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Erschienen in: International Archives of Occupational and Environmental Health 7/2014

01.10.2014 | Original Article

From embouchure problems to embouchure dystonia? A survey of self-reported embouchure disorders in 585 professional orchestra brass players

verfasst von: Anke Steinmetz, Andreas Stang, Malte Kornhuber, Marc Röllinghoff, Karl-Stefan Delank, Eckart Altenmüller

Erschienen in: International Archives of Occupational and Environmental Health | Ausgabe 7/2014

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Abstract

Objectives

Data concerning embouchure problems in professional brass players are scarce. Embouchure problems can potentially lead to focal dystonia. The aim of this study was to investigate the frequency of distinct embouchure problems in professional brass players. Furthermore, the frequency of “cramping”, a distinct symptom of embouchure dystonia, was evaluated in the context of established embouchure dystonia risk factors.

Methods

Five hundred and eighty-five professional brass players participated in a cross-sectional study concerning embouchure problems. A self-administered questionnaire was developed to evaluate embouchure fatigue, embouchure disorders and their consequences. To study the association between risk factors and cramping (a symptom of embouchure dystonia), a log-binomial regression analysis was conducted, enabling estimation of prevalence ratios (PR) and 95 % confidence intervals (95 % CI).

Results

Thirty percent (95 % CI 25.9–33.3) reported embouchure fatigue. The relative frequency of embouchure disorders was 59 % (95 % CI 54.6–63.6), with 26 % (95 % CI 22.4–29.5) reporting embouchure cramping. Embouchure disorders resulted in sick leave in 16 % (95 % CI 12.7–20.6). Female brass players (PR 2.0, 95 % CI 0.98–3.98) and musicians with a prior change in their embouchure (PR 2.4, 95 % CI 1.38–4.05) or breathing technique (PR 2.2, 95 % CI 1.25–3.72) and musicians with embouchure fatigue (PR 1.9, 95 % CI 1.18–2.93) presented more frequently with embouchure cramping than musicians with other or without risk factors.

Conclusion

This study shows a high relative frequency of embouchure problems in professional brass players. Given that embouchure dystonia is often preceded by embouchure problems, these findings may assist in gaining further insight into the characteristics of embouchure dystonia and the development of preventive strategies.
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Literatur
Zurück zum Zitat Altenmuller E (2003) Focal dystonia: advances in brain imaging and understanding of fine motor control in musicians. Hand Clin 19(3):523–538CrossRef Altenmuller E (2003) Focal dystonia: advances in brain imaging and understanding of fine motor control in musicians. Hand Clin 19(3):523–538CrossRef
Zurück zum Zitat Altenmuller E, Jabusch HC (2010b) Focal dystonia in musicians: phenomenology, pathophysiology, triggering factors, and treatment. Med Probl Perform Artist 25(1):3–9 Altenmuller E, Jabusch HC (2010b) Focal dystonia in musicians: phenomenology, pathophysiology, triggering factors, and treatment. Med Probl Perform Artist 25(1):3–9
Zurück zum Zitat Baur V, Jabusch HC, Altenmuller E (2011) Behavioral factors influence the phenotype of musician’s dystonia. Mov Disord Official J Mov Disord Soc 26(9):1780–1781. doi:10.1002/mds.23654 Baur V, Jabusch HC, Altenmuller E (2011) Behavioral factors influence the phenotype of musician’s dystonia. Mov Disord Official J Mov Disord Soc 26(9):1780–1781. doi:10.​1002/​mds.​23654
Zurück zum Zitat Byl NN, Merzenich MM, Jenkins WM (1996) A primate genesis model of focal dystonia and repetitive strain injury: I. Learning-induced dedifferentiation of the representation of the hand in the primary somatosensory cortex in adult monkeys. Neurology 47(2):508–520CrossRef Byl NN, Merzenich MM, Jenkins WM (1996) A primate genesis model of focal dystonia and repetitive strain injury: I. Learning-induced dedifferentiation of the representation of the hand in the primary somatosensory cortex in adult monkeys. Neurology 47(2):508–520CrossRef
Zurück zum Zitat Candia V et al (2002) Sensory motor retuning: a behavioral treatment for focal hand dystonia of pianists and guitarists. Arch Phys Med Rehabil 83(10):1342–1348CrossRef Candia V et al (2002) Sensory motor retuning: a behavioral treatment for focal hand dystonia of pianists and guitarists. Arch Phys Med Rehabil 83(10):1342–1348CrossRef
Zurück zum Zitat Chesky K, Devroop K, Ford J (2002) Medical problems of brass instrumentalists: prevalence rates for trumpet, trombone, French horn, and low brass. Med Probl Perform Artist 17:93–98 Chesky K, Devroop K, Ford J (2002) Medical problems of brass instrumentalists: prevalence rates for trumpet, trombone, French horn, and low brass. Med Probl Perform Artist 17:93–98
Zurück zum Zitat Elbert T et al (1998) Alteration of digital representations in somatosensory cortex in focal hand dystonia. NeuroReport 9(16):3571–3575CrossRef Elbert T et al (1998) Alteration of digital representations in somatosensory cortex in focal hand dystonia. NeuroReport 9(16):3571–3575CrossRef
Zurück zum Zitat Fishbein M, Middlestadt S, Ottati V, Straus S, Ellis A (1988) Medical problems among ICSOM musicians: overview of a national survey. Med Probl Perf Art 3(1):1–8 Fishbein M, Middlestadt S, Ottati V, Straus S, Ellis A (1988) Medical problems among ICSOM musicians: overview of a national survey. Med Probl Perf Art 3(1):1–8
Zurück zum Zitat Frucht SJ (2009b) Focal task-specific dystonia of the musicians’ hand–a practical approach for the clinician. J Hand Ther Official J Am Soc Hand Ther 22(2):136–142; quiz 143 doi:10.1016/j.jht.2008.11.006 Frucht SJ (2009b) Focal task-specific dystonia of the musicians’ hand–a practical approach for the clinician. J Hand Ther Official J Am Soc Hand Ther 22(2):136–142; quiz 143 doi:10.​1016/​j.​jht.​2008.​11.​006
Zurück zum Zitat Hirata Y, Schulz M, Altenmuller E, Elbert T, Pantev C (2004) Sensory mapping of lip representation in brass musicians with embouchure dystonia. NeuroReport 15(5):815–818CrossRef Hirata Y, Schulz M, Altenmuller E, Elbert T, Pantev C (2004) Sensory mapping of lip representation in brass musicians with embouchure dystonia. NeuroReport 15(5):815–818CrossRef
Zurück zum Zitat Jabusch HC, Altenmueller E (2006) Focal dystonia in musicians: from phenomenology to therapy. Adv Cogn Psychol 2:207–220CrossRef Jabusch HC, Altenmueller E (2006) Focal dystonia in musicians: from phenomenology to therapy. Adv Cogn Psychol 2:207–220CrossRef
Zurück zum Zitat Jabusch HC, Muller SV, Altenmuller E (2004) Anxiety in musicians with focal dystonia and those with chronic pain. Mov Disord Official J Mov Disord Soc 19(10):1169–1175. doi:10.1002/mds.20110 CrossRef Jabusch HC, Muller SV, Altenmuller E (2004) Anxiety in musicians with focal dystonia and those with chronic pain. Mov Disord Official J Mov Disord Soc 19(10):1169–1175. doi:10.​1002/​mds.​20110 CrossRef
Zurück zum Zitat Jabusch HC, Zschucke D, Schmidt A, Schuele S, Altenmuller E (2005) Focal dystonia in musicians: treatment strategies and long-term outcome in 144 patients. Mov Disord Official J Mov Disord Soc 20(12):1623–1626. doi:10.1002/mds.20631 CrossRef Jabusch HC, Zschucke D, Schmidt A, Schuele S, Altenmuller E (2005) Focal dystonia in musicians: treatment strategies and long-term outcome in 144 patients. Mov Disord Official J Mov Disord Soc 20(12):1623–1626. doi:10.​1002/​mds.​20631 CrossRef
Zurück zum Zitat Leaver R, Harris E, Palmer K (2011) Musculoskeletal pain in elite professional musicians from British symphony orchestras. Occup Med 61(8):549–555CrossRef Leaver R, Harris E, Palmer K (2011) Musculoskeletal pain in elite professional musicians from British symphony orchestras. Occup Med 61(8):549–555CrossRef
Zurück zum Zitat Lederman RJ (1991) Focal dystonia in instrumentalists: clinical features. Med Probl Perform Artist 6:132–136 Lederman RJ (1991) Focal dystonia in instrumentalists: clinical features. Med Probl Perform Artist 6:132–136
Zurück zum Zitat Middlestadt SE, Fishbein M (1988) Health and occupational correlates of perceived occupational stress in symphony orchestra musicians. J Occup Med Official Publ Indust Med Assoc 30(9):687–692 Middlestadt SE, Fishbein M (1988) Health and occupational correlates of perceived occupational stress in symphony orchestra musicians. J Occup Med Official Publ Indust Med Assoc 30(9):687–692
Zurück zum Zitat Munte TF, Altenmuller E, Jancke L (2002) The musician’s brain as a model of neuroplasticity. Nat Rev Neurosci 3(6):473–478. doi:10.1038/nrn843 Munte TF, Altenmuller E, Jancke L (2002) The musician’s brain as a model of neuroplasticity. Nat Rev Neurosci 3(6):473–478. doi:10.​1038/​nrn843
Zurück zum Zitat Rodriguez-Lozano FJ, Saez-Yuguero MR, Bermejo-Fenoll A (2011) Orofacial problems in musicians: a review of the literature. Med Probl Perform Artist 26(3):150–156 Rodriguez-Lozano FJ, Saez-Yuguero MR, Bermejo-Fenoll A (2011) Orofacial problems in musicians: a review of the literature. Med Probl Perform Artist 26(3):150–156
Zurück zum Zitat Rossett i Llobet J, Fàbregas i Molas S (2010) Musician’s Dystonia. A practical manual to understand and take care of the disorder that affect the ability to play. DMG Panamir, Rome Rossett i Llobet J, Fàbregas i Molas S (2010) Musician’s Dystonia. A practical manual to understand and take care of the disorder that affect the ability to play. DMG Panamir, Rome
Zurück zum Zitat Sayegh Ghoussoub M, Ghoussoub K, Chaaya A, Sleilaty G, Joubrel I, Rifai K (2008) Orofacial and hearing specific problems among 340 wind instrumentalists in Lebanon. Le J Med Libanais Lebanese Med J 56(3):159–167 Sayegh Ghoussoub M, Ghoussoub K, Chaaya A, Sleilaty G, Joubrel I, Rifai K (2008) Orofacial and hearing specific problems among 340 wind instrumentalists in Lebanon. Le J Med Libanais Lebanese Med J 56(3):159–167
Zurück zum Zitat Schmidt A, Jabusch HC, Altenmueller E, Kasten M, Klein C (2013) Challenges of making music: what causes musician’s dystonia? JAMA Neurology:in press Schmidt A, Jabusch HC, Altenmueller E, Kasten M, Klein C (2013) Challenges of making music: what causes musician’s dystonia? JAMA Neurology:in press
Metadaten
Titel
From embouchure problems to embouchure dystonia? A survey of self-reported embouchure disorders in 585 professional orchestra brass players
verfasst von
Anke Steinmetz
Andreas Stang
Malte Kornhuber
Marc Röllinghoff
Karl-Stefan Delank
Eckart Altenmüller
Publikationsdatum
01.10.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
International Archives of Occupational and Environmental Health / Ausgabe 7/2014
Print ISSN: 0340-0131
Elektronische ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-013-0923-4

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