Medical Problems of Performing ArtistsMedical Problems of Performing Artists

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A new method for quantification of musician's dystonia: the frequency of abnormal movements scale

June T. Spector, Alice G. Brandfonbrener
From: Medical Problems of Performing Artists: Volume 20 Number 4: Page 157 (December 2005)

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Abstract: There is currently, no validated objective method available for the quantification of musician¿s dystonia applicable to different types of instrumentalists. To address this issue, we developed the Frequency of Abnormal Movements (FAM) scale and assessed its intra- and inter-rater correlation and concordance, internal consistency, and responsiveness. We also compared the FAM scale to the arm dystonia disability scale (ADDS) and Burke-Fahn-Marsden (BFM) scale. Eighteen patients with musician¿s dystonia were videotaped playing their instruments before and after sensory motor retuning therapy. Two raters, blinded to the order of the randomized video segments, independently rated each segment using the FAM, ADDS, and BFM scales. Intra-rater correlation (intraclass correlation coefficient [ICC] = 0.92, Spearman¿s = 0.87), concordance (weighted = 0.76), and internal consistency (Cronbach¿s a = 0.96) for the FAM scale were good. Inter-rater correlation and concordance were better for the FAM scale (weighted = 0.94, ICC = 0.96, Spearman¿s = 0.90) than for the ADDS or BFM scales (weighted = 0.56¿0.57, ICC scale = 0.81¿0.82, Spearman¿s = 0.68¿0.76). The decrease in the FAM after 1 week of sensory motor retuning therapy was less likely to be due to chance (p = 0.06) than the decrease in the ADDS or BFM scales (p = 0.21¿0.53). The FAM scale may be useful for clinical and research evaluations of patients with musician¿s dystonia.

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