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Use of the adapted stress process model to predict health outcomes in pianists

Susan Yee, Karen L. Harburn, John F. Kramer
From: Medical Problems of Performing Artists: Volume 17 Number 2: Page 76 (June 2002)

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Abstract: Repetitive strain injury (RSI) often affects pianists. The present study utilized the sociological "stress process model" to examine health outcome that may relate to RSI in pianists. Thirty-three female university students were studied, using the Adapted Postural and Repetitive Risk-factors Index (APRRI) to measure stressors, the Upper Body Musculoskeletal Assessment (UBMA) to measure the stresses of pain and discomfort, the Survey of Pain Attitudes-Revised (SOPA-R) to measure mediators, and the Short-Form Health Survey (SF-36) to measure physical and mental health outcomes. Multiple linear regression analyses were used to determine the extent to which APRRI, UBMA, and SOPA-R scores predicted the SF-36 physical and mental scores. In combination, the three predictors accounted for only 29% of the variance of the physical summary score of the SF-36, with only the UBMA and the control subscale of the SOPA-R contributing significantly (p < 0.01). However, the three variables predicted only 1% of the SF-36 mental score, with none of the predictors contributing significantly (p > 0.05). Use of the stress process model showed that the stresses of pain and discomfort (UBMA) and the stress mediator called pain control (a subscale of the SOPA-R) were significant but weak predictors of health outcome (physical functioning score of the SF-36) for the sample of 33 female university piano students. While these pianists experienced pain and discomfort in their upper extremities, the majority felt physically functional, yet believed their playing was affected. Future research with the stress process model could look at more sensitive measures of stressors (e.g., specific awkward movements at joints, repetitiveness, and muscular tension), stress (i.e., pain and discomfort), and mediators (e.g., strategies of pain coping) with pianists

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