Highlights
- •Musicians’ clinical presentation as well as their relationship to injury is complex and would benefit from a clinical model that supports a musician-centered approach in alignment with the phenomenology of music performance.
- •Ecology of Musical Performance is a novel clinical model that promotes musician-centered holistic care in the clinical setting and facilitates collaborative goal setting.
- •A musician with playing related musculoskeletal disorders reported significant increase in hand function in daily activities and on the piano as measured by Quick Disabilities of Arm, Shoulder and Hand, numeric pain rating and hand strength following evaluation and treatment using the EMP model.
- •The patient increased pain-free practice and performance tolerance and was able to leverage gains in therapy for successful return to play.
Abstract
Study design
Case report
Background
Musicians with playing related musculoskeletal disorders (PRMD) require complex decision
making to interpret examination findings and develop a holistic treatment approach
that considers the unique interaction with their instrument. The Ecology of Musical
Performance (EMP) model is a novel comprehensive clinical model designed to provide
guidance for musician-centered evaluation, goal setting, and intervention planning
for musicians with PRMD.
Purpose of the study
To describe the application of EMP in the evaluation and treatment of a pianist with
PRMD.
Methods
Clinical documentation and the patient's symptom logs provided data for this study.
Special considerations unique to musicians in the initial evaluation as well as a
timeline of interventions are presented to illustrate the application of the EMP model
for a holistic approach to treatment.
Results and discussion
The pianist showed an increase in grip strength and self-reported hand function both
in daily activities and in piano performance and training. Pain free practice tolerance
increased and the patient successfully returned to participation in piano training
and performance.
Conclusion
This case demonstrates how a treatment program can be customized to benefit musicians
taking into consideration the complexity introduced by their relationship with music
making as a primary meaningful occupation. EMP may support a person-centered approach
to musicians with PRMD by aligning with the phenomenology of musical performance and
facilitating collaborative goal setting and problem solving.
Keywords
Abreviations:
PRMD (Playing related musculoskeletal disorder(s)), EMP (Ecology of Musical Performance), MIRC (The Musician-Instrument-Repertoire Complex), IC (Immediate Context), PC (Peripheral Context), ECU (Extensor Carpi Ulnaris muscle), Q-DASH DSS (Quick Disabilities of Arm Shoulder Hand Disability and/or Symptom Score), S and/or PAMS (Q-DASH Sports and/or Performing Arts Module Score)To read this article in full you will need to make a payment
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JHT Read for Credit
Quiz: # 760
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.The study design is
- a.RCTs
- b.case series
- c.case report
- d.qualitative
- a.
- # 2.The patient treatment was developed using the
- a.EMP model
- b.Peabody Musicians Program
- c.Mayo Clinic PRMD method
- d.JHU Curtis Hand Center approach
- a.
- # 3.In the Ecology of Musical Performance, interface effectors include
- a.mechanical demands of the instrument
- b.biomechanical efficiency
- c.repertoire demands
- d.all of the above
- a.
- # 4.The patient's primary instrument was the
- a.violin
- b.cello
- c.piano
- d.bass guitar
- a.
- # 5.The authors advocate a person-centered approach
- a.not true
- b.true
- a.
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Article info
Publication history
Published online: May 12, 2021
Accepted:
April 30,
2021
Received in revised form:
April 25,
2021
Received:
January 20,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
