in Musicians.
Seo, Kyoung Mook , Seo, Kyung Ho , Kim, Sung Won
J Korean Acad Rehabil Med 1998;22(6):1318-1323.

Objective: To know the clinical features of overuse injury in performing musicians and to evaluate related factors that may affect the overuse injury and playing related pain.

Methods: Eighty professional musicians and music college students were examined during 1 year. All were examined by a history taking, physical examination, radiologic exam and if needed electromyography. Nonparametric Sperman's correlation were used for the statistic analysis and 5 interval grading system, visual analog scale for pain, and stress, criteria of joint hypermobility were used for various measurements.

Results: Fifty four men were studied in 3 music colleges and a professional orchestra. Frequency of symptom was 46.3%. The string players were most frequently affected (65%), whereas the wind instrument players were least frequently affected (11.5%). The most commonly affected site was the hand and wrist (54.2%) followed by the spine. Patients were divided by the severity into 5 groups and among them the grade 1 was most common (29.6%). No significant correlation was seen between the practice hours per week but a significant correlation was noted between the stress and playing related pain. Joint hypermobility plays an important role in music playing which is dependent on the kind of instruments.

Conclusion: Incidence of the overuse injury in musicians is high in Korea and the prevention and early treatment are essential for the good outcome of overuse syndrome.

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