Freqüência dos problemas neuromusculares ocupacionais de pianistas e sua relação com a técnica pianística: uma leitura transdisciplinar da medicina do músico

Abstract

INTRODUCTION: Playing an instrument is commonly taken as something exciting and pleasurable, not offering any risk. However this is not what has been observed in the musicians medical centers. The systematic study of a musical instrument is not a simple task and requires an emotional and physical effort hardly imagined by one notinvolved with this field. In high standard performances, the act of playing is similar to an athlete performance and involves intense muscular training, with lots of hours of daily practice. Such high demand predisposes this elite to several neuromuscular problems. In spite of that, the occupational diseases of these professionals are not wellknown, not well studied and often under valuated. OBJECTIVES: Make a review of the literature on the pianists neuromuscular occupational problems and on the conceptual evolution of the piano technique and its practice; study the frequency of the occupational neuromuscular diseases among pianists in our country and the influence of the technical problems related to the piano performance in the genesis of theseoccupational problems. METHODOLOGY: This was a cross-sectional clinical occupational study, which combined three different sets of data: (1) frequency of selfreferred disconforts, determined by a questionairy applied to a group of ninety three pianists (professionals or university sudents) and to a control group of fifty one nonmusicians; (2) frequency and nature of piano thechnical problems, assessed by a vídeoof fifty one pianists performances, based on a protocol, specially developed for this purpose; (3) clinic-neurological and eletromyographic evaluation (measure of nerve conduction velocity) of the same previous fifty one pianists in order to reinforce the assessment of their performances. Each one of these three sets of data were determined by different researchers, who were blind to each others findings. RESULTS: Crossing the data led to the confirmation of a much higher frequency of neuromuscular occupational symptoms in the pianistsgroup (91,5%), against 61% of the control group (p< 0,001). The main symptoms were pain and muscular weariness; the pianistspresented pain especially in the neck, back and superior limbs. The statistics showed an etiological relationship between technical problems of performance and detected symptoms (p< 0,05). CONCLUSIONS: The incidence of occupational neuromuscular problems in pianists is very high and the technical difficulties concerning the performance can be considered a significant etiological factor.