Author ORCID Identifier

https://orcid.org/0009-0004-7236-4388

Semester

Fall

Date of Graduation

2025

Document Type

Dissertation (Campus Access)

Degree Type

PhD

College

School of Public Health

Department

Social and Behavioral Sciences

Committee Chair

Danielle Davidov

Committee Member

SueAnn Woods

Committee Member

Christa Lilly

Committee Member

Christiaan Abildso

Abstract

Introduction: Performance related musculoskeletal disorders (PRMD) among musicians are common, with various physical, financial, and emotional impacts. While research surrounding PRMD in professional musicians has led to the development of injury prevention programs, research specifically regarding PRMD in music therapists is scarce. Research specific to music therapists is important as this is growing field of unique professional musicians working in clinical settings. Aim one investigated the proportion of music therapists with PRMD and associated risk factors with a survey administered to 8,978 music therapists certified by the Certification Board for Music Therapists. Aim two explored PRMD in more depth through qualitative interviews with injured music therapists. Finally, aim three merged the results of aims one and two to develop greater insights and a comprehensive understanding of the risk factors and impacts of PRMD.

Methods: Data for aim one was collected through a cross-sectional survey containing standardized questionnaires, the Nordic Musculoskeletal Questionnaire (NMQ) and QuickDASH, sent to all board-certified music therapists in the United States. In aim one, the rate of PRMD was calculated through the NMQ. Risk factors were calculated through chi-square tests and using linear regression. Next, for aim two, 25 music therapists were sampled from participants completed the aim one survey to share their experiences with PRMD. These qualitative interviews were transcribed, coded, and analyzed for themes. Finally, aim three combined data from aims one and two via a mixed-methods convergent parallel design to confirm, clarify, and enhance data reported in aims one and two.

Results: Results from aim one revealed that 84% of the sample of music therapists completing the survey had experienced PRMD in their lifetime. Significant risk factors increasing the odds of injury included playing guitar for greater than 25% of sessions, working in private practice/being self-employed, transporting instruments by carrying, transporting instruments by a combination of carrying and utilizing a car, playing a primary instrument of strings (other than a guitar), job stress, and regularly working in twisted/best positions.

Aim two results include four themes that emerged from the stories of injured music therapists. These themes included 1) causes and modifiers of injury and pain, 2) impact, 3) coping/management of pain, and 4) recommendations for music therapists. Participants described a variety of factors they believed led to their injuries. Additionally, they described a variety of impacts on their physical, financial, and mental well-being.

For Aim three, integration of aims one and two confirmed the majority of risk factors identified in aim one. However, merging these data also enhanced our findings about multiple risk factors and led to the discovery of new information, including socioeconomic factors, that could increase the risk of developing PRMD.

Discussion: As music therapists provide healthcare services to numerous patient populations across a variety of settings, it is crucial to understand PRMD specifically to this category of professional musicians. Examining the prevalence, risk factors, and impacts of PRMD in music therapists is critical to developing injury prevention materials and policies that can improve the quality of life of music therapists.

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