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As with typically developing children, children with cerebral palsy and autism spectrum disorder develop important socio-emotional rapport with their parents and healthcare providers. However, the neural mechanisms underlying these relationships have been less studied. By simultaneously measuring the brain activity of multiple individuals, interbrain synchronization could serve as a neurophysiological marker of social-emotional responses. Music evokes emotional and physiological responses and enhances social cohesion. These characteristics of music have fostered its deployment as a therapeutic medium in clinical settings. Therefore, this study investigated two aspects of interbrain synchronization, namely, its phase and directionality, in child-parent (CP) and child-therapist (CT) dyads during music and storytelling sessions (as a comparison). A total of 17 participants (seven cerebral palsy or autism spectrum disorder children [aged 12-18 years], their parents, and three neurologic music therapists) completed this study, comprising seven CP and seven CT dyads. Each music therapist worked with two or three children. We found that session type, dyadic relationship, frequency band, and brain region were significantly related to the degree of interbrain synchronization and its directionality. Particularly, music sessions and CP dyads were associated with higher interbrain synchronization and stronger directionality. Delta (.5-4 Hz) range showed the highest phase locking value in both CP and CT dyads in frontal brain regions. It appears that synchronization is directed predominantly from parent to child, that is, parents and music therapists' brain activity tended to influence a child's. Our findings encourage further research into neural synchrony in children with disabilities, especially in musical contexts, and its implications for social and emotional development.
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Trastorno del Espectro Autista , Parálisis Cerebral , Niños con Discapacidad , Música , Humanos , Trastorno del Espectro Autista/terapia , Diencéfalo , Padres/psicologíaRESUMEN
OBJECTIVE: The objective of this study was to determine whether exposure to long-known music would evoke more extensive activation of brain regions minimally affected by Alzheimer disease (AD) pathology and outside traditional memory networks using a functional magnetic resonance imaging paradigm involving listening to long-known and recently-learned music in older adults with cognitive impairment to provide insight into mechanisms of long-term musical memory preservation in cognitively impaired older persons. METHODS: Seventeen subjects with a diagnosis of mild AD or mild cognitive impairment were recruited for this study. Subjects were scanned using functional magnetic resonance imaging while they performed a music listening task, which included short clips of personally selected music from the patient's past and newly-composed music heard for the first time 60 minutes before scanning. From this task, we obtained group-level maps comparing brain areas associated with long-known and recently-heard music in all subjects. RESULTS: Exposure to long-known music preferentially activated brain regions including the medial prefrontal cortex, precuneus, anterior insula, basal ganglia, hippocampus, amygdala, and cerebellum relative to recently-heard music. These areas are involved in autobiographical memory and associated emotional responses. In addition, they are minimally affected by early stage AD pathology, thus providing a neural basis for long-known musical memory survival. CONCLUSIONS: Long-known music activates a bilateral network of prefrontal, emotional, motor, auditory, and subcortical regions (cerebellum, putamen, limbic structures). This extensive activation, relative to recently-heard music, may offer structural and functional clues as to why long-term musical memory appears to be relatively preserved among cognitively impaired older persons.
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Enfermedad de Alzheimer/patología , Percepción Auditiva/fisiología , Mapeo Encefálico , Disfunción Cognitiva/patología , Memoria Episódica , Música/psicología , Anciano , Encéfalo/fisiología , Femenino , Humanos , Imagen por Resonancia Magnética , MasculinoRESUMEN
It is well established clinically that rhythmic auditory cues can improve gait and other motor behaviors in Parkinson's disease (PD) and other disorders. However, the neural systems underlying this therapeutic effect are largely unknown. To investigate this question we scanned people with PD and age-matched healthy controls using functional magnetic resonance imaging (fMRI). All subjects performed a rhythmic motor behavior (right hand finger tapping) with and without simultaneous auditory rhythmic cues at two different speeds (1 and 4 Hz). We used spatial independent component analysis (ICA) and regression to identify task-related functional connectivity networks and assessed differences between groups in intra- and inter-network connectivity. Overall, the control group showed greater intra-network connectivity in perceptual and motor related networks during motor tapping both with and without rhythmic cues. The PD group showed greater inter-network connectivity between the auditory network and the executive control network, and between the executive control network and the motor/cerebellar network associated with the motor task performance. We interpret our results as indicating that the temporal rhythmic auditory information may assist compensatory mechanisms through network-level effects, reflected in increased interaction between auditory and executive networks that in turn modulate activity in cortico-cerebellar networks.
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Cognición/fisiología , Señales (Psicología) , Vías Nerviosas/fisiopatología , Enfermedad de Parkinson/fisiopatología , Estimulación Acústica/métodos , Anciano , Anciano de 80 o más Años , Conducta/fisiología , Mapeo Encefálico , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana EdadRESUMEN
OBJECTIVE:: To test whether rhythmic auditory stimulation (RAS) training reduces the number of falls in Parkinson's disease patients with a history of frequent falls. DESIGN:: Randomized withdrawal study design. SUBJECTS:: A total of 60 participants (aged 62-82 years) diagnosed with idiopathic Parkinson's disease (Hoehn and Yahr stages III or IV) with at least two falls in the past 12 months. INTERVENTION:: Participants were randomly allocated to two groups and completed 30 minutes of daily home-based gait training with metronome click-embedded music. The experimental group completed 24 weeks of RAS training, whereas the control group discontinued RAS training between weeks 8 and 16. MAIN MEASURES:: Changes in clinical and kinematic parameters were assessed at baseline, weeks 8, 16, and 24. RESULTS:: Both groups improved significantly at week 8. At week 16-after the control group had discontinued training-significant differences between groups emerged including a rise in the fall index for the control group ( M = 10, SD = 6). Resumption of training reduced the number of falls so that group differences were no longer significant at week 24 ( Mexperimental = 3, SD = 2.6; Mcontrol = 5, SD = 4.4; P > 0.05). Bilateral ankle dorsiflexion was significantly correlated with changes in gait, fear of falling, and the fall index, indicating ankle flexion as a potential kinematic mechanism RAS addresses to reduce falls. CONCLUSION:: RAS training significantly reduced the number of falls in Parkinson's disease and modified key gait parameters, such as velocity and stride length.
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Accidentes por Caídas/prevención & control , Estimulación Acústica , Terapia por Ejercicio/métodos , Musicoterapia/métodos , Enfermedad de Parkinson/rehabilitación , Anciano , Anciano de 80 o más Años , Fenómenos Biomecánicos , Miedo , Femenino , Marcha/fisiología , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/fisiopatología , Proyectos de InvestigaciónRESUMEN
The 2019 coronavirus disease pandemic influenced music therapists to migrate services to online platforms, though some lost clinical hours during the pandemic when telehealth was not a viable option. This survey study aimed to ascertain factors that helped music-based therapists to continue serving autistic clients over telehealth during the pandemic. We surveyed 193 accredited music therapists located mainly in Canada and the US. In addition to gathering data on general perceptions of telehealth music therapy and Neurologic Music Therapy (NMT), one-way ANOVAs were applied to determine differences in percent-change loss of clinical hours for music therapists: (1) working in different employment settings; (2) serving children, youth, adults, or a mixture of ages; and (3) practicing NMT or not. The general perception of telehealth music therapy was positive, and NMTs believed that the clear protocols and transformation design model were helpful to them in adapting services to telehealth. There were no significant differences in percent-change of clinical hours among music therapists in different employment settings or serving different client age groups. Music therapists who said they practiced within the NMT treatment model lost a significantly lower percentage of clinical hours with autistic clients than those who did not practice NMT. Possible reasons for this result and the need for further research are discussed.
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Trastorno Autístico , COVID-19 , Musicoterapia , Telemedicina , Humanos , COVID-19/epidemiología , Musicoterapia/métodos , Trastorno Autístico/terapia , Adulto , Masculino , Femenino , Canadá/epidemiología , Niño , Estados Unidos/epidemiología , Encuestas y Cuestionarios , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Adolescente , Actitud del Personal de SaludRESUMEN
Although remote music training has its limitations, the use of technology can lower barriers to its accessibility. This exploratory study compared the effects of remote and in-person percussion training on motor performance, performance quality, and students' enjoyment. The training involved the motor aspects of playing legato on percussion instruments. Twenty percussionists received the training either remotely from an instructor using videoconferencing technology or in person from the same instructor who was in the training room. Motor behavior, legato expressivity, performance quality, and participants' self-rated enjoyment were compared to determine potential advantages and disadvantages of training in the two formats. Furthermore, participants rated their interest in continuing to receive training in the same way they had experienced it, remote or in person. Regardless of whether the instructor was remote or in person, participants lifted their mallets to a greater height above the drums post-training, perhaps because there was more spatial and velocity variability in the movements of their elbows and wrists. Changes in their patterns of post-training movements were paralleled by higher ratings for expressivity of legato and performance quality. Critically, participants who received training from the remote instructor expressed greater interest in continuing training than those who received training from the instructor who was physically present, in both the short and long term. These findings may suggest that remote and in-person instruction yielded comparable changes on motor behavior, as demonstrated by the altered speed at which movements of the elbow and wrist were executed, which in turn may influence the perception of expressivity in legato playing. The results may support the use of remote training as an adjunct to physical practice to lower some barriers to music education.
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This study investigates the functional neuroanatomy of harmonic music perception with fMRI. We presented short pieces of Western classical music to nonmusicians. The ending of each piece was systematically manipulated in the following four ways: Standard Cadence (expected resolution), Deceptive Cadence (moderate deviation from expectation), Modulated Cadence (strong deviation from expectation but remaining within the harmonic structure of Western tonal music), and Atonal Cadence (strongest deviation from expectation by leaving the harmonic structure of Western tonal music). Music compared with baseline broadly recruited regions of the bilateral superior temporal gyrus (STG) and the right inferior frontal gyrus (IFG). Parametric regressors scaled to the degree of deviation from harmonic expectancy identified regions sensitive to expectancy violation. Areas within the BG were significantly modulated by expectancy violation, indicating a previously unappreciated role in harmonic processing. Expectancy violation also recruited bilateral cortical regions in the IFG and anterior STG, previously associated with syntactic processing in other domains. The posterior STG was not significantly modulated by expectancy. Granger causality mapping found functional connectivity between IFG, anterior STG, posterior STG, and the BG during music perception. Our results imply the IFG, anterior STG, and the BG are recruited for higher-order harmonic processing, whereas the posterior STG is recruited for basic pitch and melodic processing.
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Corteza Auditiva/fisiología , Percepción Auditiva/fisiología , Mapeo Encefálico , Cuerpo Estriado/fisiología , Música , Estimulación Acústica , Análisis de Varianza , Corteza Auditiva/irrigación sanguínea , Cuerpo Estriado/irrigación sanguínea , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Oxígeno , Estimulación LuminosaRESUMEN
Auditory rhythm-based therapeutic interventions such as rhythmic auditory stimulation (RAS) are effective in improving gait and balance and preventing falls in idiopathic Parkinson's disease (PD). Research showing associated neuromodulatory effects of RAS on brain oscillations is also emerging. The neuromodulation may be induced by neural entrainment and cross-frequency oscillatory coupling. Auditory rhythm and RAS based interventions are potentially effective in improving other PD symptoms and can be extended to atypical parkinsonism.
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Enfermedad de Parkinson , Humanos , Enfermedad de Parkinson/terapia , Estimulación Acústica , Marcha/fisiología , Encéfalo , Modalidades de FisioterapiaRESUMEN
Developmental coordination disorder (DCD) remains largely underdiagnosed and masked by other co-occurring conditions. The aim of this study was to (1) provide the first review of research regarding auditory-motor timing and synchronization abilities in children with DCD and (2) examine whether reduced motor performance may be associated with difficulties in auditory perceptual timing. The scoping review was carried out across five major databases (MEDLINE, Embase, PsycINFO, CINAHL, and Scopus) in accordance with the PRISMA-ScR guidelines. Studies were screened by two independent reviewers against the inclusion criteria, without publication date restrictions. From an initial return of 1673 records, 16 articles were included in the final review and synthesized based on the timing modality studied (i.e., auditory-perceptual, motor, or auditory-motor). Results suggest that children with DCD have difficulties with rhythmic movements both with and without external auditory cues and further indicate that variability in and slowness of motor response are key characteristics of DCD, regardless of the experimental task. Importantly, our review highlights a significant gap in the literature regarding auditory perceptual abilities in DCD. In addition to testing auditory perception, future studies should compare the performance of children with DCD on paced and unpaced tasks to determine whether auditory stimuli contribute to a more or less stable performance. This knowledge may inform future therapeutic interventions.
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Accumulating evidence suggests that the neural activations during music listening differs as a function of familiarity with the excerpts. However, the implicated brain areas are unclear. After an extensive literature search, we conducted an Activation Likelihood Estimation analysis on 23 neuroimaging studies (232 foci, 364 participants) to identify consistently activated brain regions when healthy adults listen to familiar music, compared to unfamiliar music or an equivalent condition. The results revealed a left cortical-subcortical co-activation pattern comprising three significant clusters localized to the supplementary motor areas (BA 6), inferior frontal gyrus (IFG, BA 44), and the claustrum/insula. Our results are discussed in a predictive coding framework, whereby temporal expectancies and familiarity may drive motor activations, despite any overt movement. Though conventionally associated with syntactic violation, our observed activation in the IFG may support a recent proposal of its involvement in a network that subserves both violation and prediction. Finally, the claustrum/insula plays an integral role in auditory processing, functioning as a hub that integrates sensory and limbic information to (sub)cortical structures.
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Corteza Motora , Música , Adulto , Humanos , Funciones de Verosimilitud , Encéfalo/fisiología , Reconocimiento en Psicología/fisiología , Mapeo Encefálico , Percepción Auditiva/fisiología , Imagen por Resonancia MagnéticaRESUMEN
Effectively executing goal-directed behaviours requires both temporal and spatial accuracy. Previous work has shown that providing auditory cues enhances the timing of upper-limb movements. Interestingly, alternate work has shown beneficial effects of multisensory cueing (i.e., combined audiovisual) on temporospatial motor control. As a result, it is not clear whether adding visual to auditory cues can enhance the temporospatial control of sequential upper-limb movements specifically. The present study utilized a sequential pointing task to investigate the effects of auditory, visual, and audiovisual cueing on temporospatial errors. Eighteen participants performed pointing movements to five targets representing short, intermediate, and large movement amplitudes. Five isochronous auditory, visual, or audiovisual priming cues were provided to specify an equal movement duration for all amplitudes prior to movement onset. Movement time errors were then computed as the difference between actual and predicted movement times specified by the sensory cues, yielding delta movement time errors (ΔMTE). It was hypothesized that auditory-based (i.e., auditory and audiovisual) cueing would yield lower movement time errors compared to visual cueing. The results showed that providing auditory relative to visual priming cues alone reduced ΔMTE particularly for intermediate amplitude movements. The results further highlighted the beneficial impact of unimodal auditory cueing for improving visuomotor control in the absence of significant effects for the multisensory audiovisual condition.
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Señales (Psicología) , Movimiento , Humanos , Extremidad Superior , Percepción Visual , Estimulación Acústica , Percepción AuditivaRESUMEN
During the COVID-19 pandemic, music therapists transitioned services from in-person to telehealth due to health and safety concerns. Though online delivery of music therapy services for autistic individuals occurred prior to 2020, the number of North American music therapists using telehealth with autistic clients rose substantially during the pandemic. The current paper's objective was to delineate music therapists' perceptions regarding factors that helped or hindered autistic persons' engagement in online music therapy sessions. In total, 192 participants completed the survey. Qualitative content analysis of an open-ended question identified seven overarching themes regarding the benefits and challenges of telehealth music therapy for autistic clients. Findings were used to create a screening tool to help music therapists evaluate autistic persons' suitability for telehealth and meet the needs of those who can benefit from telehealth music therapy.
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Trastorno Autístico , COVID-19 , Musicoterapia , Música , Telemedicina , Humanos , Trastorno Autístico/terapia , Musicoterapia/métodos , PandemiasRESUMEN
Shared emotional experiences during musical activities among musicians can be coupled with brainwave synchronization. For non-speaking individuals with CP, verbal communication may be limited in expressing mutual empathy. Therefore, this case study explored interbrain synchronization among a non-speaking CP (female, 18 yrs), her parent, and a music therapist by measuring their brainwaves simultaneously during four music and four storytelling sessions. In only the youth-parent dyad, we observed a significantly higher level of interbrain synchronization during music rather than story-telling condition. However, in both the youth-parent and youth-therapist dyad, regardless of condition type, significant interbrain synchronization emerged in frontal and temporal lobes in the low-frequency bands, which are associated with socio-emotional responses. Although interbrain synchronization may have been induced by multiple factors (e.g., external stimuli, shared empathetic experiences, and internal physiological rhythms), the music activity setting deserves further study as a potential facilitator of neurophysiological synchrony between youth with CP and caregivers/healthcare providers.
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Parálisis Cerebral , Música , Adolescente , Encéfalo , Diencéfalo , Electroencefalografía , Femenino , Humanos , PadresRESUMEN
This study presented a novel kinematic assessment of paretic limb function "online" during the actual therapeutic exercisers rooted within the acceleration domain. Twenty-eight patients at chronic stroke stages participated in an auditory-motor intervention mapping reaching movements of the paretic arm unto surfaces of large digital musical instruments and sound tablets that provided rhythmic entrainment cues and augmented auditory feedback. Patients also wore a tri-axial accelerometer on the paretic limb during the nine-session intervention. The resulting acceleration profiles were extracted and quantified within the frequency domain. Measures of peak power and peak width were leveraged to estimate volitional control and temporal consistency of paretic limb movements, respectively. Clinical assessments included the Wolf Motor Function Test and Fugl-Meyer - Upper Extremity subtest. The results showed that peak power increased significantly from Session 1 to Session 9 within oscillatory frequency ranges associated with intentional movement execution (i.e., 4.5â Hz). Decreases in peak width over time provided additional evidence for improved paretic arm control from a temporal perspective. In addition, Peak width values obtained in Session 1 was significantly correlated with pre-test Fugl-Meyer - Upper Extremity scores. These results highlighted improvements in paretic limb acceleration as an underlying mechanism in stroke motor recovery and shed further light on the utility of accelerometry-based measures of paretic limb control in stroke rehabilitation. The data reported here was obtained from a larger clinical trial: https://clinicaltrials.gov/ct2/show/NCT03246217 ClinicalTrials.gov Identifier: NCT03246217.
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The present study examined spatial accuracy of mallet endpoints in a marimba performance context. Trained percussionists performed two- (i.e., Experiment 1) and four-mallet (i.e., Experiment 2) excerpts in three tempo conditions including slow, intermediate, and fast. Motion capture was utilized to gather data of upper-limb and mallet movements, as well as to compute velocities of the upper-limb joints. Mallet spatial accuracy was assessed by comparing mallet endpoints to a visual target positioned on the marimba. It was hypothesized that mallet spatial accuracy would be reduced as tempo condition increased, with effects on joint kinematics potentially revealing sensorimotor mechanisms underlying optimal sound production in marimba. Across both experiments, mallet accuracy was reduced as tempo condition increased. Interestingly, velocity variability in the elbows, wrists, and hands increased as mallet accuracy decreased. Such a pattern of effects suggested that sound production in marimba is suboptimal at fast relative to slow tempi. In addition, the velocity variability effects highlight the impact of motor planning mechanisms on sound production. Overall, the results shed new light on sensorimotor control in percussion which can be leveraged to enhance the training of percussionists.
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Música , Humanos , Fenómenos Biomecánicos , Movimiento , Mano , CodoRESUMEN
Sound-producing movements in percussion performance require a high degree of fine motor control. However, there remains a relatively limited empirical understanding of how performance level abilities develop in percussion performance in general, and marimba performance specifically. To address this issue, nine percussionists performed individualised excerpts on marimba within three testing sessions spaced 29 days apart to assess early, intermediate, and late stages of motor learning. Motor learning was quantified via analyses of both the temporal control of mallet movements, and the spatial variability of upper-limb movements. The results showed that temporal control of mallet movements was greater in the intermediate compared to the early learning session, with no significant additional improvements revealed in the late learning session. In addition, spatial variability in the left and right elbows decreased within the intermediate compared to the early learning session. The results suggest that temporal control of mallet movements may be driven by reductions in spatial variability of elbow movements specifically. As a result, this study provides novel evidence for kinematic mechanisms underlying motor learning in percussion which can be applied towards enhancing musical training.
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Research in basic and clinical neuroscience of music conducted over the past decades has begun to uncover music's high potential as a tool for rehabilitation. Advances in our understanding of how music engages parallel brain networks underpinning sensory and motor processes, arousal, reward, and affective regulation, have laid a sound neuroscientific foundation for the development of theory-driven music interventions that have been systematically tested in clinical settings. Of particular significance in the context of motor rehabilitation is the notion that musical rhythms can entrain movement patterns in patients with movement-related disorders, serving as a continuous time reference that can help regulate movement timing and pace. To date, a significant number of clinical and experimental studies have tested the application of rhythm- and music-based interventions to improve motor functions following central nervous injury and/or degeneration. The goal of this review is to appraise the current state of knowledge on the effectiveness of music and rhythm to modulate movement spatiotemporal patterns and restore motor function. By organizing and providing a critical appraisal of a large body of research, we hope to provide a revised framework for future research on the effectiveness of rhythm- and music-based interventions to restore and (re)train motor function.
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The present study investigated motor kinematics underlying performance-related movements in marimba performance. Participants played a marimba while motion capture equipment tracked movements of the torso, shoulders, elbows, wrists, and hands. Principal components analysis was applied to assess the movements during the performance related to sound production and sound preparation. Subsequent cluster analyses sought to identify coupling of limb segment movements that may best characterize performance styles present in the performance. The analysis revealed four clusters that were thought to reflect performance styles of expressive performance, postural sway, energy efficiency, and a blend of the former styles. More specifically, the expressive cluster was best characterized by limb movements occurring along the vertical z-axis, whereas the postural sway cluster was characterized by forwards and backwards motions of the torso and upper limbs. The energy efficient cluster was characterized by movements of the body moving left to right along the marimba, whereas the blended style demonstrated limited delineation from the alternate styles. Such findings were interpreted as evidence that performance styles occur within a framework of biomechanical constraints and hierarchical stylistic factors. Overall, the results provided a more holistic understanding of motor execution in percussion performance.
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The study compared the prevalence of the Val66Met Brain-derived Neurotrophic Factor single nucleotide polymorphism (rs6265) in a sample of musicians (N = 50) to an ethnically matched general population sample from the 1000 Human Genome Project (N = 424). Met-carriers of the polymorphism (Val/Met and Met/Met genotypes) are typically present in 25-30% of the general population and have associated deficits in motor learning and plasticity. Many studies have assessed the benefits of long-term music training for neuroplasticity and motor learning. This study takes a unique genetic approach investigating if the prevalence of the Val66Met BDNF polymorphism, which negatively affects motor learning, is significantly different in musicians from the general population. Our genotype and allele frequency analyses revealed that the distribution of the Val66Met polymorphism was not significantly different in musicians versus the general population (p = 0.6447 for genotype analysis and p = 0.8513 allele analysis). In the Musician sample (N = 50), the prevalence of the Val/Met genotype was 40% and the prevalence of the Met/Met genotype was 2%. In the 1000 Human Genome Project subset (N = 424), the prevalence of Val/Met was 33.25% and the Met/Met genotype prevalence was 4%. Therefore, musicians do exist with the Val66Met polymorphism and the characteristics of long-term music training may compensate for genetic predisposition to motor learning deficits. Since the polymorphism has significant implications for stroke rehabilitation, future studies may consider the implications of the polymorphism in music-based interventions such as Neurologic Music Therapy.
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Sustitución de Aminoácidos/genética , Factor Neurotrófico Derivado del Encéfalo/genética , Música , Plasticidad Neuronal/genética , Femenino , Humanos , Masculino , Proyectos Piloto , Prevalencia , Adulto JovenRESUMEN
OBJECTIVES: During their lifetimes, a majority of musicians experience playing-related musculoskeletal disorders (PRMD). PRMD prevalence is tied to instrument choice, yet most studies examine heterogeneous groups of musicians, leaving some high-risk groups such as oboists understudied. This paper aims to (1) ascertain the prevalence and nature of PRMDs in oboists, (2) determine relevant risk factors, and (3) evaluate the efficacy of treatment methods in preventing and remedying injuries in oboe players. METHODS: A 10-question online questionnaire on PRMDs and their treatments was completed by 223 oboists. PRMDs were compared across gender, weekly playing hours, career level, age, and years of playing experience. RESULTS: Of all respondents, 74.9% (167/223) reported having had at least one PRMD in their lifetime. A majority of these injuries (61.9% of all respondents) were of moderate to extreme severity (5 or higher on a scale of 1 to 10). Females (mean = 5.88) reported significantly more severe injuries than males. No significant effects of career level (i.e., professional vs. student vs. amateur), age, or years of playing experience were observed. We found significant non-linear relationships between weekly playing hours and PRMD prevalence and severity. Injuries were most commonly on the right side of the body, with the right thumb, wrist, hand, and forearm being most affected in frequency and severity. Of those injuries for which recovery information was provided, only 26.1% of injuries were "completely recovered." The perceived effectiveness of a few treatments (physical therapy, rest, stretching, occupational therapy, massage) tended to be ranked more highly than others. CONCLUSION: The oboists in this study experienced high rates of PRMD, particularly in the right upper extremities. Females and those playing 7-9 and 16-18 h per week reported a significantly higher severity of injuries than other groups.