The impact of injury definitions on measures of injury occurrence in classical music students: a prospective cohort study

BACKGROUND: Multiple definitions are used to investigate injuries in musicians, resulting in a wide range of prevalence rates. The aim of this study is to establish the impact of different injury definitions on the prevalence of injuries and disability in classical music students. Moreover, the practical implications of using different injury definitions are considered. METHODS: A prospective cohort study among first-year classical music students was performed using bi-monthly questionnaires focusing on injuries. Three injury definitions were used: 1) all MSK complaints injury (any MSK complaint resulting in a VAS pain score > 0 in the past eight weeks), 2) medical attention injury (any MSK complaint that resulted in a student consulting a health provider in the past eight weeks), 3) time-loss injury (any MSK complaint that resulted in partly/completely missing music classes or activities in the past eight weeks). For all injury definitions prevalences were calculated and compared. Furthermore, the Disabilities of the Arm, Shoulder and Hand performing arts module (DASH-pa) was used to calculate disability scores for all three injury definitions. RESULTS: Twenty-nine classical music students participated in the current study. The total response rate over one academic year was 85.3%. One year prevalences of all MSK complaints, medical attention and time-loss were 96.6, 17.2 and 13.8% respectively. The bi-monthly prevalences ranged from 74.1 to 96.0% for all MSK complaints, from 5.6 to 11.5% for medical attention injuries and from 0 to 11.5% for time loss injuries. Scores on the DASH-pa ranged from 15.6 to 26.9 for MSK complaints, 33.3 to 50 for medical attention and 47.9 to 62.5 for time-loss injuries. CONCLUSION: The choice of injury definition is a critical factor affecting the outcome of music injury surveillance studies. To reach a consensus, it is therefore important to consider the different injury definitions depending on the goal of the injury surveillance and the practical implications.