Health Education Literacy and Accessibility for Musicians: A Global Approach. Report from the Worldwide Universities Network Project.

OBJECTIVE: To address the need for accessible health education and improved health literacy for musicians throughout their lifespan. METHODS: Formation of a multicultural, international, and interdisciplinary collaborative research team, funded by the Worldwide Universities Network. The goal is to design a multi-strand research program to develop flexible and accessible approaches to health education for musicians, thus improving their health literacy. RESULTS: Two team meetings took place in 2018. The first was held 11 to 15 April 2018 in Perth, Australia, and involved a review of existing literature and interventions on health education in music schools, intensive development of research topics, aims, and methodologies, and identification of potential funding sources to support future large-scale research programs. This resulted in the draft design of three research projects, finalized during a second meeting in Maastricht, the Netherlands, 27 to 31 August 2018. DISCUSSION: These intensive meetings identified the need for both cultural change in music education settings as well as improved health literacy in musicians across global geographical regions. A global project to address health literacy and health education accessibility for musicians has commenced.

Rehabilitation of a cellist whose vibrato was affected by focal dystonia.

Focal dystonia can result in a variety of technical problems in the performing musician, most often affecting control of finger movement, and embouchure. Less common is the effect of focal dystonia on the vibrato of string players. The professional cellist in our study presented with difficulty controlling her vibrato, which fluctuated both in speed and amplitude, causing an inconsistency of sound. This study investigated whether instrumental retraining could alleviate her condition. We report the novel finding that instrumental retraining can significantly improve the symptoms of a dystonic vibrato in a cellist.

Validity and reliability of the Musicians' Health Literacy Questionnaire, MHL-Q19.

High prevalence of musicians' physical and mental performance-related health issues (PRHI) has been demonstrated over the last 30 years. To address this, health promotion strategies have been implemented at some post-secondary music institutions around the world, yet the high prevalence of PRHI has persisted. In 2018, an international group of researchers formed the Musicians' Health Literacy Consortium to determine how best to decrease PRHI, and to examine the relationship between PRHI and health literacy. An outcome of the Consortium was the development of a new health literacy tool for musicians, the MHL-Q19, which drew from the theoretical framework of the European health literacy suite of tools, HLS-EU. The aim of the current study was to evaluate the validity and reliability of the MHL-Q19. Participants completed a battery of questionnaires, including the HLS-EU-Q16 for the assessment of general health literacy; the Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians (MPIIQM); the RAND-12 quality of life questionnaire; and the General Self-Efficacy scale (GSE). We hypothesized that the MHL-Q19 would have a weak correlation with the HLS-EU-Q16; moderate correlation with the physical component scale and weak correlation with the mental component scale of the RAND-12; moderate correlation with the GSE; and finally, moderate correlation with pain interference and weak correlation with pain intensity of the MPIIQM. A total of 549 post-secondary music students from six English-speaking countries completed the battery of questionnaires, and 328 of these participants provided valid responses to the MHL-Q19 alone 2 weeks later. The tool showed acceptable internal consistency and test-retest reliability. Three of our hypotheses were supported, although the strength of the correlations varied from what we had predicted. The fourth hypothesis was not supported; our findings indicate that lower health literacy scores were weakly related to higher MPIIQM pain intensity and interference scores. The results of this study support the notion that musicians' health literacy is a distinct construct that cannot be fully evaluated with existing health literacy tools. Given that this is a new instrument, the evidence presented is positive and promising. Further studies will be needed to refine the tool.

Pianism retraining via video conferencing as a means of assisting recovery from focal dystonia: a case study.

Focal dystonia (FD) is a devastating neurological condition which causes involuntary muscle contractions and often results in the loss of a musician's playing ability. Our study investigated whether retraining via video conferencing could be helpful in the treatment of a professional pianist with a 5-year history of FD. Although full recovery was not seen, improvement was observed at slow tempi, and his hand was visibly less cramped as training sessions progressed. We conclude that video conferencing could be an acceptable medium to assist pianism retraining in pianists with FD when location prevents on-site retraining. However, in this study it did not seem as effective as previously reported, similar, one-on-one retraining in the same location.