Are culturally vibrant communities healthier? Relationships between performing arts activity and health outcomes in the 500 largest US cities.

AIMS: Recent reviews have demonstrated broad links between performing arts participation (e.g. music-making; dancing; acting) and receptive engagement (e.g. listening to music; attending a dance/theatre performance) and improved health, including reduced disease and mortality risk. However, no investigations to date have interrogated the links between community-level performing arts activity (i.e. participation + receptive engagement) and health outcomes - that is, do the performing arts help create healthy communities? This study aims to address this question by examining links between performing arts activity and health outcomes across 500 cities in the US. METHODS: Secondary analysis of demographic, health outcome, performing arts activity (estimated by annual performing arts revenue), and preventive/unhealthy behaviour data for 500 large cities in the US - data extracted from the US Centers for Disease Control 500 Cities Project, Dun & Bradstreet Hoovers Database, and US Census. Links between performing arts activity and 12 health/disease outcomes were evaluated using a series of hierarchical beta regression models which progressively controlled for demographic variables and preventive/unhealthy behaviour prevalence. RESULTS: The 500 analysed US cities comprise 33.4% of the total US population and 84,010 performing arts businesses (total annual revenue $27.84 billion). No significant associations were found between performing arts activity and 9 of 12 health outcomes in fully adjusted models (p ⩾ .17). Statistically significant relationships (p < .01) between increased performing arts activity and increased prevalence of chronic kidney disease, coronary heart disease, and stroke were determined to be clinically equivocal. CONCLUSIONS: This study contributes to a growing body of conflicting epidemiologic evidence regarding the impact of the performing arts on health/disease and mortality outcomes, evaluated using a range of disparate methodologies. A consensus, psychometrically rigorous approach is required to address this prevailing uncertainty in future epidemiologic studies examining the effects of performing arts activities both within and across countries and communities.

Evidence of slow and variable choice-stepping reaction time in cancer survivors with chemotherapy-induced peripheral neuropathy.

BACKGROUND: Chemotherapy-induced peripheral neuropathy (CIPN) is reported to affect up to 70 % of cancer survivors. Despite evidence that CIPN-related impairments often translate into balance and mobility deficits, the effects on stepping and quality of gait, well-documented risk factors for falls, are unclear. AIMS: (i) Establish choice-stepping reaction time (CSRT) performance in survivors with CIPN compared to young and older healthy controls and people with Parkinson's disease; (ii) document walking stability; (iii) investigate relationships between stepping and gait data to objective and patient-reported outcomes. METHODS: 41 cancer survivors with CIPN (mean (SD) age: 60.8 (9.7) years) who were ≥3months post chemotherapy, performed tests of simple and inhibitory CSRT. Walking stability measures were derived from 3-D accelerometry data during the 6-minute walk test. CIPN was assessed using neurological grading and patient-reported outcome measures (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire in CIPN Questionnaire scale EORTC CIPN20). RESULTS: In both stepping tests, CIPN participants performed at the level of adults aged 10 years older and people with mild to moderate Parkinson's disease. Mean (SD) total stepping response times in both CSRT (1160 (190) milliseconds) and inhibitory CSRT (1191 (164) milliseconds) tests were not associated with objective neurological grading but were correlated with increased difficulty feeling the ground. Participants with lower-limb vibration sensation deficit had slower and more variable CSRT times. There were no associations between walking stability and objective measures of CIPN, and limited correlations with the EORTC-CIPN20. CONCLUSIONS: Cancer survivors with CIPN showed deficits in voluntary stepping responses and seemed to compensate for their sensory and motor deficits by walking slower to maintain stability. Objective and patient-reported outcomes of CIPN were correlated with slower and more variable stepping response times. Future studies should aim to identify the causes of the apparent premature decline in cognitive-motor function and develop remediating interventions.

Effects of Physical Symptoms on Muscle Activity Levels in Skilled Violinists.

BACKGROUND: Physical symptoms present in a large percentage of instrumental musicians at all levels of expertise, yet the impact of these symptoms on patterns of muscle use and perceived exertion during performance is still unclear. PURPOSE: Quantify the effects of physical symptoms on muscle activity and perceived exertion in skilled violinists during a range of bowing actions. METHODS: Fifty-five professional or university (undergraduate or postgraduate) violinists performed 5 randomly ordered 45-second musical excerpts designed to elicit a range of right arm bowing actions. Surface electromyography data were obtained from 16 muscles of the trunk, shoulder, and right arm during each excerpt performance. Sites of current physical symptoms were reported using a pre-test questionnaire. Average rating of perceived exertion (RPE) for the excerpt performances was obtained immediately after the final excerpt performance. RESULTS: Right upper trapezius muscle activity levels were significantly reduced in participants reporting right shoulder symptoms (p<0.05). Violinists with right wrist symptoms displayed global increases in average muscle activity across all investigated muscles (p<0.03). RPE did not differ significantly between any groups of symptomatic and asymptomatic participants. CONCLUSION: Differential muscle activity patterns appear between right shoulder symptomatic, right wrist symptomatic, and asymptomatic violinists, presenting the possibility of altered biomechanical responses to physical symptoms that vary with symptom location.