Artikel
Pianists most common hand and wrist disorders as effect of forearm muscle overload
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Veröffentlicht: | 6. Februar 2020 |
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Objectives/Interrogation: Professional musicians are often compared to professional sportsman but the diversity of muscle work and its implications to patients health vast difference. Musicians maintain one improper position for long time which indicates great level of muscle overload in time. Most of the problems are caused not by high energy injury but because of microtrauma and muscle fatigue which leads to muscle imbalance and proprioception disorders. Treating musicians hand is a great challenge for surgeon as well as for therapists because very often patients admit about the problem and pain because of being afraid of playing break and losing their abilities.
Aim of the study was to asses most common hand and wrist disorders according to muscle overload while playing in professional pianist group.
Methods: 17 professional pianists (average age: 31 y.o.) with time of play min 15 years underwent clinical examination, DASH questionnaire and electromyography Noraxon Telemyo examination while playing. All participants were measured at the same instrument and with the same program - sitting position, 3min all board repetitive octave, different rest positions and pace instrumentals. To assess flexors strength global grip strength was measured.
Results and Conclusions: Clinical examination reveled most common problems with wrist pain and painful palpation. 56% of group had positive results of Thomsons, Cozens and chair test. 39% of group claimed ulnar or median neuropathy symptoms. 64% of group present incorrect posture with neck and shoulder protraction. 53% of participants had present skin laxity symptoms. The superficial electromyography reveled significant difference (p<0,05) between resting position and playing. Average amplitude during play of ECU was 72,4 uV, ECRB 55,6 uV while FCR 62,3 uV and FCU 42,3 uV and FCR 47,9 uV. Global grip strength was 29,8 kg for right hand and 28,1 for left hand.
Superficial electromyograpy indicates high overload of wrist extensors and flexors muscles which are responsible for wrist pain and disorders. Wrist laxity, poor posture and lack of proper warm up may paly important role for wrist disorders.