Chronic profession-limiting problems in musicians: Underlying mechanisms and neuroplastic routes to recovery
Creators: name: Loram, Alison
Publisher: name: unknown
Year: 2013
Subjects: subject: Performing arts
subject: Music--Performance
subject: Performance practice (Music)
subject: Human body
subject: Human mechanics
subject: Medicine

description: Musicians are subject to a wide range of medical and performance problems related to the physical and psychological demands of their profession. Such problems are usually diagnosed and treated in relation to a specific cause, for example direct treatment to reduce inflammation. While holistic factors are increasingly acknowledged, currently lacking is a mechanistic understanding of how cognitive, physiological and mechanical factors combine to cause specific symptoms. 

This thesis provides a conceptual explanation and experimental evidence to support the hypothesis that most specific symptoms arise from a common general mechanism. 

The first section "Review of Literature" provides a general, mechanistic explanation of how injury and dysfunction can arise from misconception, the rules of neuromuscular function, lack of awareness and reinforcement (wind-up) of symptoms. Within a perception-selection-action feedback loop, misconception and lack of awareness of the consequences of maladaptive selection, ensures consequences are subject to destructive (positive) feedback, until the system "breaks" at the individual's weakest point. This hypothesis suggests that a general solution lies in educational feedback and inhibitory action to break the loop at the point of selection. 

The second section presents an experimental study (i) to establish whether in playing, violinists and violists exhibit a common diagnosable musculokinematic pattern unnecessary for performance, and (ii) to test a methodology for revealing and reducing that pattern in individuals. 

Full-body, kinematic and electromyographical data showed that external feedback (ultrasound feedback of the neck muscles and verbal feedback of movement) resulted in progressive reductions in the extent to which a common musculokinematic pattern was exhibited. Differences were characterised by reductions in muscle activities and key movements, associated with performance limiting problems and injury.
description: Musicians are subject to a wide range of medical and performance problems related to the physical and psychological demands of their profession. Such problems are usually diagnosed and treated in relation to a specific cause, for example direct treatment to reduce inflammation. While holistic factors are increasingly acknowledged, currently lacking is a mechanistic understanding of how cognitive, physiological and mechanical factors combine to cause specific symptoms. This thesis provides a conceptual explanation and experimental evidence to support the hypothesis that most specific symptoms arise from a common general mechanism. The first section "Review of Literature" provides a general, mechanistic explanation of how injury and dysfunction can arise from misconception, the rules of neuromuscular function, lack of awareness and reinforcement (wind-up) of symptoms. Within a perception-selection-action feedback loop, misconception and lack of awareness of the consequences of maladaptive selection, ensures consequences are subject to destructive (positive) feedback, until the system "breaks" at the individual's weakest point. This hypothesis suggests that a general solution lies in educational feedback and inhibitory action to break the loop at the point of selection. The second section presents an experimental study (i) to establish whether in playing, violinists and violists exhibit a common diagnosable musculokinematic pattern unnecessary for performance, and (ii) to test a methodology for revealing and reducing that pattern in individuals. Full-body, kinematic and electromyographical data showed that external feedback (ultrasound feedback of the neck muscles and verbal feedback of movement) resulted in progressive reductions in the extent to which a common musculokinematic pattern was exhibited. Differences were characterised by reductions in muscle activities and key movements, associated with performance limiting problems and injury.