September 2015 163 OBJECTIVE: CANS (complaints of arm, neck, and/or shoul- der not caused by a systemic disease or acute trauma) are a rec- ognized problem in specific occupational groups such as musi- cians. This study aimed to compare the prevalence, characteristics, and consequences of CANS between music academy students and a control group of peer-age medical stu- dents. METHODS: A cross-sectional study among music acad- emy students and medical students. Data were collected using a web-based questionnaire on musculoskeletal conditions of the upper extremity in the two cohorts. RESULTS: Students of three music academies (n=345) and one medical university (n=2,870) received the questionnaire, of which 25% (n=87) and 18% (n=503) responded, respectively. The 12-month prevalence of CANS was nearly twice as high among music academy students as the control group (80.7% vs 41.5%, p<0.001). Music academy students reported 2.6 times the point prevalence as medical students (47.0% vs 18.2%, p<0.001). Chronic CANS was present in 36.1% of the music students, compared to 10.3% of the medical students (p<0.001). Music academy students presented more complaints per anatomic localization and a higher number of involved anatomic local- izations. Music students rated the influence of CANS on daily functioning as more severe (5.0 vs 3.1, p<0.001). Of all sub- jects with CANS during the last year, more music academy stu- dents (46.3%) visited a healthcare professional compared to medical students (29.8%, p=0.013). CONCLUSION: The prevalence of CANS is high in music academy students com- pared to medical students. This emphasizes the necessity of effective (preventive) interventions in these high-demanding professionals. Med Probl Perform Art 2015; 30(3):163–168. M usculoskeletal problems among musicians are frequent, with reported 12-month prevalence among music academy students and profes- sional musicians ranging from 39 to 90%, 1–8 while these numbers vary between 2 and 60% in the general working population. 9,10 These prevalence estimates are often focused on the occurrence of musculoskeletal complaints in the whole body. 2–5,11 However, playing an instrument mainly involves overuse at the upper extremity and neck area. The latter is in accordance with studies showing a high prevalence of musculoskeletal complaints among musicians at the upper extremities, neck, and mouth. 11,12 Since some studies showed that nearly half of professional musicians discontinued practicing their instrument at home during 1 year due to musculoskeletal complaints, evaluation is necessary. 2 The extent of upper extremity musculoskeletal com- plaints can be described within the CANS (Complaints of Arm, Neck, and/or Shoulder) model. 13 In the CANS model, complaints due to systemic disease or acute trauma are excluded. This model was developed to support and compare scientific research and to increase multidiscipli- nary cooperation, using a delphi consensus strategy. One of the advantages of using this model is the possibility of comparing different populations. Systematically describ- ing the scope of CANS experienced by musicians is not only an important step in recognizing the extent of the problem in that specific group in comparison to other pro- fessions, but it will also give clues for addressing preven- tive interventions. Thus, the primary aim of this study was to evaluate the prevalence of CANS among music acad- emy students compared to a control group of medical stu- dents; secondly, the impact of CANS symptoms experi- enced by music academy students compared to medical students was evaluated. METHODS Study Design A cross-sectional study on musculoskeletal conditions of the upper extremity in music academy students was per- formed. A group of medical school students was considered as a control group. Data were collected from a web-based questionnaire among 3,215 students of three music acade- mies and 2,870 students at one medical university in the Netherlands, extensively described in a previous article. 11 Data were collected between February and May 2011. All Dutch-speaking students of three music academies (n=345)—the Royal Conservatoire, The Hague; CODARTS University for the Arts, Rotterdam; the Ams- terdam School of the Arts, Amsterdam, with a classical instrument as main subject (singers and conductors were excluded)—received an invitation, as did medical students (studying to be physicians) from Leiden University Prevalence and Consequences of Arm, Neck, and/or Shoulder Complaints Among Music Academy Students A Comparative Study Laura M. Kok, MA, MD, Rob G.H.H. Nelissen, MD, PhD, and Bionka M.A. Huisstede, PhD, PT From the Department of Orthopedics (LMK, RGHHN, BMAH), Leiden University Medical Center, Leiden, and Department of Rehabilitation, Nursing Science, and Sports (BMAH), University Medical Center Utrecht, Utrecht, The Netherlands. The authors declare no funding or conflicts of interest. Address correspondence to: Dr. Laura M. Kok, Department of Orthope- dics, Leiden University Medical Center, Postzone J11R, Postbus 9600, 2300 RC Leiden, The Netherlands. Tel +31-(0)71-5263606, fax +31- (0)71-5266743. laura.m.kok@gmail. com. © 2015 Science & Medicine. www.sciandmed.com/mppa. https://doi.org/10.21091/mppa.2015.3031