Understanding the role of self-management in musicians with playing-related musculoskeletal disorders

Eleryan, Noudy 2025. Understanding the role of self-management in musicians with playing-related musculoskeletal disorders. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Background: Musicians are vulnerable to developing playing-related musculoskeletal disorders (PRMSDs). Self-management interventions can help to reduce the risk and severity of musculoskeletal disorders (MSDs). However, there is a lack of evidence-based self-management interventions for PRMSDs in musicians. Digital health interventions (DHIs) have the potential to provide personalised self-management support. This thesis aims to explore DHIs for self-management of playing-related musculoskeletal disorders (PRMSDs) in musicians. Methods: Mixed methods design. Phase 1: A scoping review of the currently available evidence on DHIs for PRMSDs in musicians was conducted to understand how DHIs are currently being designed and implemented for PRMSDs, including their theoretical underpinnings and mechanisms of action. Phase 2: An online survey and four online focus groups were conducted with UK-based musicians with current or previous PRMSDs to explore musicians’ barriers and facilitators to self-management of PRMSDs, health needs, and opinions on the use of DHIs. Phase 3: Online interviews were conducted with healthcare professionals experienced in managing PRMSDs in musicians to gather diverse perspectives on developing DHIs for their self-management. ii Results: Phase 1 identified nine studies examining DHIs for musicians, revealing significant methodological limitations across the literature, including inadequate theoretical foundations, insufficient sample sizes, use of non-validated outcome measures, and limited consideration of self-employed musicians' needs. In Phase 2, a total of 100 musicians with current or previous PRMSDs participated in the survey study. The majority were self-employed (49%), while 36% were students, 8% were full-time employed musicians, and 5% were both employed and self-employed professional musicians. Thirty-eight percent of the participants experienced PRMSDs 0 to 2 times, 24% experienced them 3 to 4 times, and the remaining 38% reported having PRMSDs more than 5 times in the past five years. The participants indicated that the main contributing factors for their PRMSDs were excessive playing and poor posture. Furthermore, the participants revealed several barriers to PRMSD self-management, including limited early health education, financial and time constraints, and insufficient accessible resources. Key facilitators and health needs identified were an understanding of musicians’ professional demands, personalised health support, peer support, and accessible resources, incorporating features such as well-being support, automated reminders for taking breaks/exercising during long rehearsals, and feedback and monitoring. In Phase 3, healthcare professionals recommended that DHIs for PRMSDs experienced by musicians should incorporate high-quality pain education, advice and resources to support load management, and potentially health tracking tools such as pain diaries, activity logs, and self-monitoring features, while addressing potential barriers such as safeguarding risks that may require professional oversight. Both iii musicians and healthcare professionals emphasised that successful DHI implementation would depend on cost, ease of use, and the consolidation of resources into a single platform. Conclusion and future implications: This research establishes a foundation for developing DHIs that empower musicians to manage their health effectively while supporting their careers and overall wellbeing. Future work should: (1) develop user-focused DHIs through collaboration with musicians, clinicians, and industry partners to co-design interventions to address musicians’ unmet health needs through pain education and appropriate load management advice and prevention, and maximise the potential for scaling up such interventions; (2) integrate key features such as personalised feedback, health tracking, consolidated resources, and peer support; (3) engage with public partners through facilitating workshops with musicians, educators, and industry representatives to ensure that interventions align with the realities of diverse musician populations and are scalable; and (4) conduct feasibility studies and eventually a full randomised controlled trial (RCT) to evaluate the effect of DHI in on PRMSDs and musicians’ ability to participate in playing their musical instruments pain-free.

Item Type:	Thesis (PhD)
Status:	Unpublished
Schools:	Schools > Healthcare Sciences
Date of First Compliant Deposit:	9 October 2025
Last Modified:	09 Oct 2025 14:14
URI:	https://orca.cardiff.ac.uk/id/eprint/181571

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