1. An Assessment of Freshman Music Students’ Health and Trunk Endurance at Matriculation Judy Palac, D.M.A. David Grimshaw, D.O. Michigan State University Musicians’ Wellness Team Judy Palac, D.M.A. David Grimshaw, D.O. Michigan State University Musicians’ Wellness Team

3. Musical Health Problems in Students  Shoup, 1995--33%  Fry et al, 1988--56%  Ackermann et al, 2002--100%  Shoup, 1995--33%  Fry et al, 1988--56%  Ackermann et al, 2002--100%

4. Brandfonbrener, 2009  300 entering freshmen over three years  79% had pain  No significant differences in pain rates between genders or among instruments  No relationship between exercise and pain  300 entering freshmen over three years  79% had pain  No significant differences in pain rates between genders or among instruments  No relationship between exercise and pain

5. Purpose  To determine the baseline overall health level of members of the freshman class in order to:  Track these levels longitudinally as they progress through music school  Plan and test intervention protocols that may improve their health along the way  To determine the baseline overall health level of members of the freshman class in order to:  Track these levels longitudinally as they progress through music school  Plan and test intervention protocols that may improve their health along the way

6. Assessment Tools  Demographic/Self-Report Questionnaire  Medical Outcomes Study 36-Item Short Form Health Survey (SF-36)  Modified Trunk Endurance Test (Kava, 2008)  Demographic/Self-Report Questionnaire  Medical Outcomes Study 36-Item Short Form Health Survey (SF-36)  Modified Trunk Endurance Test (Kava, 2008)

7. MTET Trunk Flexor Endurance Test Trunk Extensor Endurance Test

8. Lateral Trunk Endurance Test

9. Subjects

10. Sample Characteristics  N=31  M=15, F=14, ?=2  Mean age=18  Mean years of study=8.19  Mean hours/practiced over past year=12.91  11 reported exercising regularly  N=31  M=15, F=14, ?=2  Mean age=18  Mean years of study=8.19  Mean hours/practiced over past year=12.91  11 reported exercising regularly

11. Primary Performance Media Instrument/voiceNumber Double Bass3 Bassoon3 Clarinet3 Flute2 French Horn1 Oboe1 Percussion1 Piano3 Trombone2 Trumpet3 Violin5 Voice 4

12. Results Self-Report Questionnaire Everyone had at least some pain at least some of the time.

13. Location of Pain

14. MOS SF-36 Results

15. MTET Results

16. Analysis  Gender made no significant difference  Exception: Men scored significantly higher on the SF-36 Vitality subscale (p=0.17)  Exercise/no exercise made no difference  Data was not analyzed by instrument/voice  Gender made no significant difference  Exception: Men scored significantly higher on the SF-36 Vitality subscale (p=0.17)  Exercise/no exercise made no difference  Data was not analyzed by instrument/voice

17. Correlations Variables within Self-Report

18. Correlations MTET and Self-Report *. Correlation is significant at the 0.05 level (2-tailed). **. Correlation is significant at the 0.01 level (2-tailed).

19. Correlations MTET and SF-36 Subscales **. Correlation is significant at the 0.01 level (2-tailed). *. Correlation is significant at the 0.05 level (2-tailed).

20. Correlations Self-Report and SF-36 **. Correlation is significant at the 0.01 level (2-tailed). *. Correlation is significant at the 0.05 level (2-tailed).

21. Conclusions  This assessment protocol yields valuable information about students’ health and risk for occupational injury  College freshmen are already demonstrating significant occupational health problems and continue to be at risk  Exercises that increase trunk endurance, particularly of the extensors, may benefit them (Kava, 2008; Ackermann, 2002)  Intervention and education need to begin earlier (Brandfonbrener, 2009; Manchester, 2009)  This assessment protocol yields valuable information about students’ health and risk for occupational injury  College freshmen are already demonstrating significant occupational health problems and continue to be at risk  Exercises that increase trunk endurance, particularly of the extensors, may benefit them (Kava, 2008; Ackermann, 2002)  Intervention and education need to begin earlier (Brandfonbrener, 2009; Manchester, 2009)

22.  The more years they have played/sung, the moderately better their flexor and total trunk endurance  The worse their flexor and trunk endurance, the moderately more frequently they experience pain  The better their extensor endurance, the significantly longer it takes to feel pain and fatigue  The more years they have played/sung, the moderately better their flexor and total trunk endurance  The worse their flexor and trunk endurance, the moderately more frequently they experience pain  The better their extensor endurance, the significantly longer it takes to feel pain and fatigue

23. Future Directions  Continue to gather data on incoming freshmen to increase the sample size and confirm trends  Test interventions, particularly those that increase trunk endurance, to reduce/prevent pain and fatigue over time  Follow this cohort to graduation (or dropout!)  Continue to gather data on incoming freshmen to increase the sample size and confirm trends  Test interventions, particularly those that increase trunk endurance, to reduce/prevent pain and fatigue over time  Follow this cohort to graduation (or dropout!)

24.  Use this protocol to assess health of secondary music students  Develop education and intervention protocols for prevention of these issues  Use this protocol to assess health of secondary music students  Develop education and intervention protocols for prevention of these issues

25. Thank You!