Playing with the entire self: the Feldenkrais method and musicians

Musculoskeletal disorders and complaints in professional musicians: a systematic review of prevalence, risk factors, and clinical treatment effects

PURPOSE

Musicians' practice and performance routines reportedly lead to musculoskeletal complaints and disorders (MCD) that impact their wellbeing and performance abilities. This systematic review aims to assess the prevalence, risk factors, prevention and effectiveness of treatments for MCD in professional musicians and consider the methodological quality of the included studies.

METHODS

A systematic literature search was performed in December 2017 using electronic databases and supplemented by a hand search. Case-control studies, cohort studies, cross-sectional studies, interventional studies and case reports investigating the prevalence, risk factors, prevention or treatment effects of MCD in professional musicians or music students (age ≥ 16 years) were included. Quality assessments of the included studies were performed using an adapted version of the "Study Quality Assessment Tools" from the National Heart, Lung, and Blood Institute.

RESULTS

One case-control study, 6 cohort studies, 62 cross-sectional studies, 12 interventional studies and 28 case reports were included and assessed for methodological quality. The study designs, terminology, and outcomes were heterogeneous, as the analyses mostly did not control for major confounders, and the definition of exposure was often vague. Therefore, evidence that being a professional musician is a risk factor for MCD as well as the causal relationship between these factors remains low despite the fact that a large number of studies have been performed.

CONCLUSIONS

Studies with high internal and external validity regarding the prevalence, risk factors and effectiveness of the prevention or treatment of MCD in professional musicians are still missing. Further high-quality observational and interventional studies are required.

Changes in neural resting state activity in primary and higher-order motor areas induced by a short sensorimotor intervention based on the Feldenkrais method

We use functional magnetic resonance imaging to investigate short-term neural effects of a brief sensorimotor intervention adapted from the Feldenkrais method, a movement-based learning method. Twenty-one participants (10 men, 19–30 years) took part in the study. Participants were in a supine position in the scanner with extended legs while an experienced Feldenkrais practitioner used a planar board to touch and apply minimal force to different parts of the sole and toes of their left foot under two experimental conditions. In the local condition, the practitioner explored movement within foot and ankle. In the global condition, the practitioner focused on the connection and support from the foot to the rest of the body. Before (baseline) and after each intervention (post-local, post-global), we measured brain activity during intermittent pushing/releasing with the left leg and during resting state. Independent localizer tasks were used to identify regions of interest (ROI). Brain activity during left-foot pushing did not significantly differ between conditions in sensorimotor areas. Resting state activity (regional homogeneity, ReHo) increased from baseline to post-local in medial right motor cortex, and from baseline to post-global in the left supplementary/cingulate motor area. Contrasting post-global to post-local showed higher ReHo in right lateral motor cortex. ROI analyses showed significant increases in ReHo in pushing-related areas from baseline to both post-local and post-global, and this increase tended to be more pronounced post-local. The results of this exploratory study show that a short, non-intrusive sensorimotor intervention can have short-term effects on spontaneous cortical activity in functionally related brain regions. Increased resting state activity in higher-order motor areas supports the hypothesis that the global intervention engages action-related neural processes.

Feldenkrais Method, Alexander Technique, and Yoga—Body Awareness Therapy in the Performing Arts

The three disciplines described are practiced by many individuals for a myriad of reasons. Depending upon ability and depth of study, teachers of all three disciplines may have specific competencies with which to analyse, instruct, and interact with students/clients. In the author's experience, persons who seek out these practices and incorporate them into their daily lives and expressions of physical activity often are motivated to maintain or establish an optimal state of well-being and function. Physicians and therapists who work with performing artists are in a position to encourage such positive direction in patients, provide information on local resources, and consider the practices as collaborative and adjunctive to medical care.

Musculoskeletal and neuromuscular conditions of instrumental musicians

Performing Arts Medicine is a broad field that includes the study of medical conditions and injuries incurred by dancers, instrumental musicians, and vocalists. This article summarizes the most relevant literature of approximately the past 10 years concerning the musculoskeletal and neuromuscular conditions of musicians. A literature search was done for relevant articles in English by physicians or scientists. Some older, but fundamental, articles are included; incidental case reports were excluded to the extent possible. Included were articles on incidence, prevalence, pathophysiology, diagnosis, treatment, and biomechanical studies in musicians. Although nearly all of these conditions are the same ones seen in the general work force, it is clear that their occurrence patterns in the professional musician are unique, as is their impact on the life and livelihood of the patient. The content of the Arts Medicine literature does not permit a truly critical review. Research in the last 10 years appears not to have been done in a true blinded, random case-controlled fashion. Many authors support their statements with only their respective clinical experiences. The research cited here includes 58 series, 9 case studies, 5 surveys, 2 pre/post intervention studies, and 1 double-blind crossover clinical trial.