Table 3.

Characteristics of the included studies

	Response rate (%)	Number participants (n)	Age	Gender (% male)	Instruments (%)	Job characteristics	Definition or description of ‘musculoskeletal complaints’	Localization of complaints
Leaver et al. (2011)	51	243	Mean 44 (range 23–64)	56	String 62 % Woodwind 15 % Brass 16 % Other 17 %	British symphony orchestra musicians	‘The questions on musculoskeletal symptoms were based on the standardized Nordic questionnaire and concerned pain’ ‘disabling pain was defined as pain in the past 12 months present for at least a month and which prevented attendance at work for at least 1 day’	Low back, neck, upper extremities
Paarup et al. (2011)	78	441	Mean men 48 (CI 46–50) Mean women 39 (CI 37–43)	61	String 47 % Woodwind 14 % Brass 12 % Other 4 %	Danish symphony orchestra musicians	‘…adapted from the Nordic Musculoskeletal Questionnaire. The symptoms were measured as presence of trouble (ache, pain, or discomfort)’ ‘As in the DASH questionnaire four questions were asked to assess if the symptoms had led to difficulties in playing, but the time span of interest was extended to 12 months’	Neck, back, upper extremities
Kaufman-Cohen and Ratzon (2011)	66	59	Mean 43 (range 26–66 SD 11)	49	String 66 % Wind 34 %	Israelian symphony orchestra musicians	‘The presence of pain’	Upper extremities
Zaza and Farewell (1997)	67	281	Mean 31	45	String 33 % Other 67 %	USA classically trained musicians and university music students	‘Playing-related musculoskeletal problem (i.e. any pain, weakness, numbness, tingling, or other symptoms that interfere with your ability to play your instrument at the level you are accustomed to)’	Not specified
Abreu-Ramos and Micheo (2007)	90	75	Mean 38 ± 10 (Range 22–61)	79	String 43 % Woodwind 15 % Brass 17 % Percussion 4 % Other 1 %	Puerto Rico symphony orchestra musicians	‘Questions related to musculoskeletal problems, including pain, allodynia, and dysesthesias (expressed as burning, electrical sensation, ‘pins and needles’, tingling, numbness), weakness, cramps and involuntary movements’	Neck, back, upper extremities, mouth
Kaneko et al. (2005)	56	241	Mean 32 (range 18–73, SD 11)	70	String 61 % Woodwind 17 % Brass 12 % Percussion 8 % Conductor 2 %	Brazilian symphony orchestra musicians	Pain. ‘The McGill pain questionnaire was used to specify subjective pain experience using sensory, affective and evaluative word descriptors, and a body diagram was used to locate the pain’	Head, neck, back, upper extremities
Engquist et al. (2004)	43	103	Mean 40 (20–61)	61	String 56 % Wind 36 % Other 5 %	Swedish orchestra musicians	Extension of the Standardized Nordic Questionnaire	Total body
Davies and Mangion (2002)	45	240	Mean 37 (SD 11)	56	String 42 % Woodwind 18 % Brass 16 % Percussion 7 % Keyboard 12 % Guitar 5 %	Australian classical and non-classical instrumental musicians	‘Playing-related pain and/or symptoms (pins and needles, swelling, muscle weakness or loss of control)’	Not specified
Roach et al. (1994)	99	90	Mean 23	54		USA music academy instrumentalists	‘Subjects were asked to report joint pain for any site at which they had experienced pain for at least 2 days during the preceding 4 weeks’	Neck, upper back, upper extremities
O’Neill et al. (2001)	50	103	Mean 36 (range 18–66)	49	String 34 % Trumpet 9 % Piano 8 % Percussion 8 %	Instrumentalists from orchestras, a music academy and privately studying musicians in Canada	‘Respondents reported that they had experienced pain as a result of playing their instrument at least once in the course of their musical studies’ ‘Chronic injury, that is, pain lasting for longer than 3 months’	Not specified
Kok et al. (2013a, b)	26	83	Mean 22 (SD 2) (>18)	26	String 39 % Woodwind 33 % Brass 8 % Percussion and keyboard: 20 %	Dutch music academy students	‘Questions on each of these body regions started by asking about complaints of—the specific body region—during the last 12 months’	Total body
Fishbein et al. (1988); Middlestadt and Fishbein (1988, 1989)	55	2212	Mean 42	64	String 62 % Woodwind 16 % Brass 16 % Percussion 4 % Keyboard: 1 % Other: 1 %	USA orchestra instrumentalists	‘Thus musicians were asked to circle the number of all those problems they had experienced’ ‘… of ICSOM musicians at one particular point in time. Thus, the data reflect prevalence, but not incidence’	Total body
Ackermann et al. (2012), Kenny and Ackermann (2015)	70	377	Mean 42 (SD 10)	49	Strings 63 % Woodwinds 18 % Brass 15 % Percussion 3 % Other 1 %	Australian symphony orchestra musicians	‘Performance-related musculoskeletal disorders were defined as ‘any pain, weakness, numbness, tingling or other physical symptoms that interfere with your ability to play your instrument at the level to which you are accustomed. This definition does not include mild transient aches or pains’	Total body
Arnason et al. (2014)	?	60 (74 including vocalists)a	Mean 22 (SD 4)	57	Strings: 32 % Woodwinds and brass: 23 % Keyboard: 23 % Percussion: 4 % Vocalists: 19 % a	Icelandic music school students	‘Both the cumulative and current prevalence, as well as the severity of PRMD among musicians’ Adapted and translated formerly used questionnaire	Total body
Steinmetz et al. (2015)	57	408	Mean 44 (SD 10)	58	Strings: 56 % Woodwinds: 15 % Brass: 14 % Percussion: 3 % Other: 3 % Missing: 10 %	German orchestra musicians	‘Regarding playing-related musculoskeletal pain, participants were asked whether they had experienced current or past pain in several body regions’	Total body
Chimenti et al. (2013)	26	261	Range 22–75; 78 % between 30 and 59	47	Strings: 66 % Woodwinds: 18 % Brass: 14 % Other: 3 %	Professional orchestra musicians of the international conference of symphony and opera musicians	‘Playing-related symptoms, including but not limited to: pain, weakness, stiffness, swelling, numbness, and/or decreased coordination associated with playing’	Total body
Fotiadis et al. (2013)	60	147	Mean 39 (SD?)	66	Strings: 63 % Woodwinds: 17 % Brass: 14 % Percussion: 5 % Other: 1 %	Greek professional orchestra musicians	Standardized Nordic Questionnaire	Total body

^aVocalists excluded in the reviewed prevalence rates