The key reasons for dropout in Slovenian music schools - a qualitative study.

Music education often struggles to sustain students' long-term commitment, with many perceiving lessons as frustrating or unengaging, leading to discontinuation. To address this gap, our study aimed to elucidate the primary reasons for dropout from the perspectives of various stakeholders, including students, parents, teachers, and principals. Drawing upon the self-determination theory, our research comprehensively investigated external and internal factors contributing to dropout. Among external factors, competing extracurricular commitments, music theory and solfége lessons, and teacher's approach emerge as the most prominent. Among internal factors, our findings highlighted the critical role of autonomy, competency, and relatedness in shaping students' decisions to continue or discontinue music education. Inadequate teacher-student relationships, limited peer interactions, and uninspiring classroom atmospheres significantly impacted dropout. Moreover, challenges in the music school curriculum, such as difficulties with music theory and solfège, resource limitations, and excessive workloads, emerged as prominent barriers to student engagement. By addressing these multifaceted issues, our study underscores the importance of fostering supportive environments that cater to individual needs and interests, ultimately enhancing the overall music education experience and reducing dropout rates. This research represents the first systematic empirical study in Slovenian music education, laying the groundwork for future quantitative investigations to advance education practices in Slovenia.

The influence of music performance anxiety on career expectations of early musical career students: self-efficacy as a moderator.

Music performance anxiety (MPA) is recognized as a distinct emotional behavior rather than merely a motor control disorder and is influenced by specific conditioning experiences. This study investigates the interrelationships between MPA, self-efficacy, and future career expectations among music students within the Chinese context. The participants of this study were 340 high school students majoring in music education and performance, drawn from three music schools in China. Data were collected using several questionnaires: the MPA Inventory for Adolescents (MPAI-A), the Self-Efficacy Formative Questionnaire, and the Career Futures Inventory (CFI). The findings indicate that MPA is negatively associated with self-efficacy and future career expectations. Additionally, self-efficacy acts as a partial moderator between MPA and career expectations, suggesting that enhancing the self-efficacy of music students can boost their future career aspirations and mitigate the adverse effects of MPA. This research explores the complex relationships among MPA, self-efficacy, and future career expectations, emphasizing the importance of curriculum and pedagogical strategies in music schools. Music students with high levels of self-efficacy may exhibit more confidence and stable performances before audiences. According to the panel regression analysis, self-efficacy significantly positively influences career expectations. An appropriate educational environment and supportive pedagogical approaches to MPA can foster the early career development of musicians.

Health consultations at a performing arts health centre among classical music students based on electronic health record data: a cross-sectional study.

Physical and mental health problems in music students are usually identified using self-reported data. The use of an Electronic Health Record database can avoid biases to give an overview of the extent of health problems in this population. Therefore, the aim of this study is to gain insight into both physical and mental health related issues in classical music students using this type of data collection. An Electronic Health Record database including five years of data from a Performing Arts Health Centre (PAHC) of a university or the arts, was used to analyze the number and characteristics of health consultations in music students. The total number of students, health consultations and the average number of visits per health consultation were calculated over five years. Furthermore, numbers and percentages of both physical and mental health consultations were registered. Also, the number and percentage of health consultations per instrument group were compared to the proportion of each instrument group within the specific sample. Over a period of five years, 230 students visited the PAHC and 417 health consultations were reported. 43.5% of the students who visited a health professional indicated at least one physical health consultation, 29.1% at least one mental health consultation and 27.4% at least one in both categories. An injury was the most frequently registered physical health consultation (40.2%), followed by performance improvement (9.8%) and stress (9.6%). Voice students registered relatively most health consultations. As far as we know, this is the first cross-sectional study using Electronic Health Record data from a PAHC to gain insight into both physical and mental health related issues in a population of classical music students. Looking at the variety of health consultations registered in the database, a multidisciplinary team and multidisciplinary approach are necessary to meet the needs of the students in terms of physical and mental health support and performance improvement.

Corrigendum: Effect of manual therapy on music students with playing-related musculoskeletal disorders: a prospective study.

[This corrects the article DOI: 10.3389/fpain.2023.1151886.].

Positive Childhood Experiences and Depression Among College Students During the COVID-19 Pandemic: A Moderated Mediation Model.

Purpose: In light of the ongoing COVID-19 pandemic, mental health concerns have become more prevalent worldwide. However, there is a lack of research specifically addressing the mental well-being of college art students. Therefore, the purpose of this study is to examine the prevalence of depressive symptoms among college music students and explore the factors that predict and alleviate these symptoms amidst the challenges posed by the COVID-19 pandemic. Materials and Methods: An online survey was conducted among college music students (n = 407) from two universities at May 2022 in China. Self-report scales were used to measure levels of depression (Zung Self-Rating Depression Scale), positive childhood experiences (Benevolent Childhood Experiences Scale), social support (Multi-Dimensional Scale of Perceived Social Support), and regulatory emotional self-efficacy (Regulatory Emotional Self-Efficacy Scale). Hayes PROCESS macro for SPSS was used to test the hypothesized effects of regulatory emotional self-efficacy and social support in the relationship between positive childhood experiences and depression. Results: Results showed that, the prevalence of depression symptoms of the current study sample was 64.13%, positive childhood experiences had a significant and negative predictive effect on the depression of college music students, and the relation was partially mediated by regulatory emotional self-efficacy. Furthermore, social support moderated the relationship between positive childhood experiences and regulatory emotional self-efficacy, the relation was significant only for students with higher levels of social support, social support may enhance and amplify the positive impacts of positive childhood experiences on regulatory emotional self-efficacy. Conclusion: The findings reveal a significant prevalence of depression among college music students during the COVID-19 epidemic, underscoring the seriousness of the issue. Moreover, this study contributes to a deeper comprehension of how positive childhood experiences alleviate depression among college music students. These insights hold potential for informing mental health education initiatives tailored to college art students in the post-pandemic era, offering valuable guidance for promoting their well-being and resilience.

The relationship between musicianship and pain. Is chronic pain and its management a problem for student musicians only?

Introduction: The neuro-biological side of chronic pain research has presented reliable evidence of distinct cortical and spinal alteration compared to healthy individuals. Furthermore, research suggests that musicians are especially vulnerable to pain, and recent neurological investigations into musicians' brain plasticity support this hypothesis. However, chronic pain is not acute pain plus time, but a separate condition, and little is known about musicians' chronic pain-related emotions and behaviors. This knowledge, however, is a crucial step in understanding how chronic pain is processed by musicians. Methods: This study investigated pain catastrophizing as a critical pain-related behavior and emotional concept alongside six complementary variables: anxiety, depression, depersonalisation, burnout, coping strategies and professional identity. Results: 103 under- and postgraduate students from various higher education institutions participated in an online survey. Students were allocated into three groups according to their main study subject and type of institution: music college musicians, university musicians and university non-musicians. A tree model confirmed the current chronic pain multifactorial model, suggesting a combination of several variables before catastrophizing pain. Group testing, however, showed that university non-musicians' pain catastrophizing was significantly worse especially when compared to music college musicians. Music college musicians and university musicians were less prone to maladaptive pain processes, despite perceiving pain for significantly longer. Discussion: This novel finding indicates that chronic pain does not inevitably lead to dysfunctional pain processing for musicians and should be reflected accordingly to optimize pain-control. The biopsychosocio model of chronic pain provides a robust framework for future research in this population.

Norwegian music students' perceptions and experiences of challenges and resources for health.

Introduction: Music students in higher education experience health-related challenges linked to practice and performance, while an understanding of these challenges and access to resources to deal with them are required to promote the students´ health. Health literacy and health education are integral parts of health promotion and resources for health, which encompasses health-related knowledge and competence aiming to improve health. The aim of this study was to explore Norwegian music students' perceptions and experiences of resources and challenges for health and address the following research question: What health-related challenges do music students in higher music education meet, and what health promoting resources do they need and use to deal with these challenges and promote their health? Methods: We conducted a qualitative study including three focus group interviews with 13 music students aged between 19 and 31 years studying classical, folk, jazz or rhythmic genres from five different music departments in Norwegian universities. The Salutogenic model of health was used as theoretical framework and a few questions regarding the concept of health literacy were included in the interviews. We used thematic network analysis to analyze the data. Results: Main health challenges were related to performance pressure and difficulties implementing good health habits in the students` daily lives. Furthermore, the findings revealed several resources that promoted the students' health: (1) Personal resources included situational understanding, using adequate coping strategies, high motivation and participating in regular physical activity. (2) Social resources involved an understanding of the importance of social support from peers and teachers and synergy created between themselves and the audience through sharing of music. (3) Environmental resources were linked to access to good rehearsal rooms. The music students expressed a need for increased competence in health promoting routines during practice and performance and suggested that health-related topics should be an integrated part of education.

Effect of manual therapy on music students with playing-related musculoskeletal disorders: a prospective study.

Playing Related Musculoskeletal Disorders (PRMD) belong to the most prevalent medical ailments affecting musicians' health and career. This study documents the effect of a physiotherapeutic treatment as well as functional impairments of PRMD on the musculoskeletal system. In total, 32 music students suffering from PRMD were examined in Hanover Medical School (MHH) before and after they received twelve physiotherapeutic treatments, which were carried out over 20 min each over 6 weeks. Additionally, 32 healthy music students, matched by age and gender, were examined at one time point in the MHH to explore which musculoskeletal restrictions are associated with PRMD. The examination included the evaluation of the pain on the Visual Analogue Scale for pain (VAS), a body composition, and body posture measurement, the finger-to-floor distance, the range of motion of the cervical spine, the pressure pain and muscular hypertension examination, the temporomandibular joint-test, the Beighton score screening test, and the testing of the widespread pain score (WSP). After analyzing the data of the patient group (PG) a significant reduction of pain level on the VAS from an average pain of 6.31 to 3.53 was found (large effect). Additionally, a significant reduction of the pressure pain of the M. levator scapulae, the M. rhomboideus, the M. sternocleidomastoideus on the left side and the paravertebral muscles of the cervical spine on the right side after the treatment of the patients could be detected. Regarding the WSP, the positive testing significantly differed, showing a 28% positive testing in the patient group vs. a positive testing of 9% in the control group (CG). As hypermobility is a common phenomenon in musicians, the percentage of those being diagnosed with generalized hypermobility by using the Beighton score in both groups (PG: 37.5%; CG: 25%) was remarkably higher compared to previous studies. In this study, a short course of manual therapy, client tailored for each musician's specific problem, was shown to reduce pain levels in musicians with PRMD.

How audience and general music performance anxiety affect classical music students' flow experience: A close look at its dimensions.

Flow describes a state of intense experiential involvement in an activity that is defined in terms of nine dimensions. Despite increased interest in understanding the flow experience of musicians in recent years, knowledge of how characteristics of the musician and of the music performance context affect the flow experience at the dimension level is lacking. In this study, we aimed to investigate how musicians' general music performance anxiety (MPA) level (i.e., the general tendency to experience anxiety during solo music performances) and the presence of an audience influence the nine flow dimensions. The participants were 121 university music students who performed solo a music piece once by themselves (private performance) and once in front of an audience (public performance). Their general MPA level was measured with an adapted version of the STAI and ranged from 27 (very low MPA) to 76 (very high MPA). The level of the nine flow dimensions was assessed with the Flow State Scale-2 after each performance. The levels of "concentration on task at hand," "sense of control," and "autotelic experience" decreased significantly with increasing general MPA level. The levels of "unambiguous feedback" and "loss of self-consciousness" decreased significantly with increasing general MPA level during the public performance only. The level of "sense of control" was significantly lower during the public performance than the private performance across participants. The level of "unambiguous feedback" was significantly lower during the public performance than the private performance for participants with a general MPA level higher than 47. The level of "loss of self-consciousness" was significantly lower during the public performance than the private performance for participants with a general MPA level higher than 32. In contrast, the general MPA level and the audience did not significantly affect the levels of "challenge-skill balance," "clear goals," and "action-awareness merging." These results show that the effects of general MPA level and audience vary greatly across flow state dimensions. We conclude that musicians' flow state should be analyzed at the dimension level rather than as a global score. We discuss how our findings could inform the development and implementation of interventions.

Social contact, practice, organization and technical knowledge: Experiences of music students in the course of the COVID-19 pandemic.

For music students, the COVID-19 pandemic has had a great impact, forcing them to adapt to certain coronavirus regulations laid down by the state. In this study, the experiences of music students in three consecutive semesters under different coronavirus-related conditions are investigated. At the end of three semesters, the lockdown semester [SS (Summer Semester) 2020: April - July], a partially opened semester [WS (Winter Semester) 2020/21: October - February] and a mostly opened semester (SS 2021), a total of 152 music students at the University of Music Freiburg were asked to fill in an online survey. A mixed-methods approach was used, with results showing that the qualitative statements of the students support the quantitative data. The results of the cross-sectional study demonstrate that self-regulated learning improved during the lockdown semester, through new time management and focused practice with regular breaks. During the partially opened semester, the use of blended learning formats led to organizational problems, such as travel time and change of locations. Furthermore, music students were challenged by the social distancing, which improved during the partially opened, and mostly opened semester. New technologies regarding digital communication formats were emerged, which have evolved over the course of the three semesters. Concerning the overall experience, students stated that the partially-opened semester was most challenging, since distances and change of locations had to be combined with quickly changing public COVID-19-regulations. These findings during different stages of the COVID-19 pandemic provide constructive starting points for future teaching.

A Longitudinal Study of Physical and Mental Health and Health-Related Attitudes Among Music Students: Potentials and Challenges for University Health Promotion Programs.

Objective: Well-being of music students has been an increasing matter of concern since studies show that up to 50% of beginners suffer from playing-related pain or anxiety. The aim of this longitudinal study was to examine health status, health-related attitudes, behaviors, knowledge, skills, and coping strategies of students at the beginning of their education at a music university and at the end of their second semester. Methods: Based on a longitudinal online survey conducted among students at a German music university since 2017, we investigated mental and physical health status, health-related attitudes, knowledge, skills, behaviors, and coping strategies of music students at the beginning of their first year (n = 205). We analyzed differences between performance and music education majors and between students playing different main instruments. In a subsample (n = 62), we additionally analyzed changes between the beginning of the music students' first and the end of their second semester, also depending on whether they attended courses on musicians' health. Results: Music students are already in demand when they enter a music university, practicing on average almost 3 h daily. Compared to other body regions, pain in shoulders/back is most prevalent in first-year students, especially in those playing string instruments. Performance majors reported better knowledge about health risks and protective measures for musicians, better coping abilities, and practiced more than music education majors. First-year students assessed their overall and mental health status at the beginning of their first semester mainly as good, but we found a decrease in mental health status at the end of the second semester. After two semesters, students attending courses on musicians' health showed increased knowledge and skills regarding different aspects of musicians' health. Conclusion: The health status of music students when they first enter a music university is still a concern. Information and practical courses enabling students to prevent overuse and cope with performing anxiety and other stressors are important components of a comprehensive study program. Knowledge about music students' needs can help conservatories better respond to the requirements and develop courses and measures supporting students from the beginning of their education.

Health education for musicians in the UK: a qualitative evaluation.

Musical training in higher education music institutions (e.g. conservatoires) has been associated with health-related issues among musicians. The Health Promotion in Schools of Music project in the USA and the Healthy Conservatoires project in the UK have therefore recommended health promotion at conservatoires. Few health education courses have been evaluated to date, however. A 5-month health education programme for first-year undergraduate students at a British conservatoire was introduced as part of the core curriculum in September 2016. The programme, which involved both lectures and seminars, was evaluated using quantitative and qualitative approaches. This article reports only the qualitative evaluation. Twenty semi-structured individual interviews were conducted either face-to-face or via Skype in April 2017. The data were transcribed verbatim and analysed thematically. Five themes were identified: (i) the programme as a catalyst for engagement with health; (ii) behavioural changes; (iii) barriers to engaging with the programme material and initiating changes; (iv) suggestions for improvement; and (v) misinformation. Generally, participants viewed the programme as relevant and informative, particularly appreciating the intimate nature of the seminars. They reported that the programme helped them take a broader perspective on musicianship and that they would welcome sessions that are more practical than theoretical. They also reported instances of change in their behaviours relating to both lifestyle and management of music practice. In conclusion, undergraduate music students viewed this health education programme positively. Their feedback illustrates the complex nature of health promotion in the conservatoire setting.

Professional classical musicians struggle with a range of occupational health issues. It has therefore been recommended that health education be integrated as part of their higher education training. Although some programmes of this nature have been implemented in recent years, very few were evaluated, so it is often unclear if they work and if so, how. This paper reports the evaluation of one such programme that lasted 5 months and was delivered to first-year undergraduate music students in the UK. Although the evaluation of the programme was complex and involved many measurements, this article reports only the analysis of themes arising from interviews with 20 participants that were audio-recorded and transcribed verbatim. The results of the analysis show that participants viewed the course positively. Specifically, they viewed the programme as relevant and informative, and appreciated the intimate nature of the seminars. The programme seemed to widen their perspective on musicianship and they reported changes in their behaviours related to preventative health and music practice, although they also expressed a preference for an even more practical and thus less theoretical approach.

Factors Associated with Mental Health among Malaysian University Music Students: Roles of Fear of COVID-19, Nomophobia, Loneliness, Sleep Quality, and Socioeconomic Status.

Previous mental health studies have shown higher levels of anxiety, stress, and depression symptoms among university music students. In general, some similar findings have been observed for Malaysian music university students. In diagnosing the complications of mental health, there is consensus that it is essential to develop and evaluate a model oriented toward mental health illness prevention and treatment. To date, a suitable pattern for estimating mental health in terms of anxiety, stress, and depression among music university students is lacking. To fill this gap, we collected the necessary data from 691 music and 871 general students who were students for one year. The introduced pattern includes socioeconomic status, fear of COVID-19, nomophobia, sleep quality, loneliness, and mental health. Our data analysis proved that the levels of anxiety, depression, and stress of music students were lower than those of general students. Unlike some previous studies, in this study, the fear of COVID-19 and nomophobia didn't have the most significant impact on mental health. The most significant impacts were related to sleep quality and loneliness. These findings have the potential to inform health promotion and services in the music education system.

MusicCohort: Pilot feasibility of a protocol to assess students' physical and mental health in a Canadian post-secondary school of music.

OBJECTIVE: Music-related physical and mental health conditions are common among post-secondary music students, with many studies reporting a prevalence greater than 70%. However, there is currently no consensus on appropriate, validated assessments for this population. The aim of this pilot study was to test the feasibility of an assessment protocol developed for a German longitudinal study with Canadian post-secondary music students, and to compare the health of music students to non-music students. Using a cross-sectional design, first-semester music and non-music control students were recruited at two campuses at the same university. Both groups completed questionnaires and physical testing, including range of motion, core strength, and pressure pain threshold. Nineteen music students and 50 non-music student controls participated in this study. RESULTS: The German protocol is feasible in a Canadian post-secondary setting. Canadian music students demonstrated similar health outcomes to those in the parent study. All participants demonstrated poorer mental and physical quality of life than the Canadian norms, though this was not statistically significant. The results of this study should be confirmed in a larger study. Future studies with larger sample sizes can provide further insight into the health of Canadian music students, providing a basis for prevention and intervention.

Social Support as a Facilitator of Musical Self-Efficacy.

Previous research has shown that musical self-efficacy is one of the predictors of academic achievement, but few studies have analyzed the function of social support in the construction of musical self-efficacy. In this study we analyze the relationship between three sources of support perceived by music students - parents, teachers, and peers - and their influence on levels of self-efficacy for learning and for public performance. We analyze three groups of students under the hypothesis that relationships among those variables can vary with age and the level of education. A total of 444 students enrolled in six Spanish music schools, two music universities, and four advanced music schools, completed the Social Support Scale for Music Students, as well as the General Musical Self-Efficacy Scale. Results reveal significant relationships among the aforementioned variables, with considerable variation according to academic level. For the youngest students enrolled in advanced music schools (conservatorios profesionales), the role of parents and teachers was crucial, especially for predicting self-efficacy for learning, which, in turn, is the best predictor of self-efficacy for public performance. For the 16-18-year-olds enrolled in the same advanced music schools, their peers play a particularly relevant role in reinforcing their self-efficacy for learning. Social support had a negligible influence on the self-efficacy of university-level students, but they did experience a strong relationship between self-efficacy for learning, on the one hand, and public performance, on the other. We interpret these results in view of potential long-term careers in music, relating them with a series of different agents.

Anxiety and Depression Symptom Level and Psychotherapy Use Among Music and Art Students Compared to the General Student Population.

Purpose: Previous epidemiological studies have shown higher levels of anxiety and depressive symptoms among professional musicians, compared to the general workforce. Similar findings have been observed for psychotherapy use among musicians. To date, large-scale investigations of prevalence rates among music and arts students are lacking. Methods: Eight hundred and eighty students from music and arts institutions and faculties were derived from a national health student survey for higher education in Norway (the SHoT study). They were compared to a sample of the general student population (n = 48,729). We used logistic regression analysis, adjusting for age, sex, and semesters of study. Results: Music and arts students reported higher rates of anxiety [OR 1.60 (1.38-1.85), Prevalence difference (PD) 9.6 (6.3-12.8)] and depression symptoms [OR 1.41 (1.22-1.62), PD 7.9 (4.5-11.2)] compared to the general student force. Similar patterns were observed for self-reported mental disorders [OR 1.71 (1.46-2.01), PD 8.1 (5.3-11.0)], as well as psychotherapy use [OR 1.91 (1.60-2.29), PD 7.4 (4.9-9.9)] in music and arts students. Conclusions: Our findings are consistent with studies comparing musicians to the general workforce, and indicate that challenges also exist at student level, and not only after becoming a professional in the performing arts, which is important when planning health-related measures. These findings have the potential to inform on health promotion and services in the educational system.

Musical Practice in Music Students During COVID-19 Lockdown.

The pandemic situation has forced students in higher education to use alternative learning routines due to reduced activities at universities and educational facilities. Especially music students needed to adapt their musical learning to this particular situation. Mostly affected by the lockdown was the musical practicing behavior, especially when practicing at the University of Music was not possible. In this study, music students in their second and third semesters were asked to provide information on their practicing situations during the coronavirus disease 2019 (COVID-19) lockdown. They were required to fill in questionnaires about the practicing time and concepts of self-efficacy and self-regulation for musical learning. The data of 18 music students were collected. For the analysis, they were compared with the answers of 15 music students who were asked the same questions half a year earlier before the pandemic situation occurred. The results showed that the music students relocated mostly to their parents' homes for practicing during the lockdown. In the amount of practicing, the bachelor of music students practiced less during lockdown compared with before the lockdown. The mean self-efficacy for musical learning did not differ between before and during the lockdown. For the self-regulated musical learning, the music students showed significantly higher values in the subscale on reflecting and creating a framework for the progress of musical learning during the lockdown. The findings indicate that the music students developed certain self-regulated learning skills during the lockdown and managed to find suitable solutions in continuing with their musical learning without reservation.

Studying Music During the Coronavirus Pandemic: Conditions of Studying and Health-Related Challenges.

OBJECTIVE: The coronavirus pandemic affects all areas of life. Performing arts and music studies have also experienced considerable changes, with university closures and a fluctuating return to normal and more limited operations. Prior studies detail the impact of the pandemic on college students, but we do not yet know what specific consequences it has for music students. The aim of this study is to examine the impact of the coronavirus pandemic on music students' health, practicing behavior, and everyday life. METHODS: In July 2020, we conducted an online survey of 80 students enrolled in performance and music education programs at a German music university and compared these data with data from a survey of 75 students at the same music university carried out in summer 2019. RESULTS: The survey revealed that the coronavirus pandemic led to a decrease in practicing hours and an increase of stressful thoughts and feelings. Students were mostly satisfied with Corona-measures taken by the university. Of analyzed determinants, only general fear of health problems was identified as a significant predictor of mental health status. Mental health status did not significantly differ between students surveyed in 2019 and 2020. CONCLUSION: Knowledge about the specific challenges the pandemic poses for music students can help conservatories to better respond to the needs of their students. Specifically, this study will inform future measures supporting music students in coping with difficult situations like a pandemic.

Patterns of pain location in music students: a cluster analysis.

BACKGROUND: According to existing literature, musicians experience high rates of musculoskeletal (MSK) disorders involving different anatomical areas. The aim of the study was to identify patterns of pain location in a sample of music students enrolled in different pan-European music institutions. A further goal was to explore the association between the identified pain patterns and students' characteristics. METHODS: A total of 340 music students (mean age 23.3 years, 66.2% female) with current MSK pain completed a web-based questionnaire including both background information (i.e. lifestyle and physical activity, practice habits) and clinical features (i.e. pain characteristics, disability, pain self-efficacy, psychological distress, perfectionism and fatigue). RESULTS: Five patterns of pain location were identified by hierarchical cluster analysis: wrist pain (WP) representing 22.6% of the total sample, widespread pain (WSP) (16.9%), right shoulder pain (RSP) (18.5%), both shoulders pain - left concentrated (LSP) (23.2%), neck and back pain (NBP) (18.8%). Amongst the identified patterns of pain location, bivariate analysis identified the WSP cluster as containing the largest number of associated variables. Participants in this cluster reported a higher percentage of women (p < .05), a higher perceived exertion (p < .01) and psychological distress (p < .001), as well as a lower level of self-efficacy (p < .01). Similarly, a higher percentage of participants included in the WSP cluster perceived their musical activity as the main cause of their MSK pain (p < .01). Additionally, a higher level of disability in relation to playing-related activity was reported by participants included in the WP and WSP clusters (p < .001). The RSP cluster was characterised by a higher percentage of participants playing an instrument in a neutral position (p < .001) and lower levels of socially prescribed perfectionism (p < .01). A higher percentage of participants playing an instrument with both arms elevated in the left quadrant position were included in the LSP cluster and a higher percentage of singers were included in the NBP cluster (p < .001). CONCLUSIONS: Five distinct patterns of pain location were identified and their associations with the students' characteristics were explored. These findings may be helpful in the exploration of different aetiologies of MSK pain among musicians and in the development of targeted preventive strategies and treatments.

Pure-Tone Hearing Thresholds and Otoacoustic Emissions in Students of Music Academies.

The objective of this study was to assess the hearing of music students in relation to their exposure to excessive sounds. A standard pure-tone audiometry, transient-evoked otoacoustic emissions (TEOAEs) and distortion-product otoacoustic emissions (DPOAEs) were determined in 163 students of music academies, aged 22.8 ± 2.6 years. A questionnaire survey and sound pressure level measurements during solo and group playing were also conducted. The control group comprised 67 subjects, mainly non-music students, aged 22.8 ± 3.3 years. Study subjects were exposed to sounds at the A-weighted weekly noise exposure level (LEX,w) from 75 to 106 dB. There were no significant differences in the hearing thresholds between groups in the frequency range of 4000-8000 Hz. However, music students compared to control group exhibited lower values of DPOAE amplitude (at 6000 and 7984 Hz) and signal-to-noise ratio (SNR) (at 984, 6000, and 7984 Hz) as well as SNR of TEOAE (in 1000 Hz band). A significant impact of noise exposure level, type of instrument, and gender on some parameters of measured otoacoustic emissions was observed. In particular, music students having LEX,w ≥ 84.9 dB, compared to those with LEX,w < 84.9 dB, achieved significantly lower DPOAE amplitude at 3984 Hz. Meanwhile, both TEOAE and DPOAE results indicated worse hearing in students playing percussion instruments vs. wind instruments, and wind instrument players vs. students playing stringed instruments.