The RISMUS Cohort Study: Risk Among Music Students.

This observational cohort study involves repeated cross-sectional observations in order to identify those factors associated with increased risk of PRMDs among music students.

All pre-college and university-level students from several European music academies will receive an invitation to complete a web-based questionnaire survey at each of three occasions (baseline; 6-months follow-up; 12-months follow-up).

Professional musicians are exposed to chronic high volume of continuous and repeated physical movements, sometimes in challenging and ergonomically unfavourable anatomical body positions, in order to acquire and improve technical playing skills. As a consequence, musicians are vulnerable to developing adverse playing-related musculoskeletal disorders (PRMDs) that may affect the manner in which and the extent to which music can be practised and performed.

In order to find out effective solutions for PRMDs and to develop future preventive measures, it is fundamental to firstly identify the main risk factors that play a significant role in the development of adverse musculoskeletal (MSK) conditions and symptoms.

The longitudinal cohort study will be conducted through the following three phases:

1. a baseline cross-sectional survey (i.e. web-based questionnaire) to characterise the study population and subgroups, and form the basis for the evaluation of associated factors and relationships with the development of PRMDs;
2. a 6-months follow-up survey, and
3. a 12-months follow-up survey.

After the first baseline data collection (Phase 1), the cohort of students will be broken down into:

* Cohort 1: music students (both pre-college and university-level) who are free of pain and PRMDs at baseline data collection
* Cohort 2: music students (both pre-college and university-level) who aren't free of pain and PRMDs at baseline data collection

Afterwards, the two cohorts will be followed and invited for reassessment at 6 months (Phase 2) and 12 months (Phase 3).

Both the follow-ups will permit longitudinal change in outcome scores to be generated and compared (longitudinal comparisons) for strength and progression of association, alongside those from absolute outcome scores at several cross-sectional analyses.

The web-based survey will include questions about any pain, PRMD and/or MSK problem they may have due to their musical practice, and different outcome measures (i.e. lifestyle and physical activity, practice habits, behaviour toward prevention and health history, level of stress, perfectionism, fatigue and disability).

The outcome measures have been selected according to the relevant findings of previous cross-sectional studies and systematic reviews among the performing arts literature.

Each outcome measure correspond to a suspected factor that may be associated with the development of a PRMD.

To the best of our knowledge, no other longitudinal studies on risk factors for PRMDs have been conducted so far. Therefore, the study can be considered as an opportunity to fill the gaps of current research on PRMDs and generate new knowledge in educational and employment musical contexts.

Eligibility Criteria:
Inclusion Criteria:

* All pre-college and university-level students from music academies, with a classical instrument as main subject.

Exclusion Criteria:

* Music students without a classical instrument as main subject (composers and conductors)
* Positive history for neurological, rheumatic, psychological disorders or emotional distress, as well as surgery of the upper limbs and/or the spine in the last 12 months.