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      Profiling the Location and Extent of Musicians’ Pain Using Digital Pain Drawings

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          Abstract

          Background and Aims

          According to existing literature, musicians are at risk of experiencing a range of painful musculoskeletal conditions. Recently, a novel digital technology was developed to investigate pain location and pain extent. The aim of this study was to describe pain location and pain extent in musicians using a digital method for pain drawing ( PD) analysis. Additionally, the association between PD variables and clinical features were explored in musicians with pain.

          Methods

          One hundred and fifty‐eight musicians (90 women and 68 men; aged 22.4 ± 3.6 years) were recruited from Swiss and U.K. conservatories. Participants were asked to complete a survey including both background musical information and clinical features, the Quick DASH ( QD) questionnaire, and the digital PDs.

          Results

          Of the 158 participants, 126 musicians (79.7%) reported having pain, with higher prevalence in the areas of the neck and shoulders, the lower back, and the right arm. The mean percentage of pain extent was 3.1% ± 6.5%. The mean QD score was higher for musicians with pain than for those without pain. Additionally, the results indicated a positive correlation between the QD score and pain extent, and there were significant correlations between age and pain intensity, as well as between pain extent and pain intensity.

          Conclusions

          The high prevalence of pain among musicians has been confirmed using a digital technique for PD acquisition and analysis. In addition, positive correlations between pain extent and upper limb disability have been demonstrated. Our findings highlight the need for effective prevention and treatment strategies for musicians.

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          Most cited references66

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          Development of the QuickDASH: comparison of three item-reduction approaches.

          The purpose of this study was to develop a short, reliable, and valid measure of physical function and symptoms related to upper-limb musculoskeletal disorders by shortening the full, thirty-item DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure. Three item-reduction techniques were used on the cross-sectional field-testing data derived from a study of 407 patients with various upper-limb conditions. These techniques were the concept-retention method, the equidiscriminative item-total correlation, and the item response theory (Rasch modeling). Three eleven-item scales were created. Data from a longitudinal cohort study in which the DASH questionnaire was administered to 200 patients with shoulder and wrist/hand disorders were then used to assess the reliability (Cronbach alpha and test-retest reliability) and validity (cross-sectional and longitudinal construct) of the three scales. Results were compared with those derived with the full DASH. The three versions were comparable with regard to their measurement properties. All had a Cronbach alpha of > or = 0.92 and an intraclass correlation coefficient of > or = 0.94. Evidence of construct validity was established (r > or = 0.64 with single-item indices of pain and function). The concept-retention method, the most subjective of the approaches to item reduction, ranked highest in terms of its similarity to the original DASH. The concept-retention version is named the QuickDASH. It contains eleven items and is similar with regard to scores and properties to the full DASH. A comparison of item-reduction approaches suggested that the retention of clinically sensible and important content produced a comparable, if not slightly better, instrument than did more statistically driven approaches.
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            Role of distorted body image in pain.

            Body image is the way a person's body feels to them. Growing evidence shows that body image can be distorted in people with pain, particularly chronic pain. Most data relate to people with deafferentation via amputation or neural injury, but deafferentation is neither sufficient nor necessary for distorted body image or pain. In this review, we examine the literature relating to body image distortion in people with pain, and we discuss three themes: 1) evidence of distorted body image in people with pain; 2) evidence of distortion of the neural representations of body image held in primary sensory and primary motor cortex; and 3) clinical findings that correlate with distorted body image, distorted neural representation, or both. We then review the emerging evidence regarding therapeutic approaches to distorted body image in people with painful disease.
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              I can't find it! Distorted body image and tactile dysfunction in patients with chronic back pain.

              The conscious sense of our body, or body image, is often taken for granted, but it is disrupted in many clinical states including complex regional pain syndrome and phantom limb pain. Is the same true for chronic back pain? Body image was assessed, via participant drawings, in six patients with chronic back pain and ten healthy controls. Tactile threshold and two-point discrimination threshold (TPD) were assessed in detail. All the patients, and none of the controls, showed disrupted body image of the back. Five patients were unable to clearly delineate the outline of their trunk and stated that they could not "find it". TPD was greatly increased in the same zone as the absence or disruption of body image, but was otherwise similar to controls. The disturbance of body image and decrease in tactile acuity coincided with the normal distribution of pain, although there was no allodynia and there was no relationship between resting pain level and TPD. Tactile threshold was unremarkable for patients and controls. These preliminary data indicate that body image is disrupted, and tactile acuity is decreased, in the area of usual pain, in patients with chronic back pain. This finding raises the possibility that training body image or tactile acuity may help patients in chronic spinal pain, as it has been shown to do in patients with complex regional pain syndrome or phantom limb pain.
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                Author and article information

                Contributors
                cinzia.cruder@supsi.ch
                Journal
                Pain Pract
                Pain Pract
                10.1111/(ISSN)1533-2500
                PAPR
                Pain Practice
                John Wiley and Sons Inc. (Hoboken )
                1530-7085
                1533-2500
                28 May 2017
                January 2018
                : 18
                : 1 ( doiID: 10.1111/papr.2018.18.issue-1 )
                : 53-66
                Affiliations
                [ 1 ] Department of Research and Development Conservatory of Southern Switzerland Lugano Switzerland
                [ 2 ] Rehabilitation Research Laboratory (2rLab) Department of Business Economics, Health and Social Care University of Applied Sciences and Arts of Southern Switzerland Manno Switzerland
                [ 3 ] Centre of Precision Rehabilitation for Spinal Pain (CPR Spine) School of Sport, Exercise and Rehabilitation Sciences College of Life and Environmental Sciences University of Birmingham Birmingham U.K.
                [ 4 ] Department of Innovative Technologies Dalle Molle Institute for Artificial Intelligence University of Applied Sciences and Arts of Southern Switzerland Manno Switzerland
                [ 5 ] Centre for Performance Science Royal College of Music London U.K.
                [ 6 ] Faculty of Medicine Imperial College London London U.K.
                Author notes
                [*] [* ]Address correspondence and reprint requests to: Cinzia Cruder, MA, Conservatory of Southern Switzerland, via Soldino 9, 6900 Lugano, Switzerland. E‐mail: cinzia.cruder@ 123456supsi.ch .
                Author information
                http://orcid.org/0000-0001-8579-0686
                Article
                PAPR12581
                10.1111/papr.12581
                6849566
                28466572
                46ff73e7-5f20-4b21-a42e-a352400fab21
                © 2017 The Authors. Pain Practice published by Wiley Periodicals, Inc. on behalf of World Institute of Pain

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 31 December 2016
                : 02 March 2017
                : 08 March 2017
                Page count
                Figures: 6, Tables: 3, Pages: 14, Words: 8244
                Funding
                Funded by: Arts and Humanities Research Council (UK) , open-funder-registry 10.13039/501100000267;
                Award ID: AH/K002287/1
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                January 2018
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.1 mode:remove_FC converted:12.11.2019

                pain location,pain extent,musicians,pain drawings
                pain location, pain extent, musicians, pain drawings

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