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Comparing the Impact of Specific Strength Training Vs General Article Comparing the Impact of Specific Strength Training vs General Fitness Training on Professional Symphony Orchestra Musicians A Feasibility Study Lotte Nygaard Andersen, PhD, Stephanie Mann, BSc, Birgit Juul-Kristensen, PhD, and Karen Søgaard, PhD Musculoskeletal symptoms, especially in the upper body, improved aerobic capacity (34.1±7.9 mL/min/kg to are frequent among professional symphony orchestra 40.0±13.6 mL/min/kg) compared to no significant gain musicians. Physical exercise may relieve pain but might for SST. For GFT, a significant improvement was seen in also interfere with playing performance. OBJECTIVE : To self-reported muscle strength (5.7±1.3 to 6.5±1.8) with a evaluate the feasibility and effect of “specific strength tendency toward significant improvement in self- training” (SST) versus “general fitness training” (GFT). reported aerobic fitness (5.6±2.3 to 6.2±2.5). CONCLU - METHODS : A feasibility study using randomized con - SION : Exercise interventions have the potential to trolled methods. Primarily, evaluations involved self- improve musicians’ working situation. For future research, reported impact on instrument playing and satisfaction muscle-strengthening exercises and aerobic fitness exer - with the interventions. Secondary evaluations included cises might be combined in an intelligently designed pro - pain intensity, hand-grip strength, aerobic capacity, body gram, which may include other relevant educational mass index, and self-assessed physical fitness. A total of activities. Med Probl Perform Art 2017; 32(2):94–100. 23 professional symphony orchestra musicians were ran - domly allocated to either the SST ( n=12) or GFT ( n=11) usculoskeletal disorders and pain symptoms related groups. Participants conducted three 20-minutes exer - M to instrumental playing are highly prevalent among cise periods/wk at the workplace for 9 weeks. RESULTS : musicians, 1,2 and most of these disorders are perceived to be Evaluations of both interventions showed that approxi - 3 mately 50% of musicians were satisfied with the interven - work-related owing to factors such as repetitive move - tions and experienced a positive impact on playing, while ments, static postures, and a stressful and competitive 18% reported a slightly negative impact. From baseline to lifestyle. 4,5 Previously, it has been shown that the most follow-up, SST showed a significant reduction in pain prevalent complaints are pain symptoms or injury to the (26.3±22.5 to 11.4±15.2 mm), with no significant reduction back, neck, and shoulder. 1,3 Playing a musical instrument at for GFT (19.7±24.0 to 13.5±26.0 mm). GFT significantly an elite level requires many hours of rehearsal, and perform - Dr. Nygaard Andersen is Associate Professor, Department ances pose considerable demands on the musculoskeletal of Sports Science and Clinical Biomechanics and Depart - system. 6 A systematic review found that for a 12-month ment of Psychology, University of Southern Denmark, period the prevalence of musculoskeletal complaints in pro - Odense; Dr. Mann is Physiotherapist and Dr. Juul-Kristensen fessional musicians ranged from 41 to 93%. 1 is Associate Professor, Department of Sports Science and Such problems may entail serious consequences for the Clinical Biomechanics, University of Southern Denmark, Odense; and Dr. Søgaard is Professor, Department of musicians’ performance, their ability to play the instru - Sports Science and Clinical Biomechanics, University of ment, 3 and ultimately their career. 6 Playing-related disor - Southern Denmark, Odense, and the Center for Musicians’ ders of this kind depend on a number identifiable risk fac - Health, Odense University Hospital, Denmark. tors, as well as associated risk factors about which more 1 The authors declare no funding or conflicts of interest scientific knowledge is needed. related to this study. Many different methods have been suggested for the treatment and prevention of playing-related disorders, but This article is freely available online through the MPPA none has produced convincing evidence for their effects. 7 Open Access option. Evidence is limited, and more knowledge is needed about Address correspondence to: Dr. Nygaard Andersen, Cam - physical exercises that might be specifically well suited for pusvej 55, Dep. of Sports Science and Clinical Biomechan - musicians. Among music students, non-randomized stud - ics, University of Southern Denmark, 5230 Odense M, Den - ies 8,9 suggest a decrease in playing-related pain symptoms mark. Tel +45 65 50 75 91. [email protected]. for those doing physical exercises, while a small random - https://doi.org/10.21091/mppa.2017.2016 ized controlled trial in music students showed that 2017 Science & Medicine. www.sciandmed.com/mppa endurance training over 6 weeks reduced the perceived 94 Medical Problems of Performing Artists exertion of instrument playing. 10 Among professional sym - vention procedures that were used in the present trial were phony orchestra musicians, one study 11 of a combined approved by the Regional Scientific Ethics Committee for intervention also showed improvements in musicians’ Southern Denmark (project-ID S-20110040). physical competence and a decrease in playing-related mus - culoskeletal disorders, but the authors point out that the Study Population and Randomization musicians’ motivation is important for achieving effects. The study population consisted of professional symphony As a continuation of this, a study by Chan et al. 12 following orchestra musicians of the Odense Symphony Orchestra. musicians who used an exercise DVD found that this exer - Inclusion criteria were that they should be employed by cise program appeared to be feasible and effective in the the orchestra during the study period. Exclusion criteria management of playing-related musculoskeletal disorders. were serious physical conditions or illnesses that could The present feasibility study was intended to provide interfere with participation in the interventions, e.g., car - additional knowledge about the effects on musicians of pre - diovascular disease or pregnancy. ventive activities comprising two contrasting forms of All musicians ( n=73) in the orchestra were invited to an physical exercises. Both of these forms of standardized information meeting. After the meeting, 27 musicians physical exercise have, in randomized controlled designs, agreed to enroll in the study. Recruited participants were proved effective in pain reduction for workers in monoto - randomized to participate in either the SST or GFT group. nous jobs who experience musculoskeletal troubles. 13,14 For The study made use of an allocation concealment proce - musicians, however, the high quality of their performance dure to ensure that group allocation was not known until is paramount, and while physical exercise may relieve pain, the participant was enrolled in the study. Participant flow it might also interfere with playing performance. This was registered as recommended by the CONSORT. 15 could be the case in specific strength training in particular. Accordingly, each program was submitted to particular Interventions scrutiny in order to provide methodological information for future studies combining two exercise programs. Both SST and GFT groups received supervised physical The aim of the present feasibility study was to evaluate, exercises 3 times/week for 20 minutes over 9 weeks. Both among professional symphony orchestra musicians, the types of intervention are add-on workplace-based physical feasibility of “specific strength training” (SST) as com - activity interventions, meaning that they are additional to pared to “general fitness training” (GFT) to assess their rel - any existing lifestyle activity, and both interventions ative self-reported impact on instrument playing and the amounted in total to 1 hr/wk spent on exercises. If partic - musicians’ satisfaction with such interventions. A second - ipants were unable to attend the training at the workplace, ary aim was to record objectively measured hand-grip they were encouraged to exercise on their own. strength, aerobic capacity, and body mass index (BMI), as Musicians most often report pain symptoms in the neck well as self-reported measures of pain, physical fitness, region (including trapezius) 16 but also in the back and muscle strength, and endurance. More specifically, the shoulder areas. These self-reported symptoms should be hypotheses were that SST would have a more pronounced seen alongside results of a previous study, which showed effect on pain reduction than GFT, that GFT would have convincing effects of SST and GFT on shoulder and neck a more pronounced effect on aerobic capacity, and that pain reduction in office workers with chronic trapezius both types of exercise would have a positive impact on myalgia 13 ; therefore, the exercise protocol for SST and playing an orchestral instrument. GFT in our study closely followed this previous training protocol . Three trained physiotherapy students supervised METHODS and corrected the groups as they exercised. Interventions started within 1 week after the baseline measurements. Design and Settings The SST group performed supervised high-intensity spe - cific strength training, focusing on the neck and shoulder The current feasibility study was a parallel randomized muscles. The program for the neck and shoulder muscles controlled study conducted in the workplace. The infor - contained five dumbbell exercises; one-arm row (45° bend mation meeting, interventions,
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