Gut microbiota-derived Tryptophanol driven by N-Carbamylglutamate alleviates premature ovarian failure through inhibiting oxidative stress.

Playing-related musculoskeletal disorders (PRMDs) are a common problem among musicians, with overuse resulting from prolonged practice and performance identified as a primary causative factor [–]. This is particularly evident in the fingers and hands of keyed and stringed instrument players, in whom repetitive motion is intrinsic to playing [,]. PRMDs frequently develop not only in the fingers and hands but also in the neck, shoulders, and low back, [, ] and these disorders are theorized to be related to instrument-playing posture [, ]. Edling et al. [] investigated this relationship in 47 music teachers and reported that an asymmetrical playing posture may increase the risk of neck, shoulder, and low-back disorders. However, due to several limitations, including a small sample size, inclusion of various instrument types, variation in playing frequency, and a wide participant age range, this relationship could not be definitively confirmed []. Notably, the wide age range represents a critical limitation, as factors contributing to PRMDs may differ between adolescents and adults. Of particular public health relevance, low-back pain during adolescence is a known predictor of low-back pain in adulthood [, ]. Therefore, identifying factors contributing to PRMDs in adolescent musicians is essential for developing effective preventive strategies. Consequently, investigations should standardize participant characteristics, particularly age, to clarify the relationship between playing posture and PRMDs. In addition, Mitani et al. [] measured muscle activity in the cervical paraspinal muscle, the upper fiber of the trapezius, and the lumbar paraspinal muscle while holding the flute, trumpet, and marching euphonium playing postures while standing. The results showed that the activities of these muscles were increased not only with the marching euphonium, which is a heavy instrument, but also with the flute, which has an asymmetrical playing posture. These findings suggest that both playing posture and instrument characteristics may influence physical load on the neck-and-shoulder region and low back and are possibly related to pain. However, instrument weight alone may not adequately represent the biomechanical stress imposed during performance; factors such as trunk posture, forward inclination, sustained static muscle activity, and the method of instrument support—collectively referred to as “functional” or “postural” load—may reflect the physical demands of playing more accurately. Accordingly, investigations on PRMDs need to consider the broader concept of functional load along with instrument weight and playing posture.