Prevalence of Playing-related Musculoskeletal Disorders in String Players: A Systematic Review

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Objective:This systematic review aimed to assess the methodological quality of articles about the prevalence of playing-related musculoskeletal disorders (PRMDs) in string players and to identify the rate of prevalence and associated factors of PRMD.Methods:Cross-sectional studies describing data on separate string players published in 5 different languages between January 1, 1980, and January 31, 2014, were included. The following databases were searched: MEDLINE, sciELO, and LILACS. Other sources and reference lists of published papers also were searched. The Loney Scale was used by 2 independent reviewers to evaluate the methodological quality, and only studies that achieved high scores were included.Results:Of 1910 retrieved articles, 34 cross-sectional studies were selected for methodological assessment. However, only 8 studies reached satisfactory methodological quality scores. The prevalence rate of PRMD was alarmingly high, ranging from 64.1% to 90%. Women and older musicians were more affected in comparison to other instrumentalists. There seems to be a predominance of symptoms in the left upper limb in violinists and violists, whereas cellists and bassists report injuries in the right upper limb.Conclusions:Professional and amateur string players are subject to development of PRMD. Low response rates were the most observed source of bias, and there is still a lack of publications with high methodological quality in the literature.

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