Effects of E-learning for Postural Education in Music Students (El-Poems): A Randomized Controlled Trial Among Iranian Adolescents

Abstract

Aims: Musculoskeletal (MSK) pain represents a major health problem facing music students worldwide. There is some evidence that posture education could be effective in reducing pain and disability among music students. The aim of this study was to assess the effective¬ness of E-learning for posture education in music students (El-Poems) on the presence of MSK pain, MSK pain intensity, as well as postural behavior.

Methods: This was a matched-pair, two-arm parallel randomized controlled trial. Participants were music students (aged 12-18 yrs), randomized to intervention (n=134) and control (n=133) groups. The education program included four online sessions of the risks of incorrect posture and the necessary skill for correct postural behavior. A numeric rating scale (NRS) and the Nordic body map were used to evaluate the primary outcomes (MSK pain intensity, presence of MSK pain, and location). A secondary outcome (postural behavior) was assessed using the Rapid Entire Body Assessment checklist. Data were collected at two points, baseline and 6-month follow-up. ANOVA and Wilcoxon tests were performed to assess the time x group interaction effect.

Results: A total of 267 music students participated this study. Of these, 150 (56.2%) reported at least one symptomatic region over the previous week. A significant reduction was found from baseline to 6-month follow-up in mean scores in the intervention group for MSK pain prevalence (from 55.2% to 43.3%, Z=-2.71, P=0.004, etap2=0.07), MSK pain intensity (from 2.21±2.51 to 1.94±2.47, F263=32.27, P<0.001, etap2 = 0.11), and postural behavior (from 6.99±2.97 to 6.65±2.72, F263=27.35, P<0.001, etap2=0.09).

Conclusion: The results demonstrated that the E-learning postural education program was associated with a decrease in the prevalence of MSK pain, a reduction in pain intensity, and improved postural behavior. Iranian Registry of Clinical Trials: reg. no. IRCT20180528039885N2, Nov-09-2021.