Table of Contents

MARCH 2026, Vol 41, No 1

ARTICLES

Translation and Initial Validation of the Simplified Chinese Version of the Performance-Related Pain in Musicians Questionnaire (PPAM-C) Among Music Students in Shandong, China
Yu Fu, Fung Chiat Loo, Ana Zão

The problem of occupational injuries and pain among musicians continues to receive wide attention. However, the limitations of survey tools have hindered the in-depth development of occupational health research on musicians across different regions to a certain extent. The aim of this study was to translate the Performance-Related Pain in Musicians Questionnaire (PPAM) into Simplified Chinese (PPAM-C) and to conduct the cultural adaptation and initial validation of the PPAM-C for music students. The reliability and validity of the questionnaire were tested with Chinese music students. A total of 610 valid questionnaires were collected (students’ mean age 19.4 yrs, SD 1.146); females accounted for 69.7%. The respondents represented a variety of primary musical instrument types. Exploratory factor analysis (EFA) supported a three-factor structure consistent with the original version: pain intensity, pain interference in general activities, and pain interference in performance. The sample fit was good (KMO = 0.851; Bartlett’s test of sphericity, p <0.001). The communalities and eigenvalues showed the robustness of the factor structure. The internal consistency (Cronbach’s α =0.786–0.937) of the subscales was good. …

Exploring Breathing During Ballet Performance: A Case Report
Akito Miura, Natsuko Oshima, Mao Fujimuro, Azusa Yokoyama, Haruka Okuyama, Takahide Etani

Literature on renowned classical ballet dancers and educators highlights the importance of breathing in dancing. The purpose of this case study was to explore the feasibility of investigating the underexplored relationship between breathing and dance movements. The participant, a 25-year-old female professional classical ballet dancer, performed ballet choreography requiring significant stamina and pointe technique. Her breathing sounds and video footage were recorded simultaneously using two smartphones. The timings of breathing and kinematic events were identified in the two segments. In both segments, the respiratory rate was approximately 60 breaths/minute, suggesting that breathing may be finely controlled in ballet. In the first segment, breathing occurred at a steady rhythm, and no clear coupling between breathing and movement phases was observed. In the second segment, the rhythms of turns and breathing appeared to be coupled, suggesting possible coordination between breathing and movement. These exploratory findings provide a basis for future research on breathing during ballet performance.

Prevalence and Treatment of Guitar-Related Medical Problems: A Systematic Review of Clinical Studies [Open Access]
Tae-Hun Kim, Jung Won Kang, Hee Youn Kim

AIMS: As the number of professional and amateur guitarists continues to grow, there is a need to summarize the clinical evidence on the prevalence and treatment of this population. This systematic review aimed to provide an overview of the diseases and symptoms affecting guitarists and the available treatments. METHODS: Published clinical studies, ranging from case reports to systematic reviews, addressing medical problems among guitarists were systematically searched in PubMed, EMBASE, and the Cochrane Library up to June 2025. A proportion meta-analysis was conducted to estimate the prevalence of these conditions, and the treatment evidence was summarized. RESULTS: Among 1,001 publications identified from the literature search, a total of 42 clinical studies were included in this review, including case studies, observational studies, and randomized controlled trials. Guitarists were found to have a high prevalence of musculoskeletal pain (0.56, 95% confidence interval [0.26 to 0.84]) and psychological problems. Guitarists’ musculoskeletal pain was potentially related to the long practice duration and inappropriate posture while playing. Various invasive and noninvasive treatment options are available for dystonia in guitarists, but clinical evidence of their effectiveness and safety has not yet been established. Moreover, there were some publications on rare conditions, which should be assessed from the perspective of therapeutic options and prevention in future research. DISCUSSION: Guitarists are at notable risk of physical and psychological conditions. Therefore, preventative education and train­ing are necessary. In addition, clinical evidence for treating these diseases remains inconclusive, and well-designed clinical studies for various interventions are necessary in the future. [Protocol: INPLASY202560088] [Open Access: Licensed under CC-BY-NC-ND 4.0 Int.]

Alcohol and Drug Use in Musicians: A Systematic Review [Open Access]
Tsung-Ko Lin, Stanley King Hei Lam, Mei-Chen Yeh, Lee-Wen Dai, Daniel Chiung-Jui Su

Musicians face unique psychological and professional challenges, which may increase their risk of substance abuse. Previous studies have reported that the prevalence of alcohol or drug use among musicians ranges from 13% to over 80%, depending on the substance, genre, and measurement tools. This systematic review includes studies on alcohol and drug use among musicians, summarizing their prevalence, associated factors, and the bidirectional impact on mental health. Following PRISMA guidelines, a total of 551 records were initially identified before screening and exclusion, and the review included 23 qualitative and quantitative studies published between 1959 and 2024, involving a total of 36,245 participants. The research results show that the incidence of substance abuse (especially alcohol and cannabis) among musicians is higher than that of the general population. Most studies concluded that this could be due to insufficient coping strategies, the unique challenges of their workplace, and the cultural norms of the music industry. Certain music genres and performance roles as well as economic instability also affect the substance abuse of musicians. Compared to previous studies, this review places more emphasis on the complex interaction between the psychological distress of musicians, their professional environment, and professional expectations. Future research should incorporate more longitudinal designs, include more multicultural backgrounds, and focus on the perspectives of musicians themselves. This review provides information for formulating mental health interventions and policies for the music profession. [Open Access: Licensed under CC-BY 4.0 Int]