Musculoskeletal pain and upper quadrant disability in stringed-instrument students: A cross-sectional pilot study

Authors

  • Ornella Cheuquel Jara Universidad San Sebastián, Programa Magíster en Kinesiología Musculoesquelética. Lientur #1457, Concepción, Chile. https://orcid.org/0009-0009-5215-4240
  • Jetzabel Rodríguez Alegría Universidad San Sebastián, Programa Magíster en Kinesiología Musculoesquelética. Lientur #1457, Concepción, Chile. https://orcid.org/0009-0005-6562-3529
  • Claudio Carvajal-Parodi Universidad San Sebastián, Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación. Lientur #1457, Concepción, Chile. https://orcid.org/0000-0003-4271-9657
  • Gonzalo Arias-Álvarez Universidad San Sebastián, Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación. Lientur #1457, Concepción, Chile. https://orcid.org/0000-0001-5129-6612
  • Cristhian Mendoza Universidad San Sebastián, Escuela de Medicina, Facultad de Medicina y Ciencia, Universidad San Sebastián, Concepción 4030000, Chile. https://orcid.org/0000-0002-5038-0991
  • Adolfo Soto-Martínez Departamento de Kinesiología, Facultad de Medicina, Universidad de Concepción, Concepción 4030000, Chile. https://orcid.org/0000-0003-4677-3220
  • Francisco Guede-Rojas Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, 7591538, Chile. https://orcid.org/0000-0002-1870-1396

DOI:

https://doi.org/10.47197/retos.v55.104062

Keywords:

Musculoskeletal pain, string students, QuickDash, Neck Disability Index, DN4

Abstract

Background: Musculoskeletal pain (MSP) is prevalent in musicians and is mainly located in the upper quadrant, affecting functionality. Repetitive movements, type of instrument, age, and sex influence this behavior, among other factors. Although the evidence is limited, it seems that string players are among those who most frequently report pain and disability of musculoskeletal origin. Objective: To characterize MSP and the level of upper quadrant disability associated with stringed instrument playing in conservatory students. Methods: In this cross-sectional observational pilot study, six self-reported assessment instruments were applied to 14 string students (8 males and six females) of different instruments (violin, viola, classical guitar, cello and double bass): Quick Dash Global (QDG) and High Performance/Musicians (QDL), Neck Disability Index (NDI), Chronic Pain Grading Scale (EGDC), the Neuropathic Pain Questionnaire (abbreviated DN4) and the Body Map of Pain (body chart). Results: 100% of the sample presented MSP at the time of the evaluation, mostly of low intensity, being in 21.42% of the cases of chronic and disseminated character. Neuropathic pain was present in 64.28% of cases. General functionality measured with EGDC was affected in 71.42% of the individuals. Upper limb functionality presented a mean QDG of 16.4 ±15.63 and a mean QDL of 32.11 ±16.78, while at the cervical level, 64.28% presented mild to moderate disability measured with NDI. Conclusion: DME and upper quadrant disability are frequent conditions in chordophone student musicians. Future studies should deepen the causes and investigate efficient strategies to prevent these conditions throughout their training process.

Keywords: Musculoskeletal pain in musicians, string musicians, QuickDash, Neck Disability Index, DN4.

References

Ajidahun, Adedayo T., Mudzi, W., Wood, W.-A., & Myezwa, H. (2017). Musculoskeletal problems among string instrumentalists in South Africa. South African Journal of Physiotherapy, 73(1), 7 pages. https://doi.org/10.4102/sajp.v73i1.327

Ajidahun, Adedayo Tunde, Mudzi, W., Myezwa, H., & Wood, W.-A. (2016). Upper extremity disability among string instrumentalists–use of the quick DASH and the NDI. Cogent Medicine, 3(1), 1234535. https://doi.org/10.1080/2331205X.2016.1234535

Almonacid-Canseco, G., Gil-Beltrán, I., López-Jorge, I., & Bolancé-Ruiz, I. (2013). Trastornos músculo-esqueléticos en músicos profesionales: Revisión bibliográfica. Medicina y Seguridad Del Trabajo, 59(230), 124–145. https://doi.org/10.4321/S0465-546X2013000100009

Amaral Corrêa, L., Teixeira dos Santos, L., Nogueira Paranhos Jr, E. N., Minetti Albertini, A. I., do Carmo Silva Parreira, P., & Calazans Nogueira, L. A. (2018). Prevalence and Risk Factors for Musculoskeletal Pain in Keyboard Musicians: A Systematic Review. PM&R, 10(9), 942–950. https://doi.org/10.1016/j.pmrj.2018.04.001

Andrade Ortega, J. A., Delgado Martínez, A. D., & Almécija Ruiz, R. (2010). Validation of the Spanish version of the Neck Disability Index. Spine, 35(4), E114-118. https://doi.org/10.1097/BRS.0b013e3181afea5d

Baadjou, V. A. E., Roussel, N. A., Verbunt, J. A. M. C. F., Smeets, R. J. E. M., & de Bie, R. A. (2016). Systematic review: Risk factors for musculoskeletal disorders in musicians. Occupational Medicine, 66(8), 614–622. https://doi.org/10.1093/occmed/kqw052

Baadjou, V., de Bie, R., Guptill, C., & Smeets, R. (2018). Psychometric properties of the performing arts module of the Disabilities of the Arm, Shoulder, and Hand questionnaire. Disability and Rehabilitation, 40(24), 2946–2952. https://doi.org/10.1080/09638288.2017.1362707

Berque, P., Gray, H., & McFadyen, A. (2014). Development and psychometric evaluation of the Musculoskeletal Pain Intensity and Interference Questionnaire for professional orchestra Musicians. Manual Therapy, 19(6), 575–588. https://doi.org/10.1016/j.math.2014.05.015

Blanco-Piñeiro, P., Díaz-Pereira, M. P., & Martínez, A. (2017). Musicians, postural quality and musculoskeletal health: A literature’s review. Journal of Bodywork and Movement Therapies, 21(1), 157–172. https://doi.org/10.1016/j.jbmt.2016.06.018

Bouhassira, D., Attal, N., Alchaar, H., Boureau, F., Brochet, B., Bruxelle, J., … Vicaut, E. (2005). Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). PAIN, 114(1), 29. https://doi.org/10.1016/j.pain.2004.12.010

Bragge, P., Bialocerkowski, A., & McMeeken, J. (2006). A systematic review of prevalence and risk factors associated with playing-related musculoskeletal disorders in pianists. Occupational Medicine, 56(1), 28–38. https://doi.org/10.1093/occmed/kqi177

Butler, S., Landmark, T., Glette, M., Borchgrevink, P., & Woodhouse, A. (2016). Chronic widespread pain—The need for a standard definition. Pain, 157(3), 541–543. https://doi.org/10.1097/j.pain.0000000000000417

Chamorro, C., Alvares, D., Berger, S., Balocci, F., Rodriguez, X., & Soza, F. (2020). Propiedades psicométricas de la versión chilena del cuestionario Quick Disabilities of the Arm, Shoulder and Hand en pacientes con patologías de hombro. Arch. med. deporte, 37(199), 305–309. https://doi.org/10.18176/archmeddeporte.0004

Chan, C., Driscoll, T., & Ackermann, B. (2013). The usefulness of on-site physical therapy-led triage services for professional orchestral musicians – a national cohort study. BMC Musculoskeletal Disorders, 14(1), 98. https://doi.org/10.1186/1471-2474-14-98

Chiaramonte, R., & Vecchio, M. (2021). Rehabilitación de la distonía focal de mano en músicos: Una revisión sistemática de los estudios. Revista de neurología, 72(8), 269–282.

Collard, X., Kaux, J. F., & Forthomme, B. (2022). [Neuromusculoskeletal disorders related to musical playing—A review of the literature]. Revue Medicale De Liege, 77(4), 231–235.

Cook, C. (2010). Mode of administration bias. Journal of Manual & Manipulative Therapy, 18(2), 61–63. https://doi.org/10.1179/106698110X12640740712617

Cruder, C., Barbero, M., Soldini, E., & Gleeson, N. (2021). Patterns of pain location in music students: A cluster analysis. BMC Musculoskeletal Disorders, 22(1), 184. https://doi.org/10.1186/s12891-021-04046-6

de Queiroz, J. R. C., Mollica, F. B., Benetti, P., de Araujo, M. A. M., & Valera, M. C. (2014). Degree of chronic orofacial pain associated to the practice of musical instruments in orchestra’s participants. Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research, 25(1), 28–31. https://doi.org/10.4103/0970-9290.131050

Díaz-Narváez, V. P., Mercurio, M. A. C., Albornoz, J. F. A., Reyes, Y. B. V., & Escobar, C. D. (2023). Relación entre catastrofización, kinesiofobia, discapacidad e intensidad de dolor en pacientes con síndrome de hombro doloroso (Relationship between catastrophizing, kinesiophobia, disability and pain intensity in patients with painful shoulder syndrome). Retos, 47, 926–932. https://doi.org/10.47197/retos.v47.96195

Directrices de la OMS Sobre Actividad Física y Comportamientos Sedentarios. (2021). Geneva: World Health Organization. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK581972/

Fernández, R., Ahumada, M., Muñoz, R., Urra, X., Yáñez, M. V., Velasco, M., … Mora, X. (2011). Guía para definición y manejo del dolor neuropático localizado (DNL): Consenso chileno. Dolor, 12–31.

Ferrer-Peña, R., Gil-Martínez, A., Pardo-Montero, J., Jiménez-Penick, V., Gallego-Izquierdo, T., & La Touche, R. (2016). Adaptación y validación de la Escala de gradación del dolor crónico al español. Reumatología Clínica, 12(3), 130–138. https://doi.org/10.1016/j.reuma.2015.07.004

Gasenzer, E. R., Klumpp, M.-J., Pieper, D., & Neugebauer, E. A. M. (2017). The prevalence of chronic pain in orchestra musicians. GMS German Medical Science, 15, Doc01. https://doi.org/10.3205/000242

Gembris, H., Menze, J., Heye, A., & Bullerjahn, C. (2020). High-Performing Young Musicians’ Playing-Related Pain. Results of a Large-Scale Study. Frontiers in Psychology, 11. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyg.2020.564736

Gómez-Rodríguez, R., Díaz-Pulido, B., Gutiérrez-Ortega, C., Sánchez-Sánchez, B., & Torres-Lacomba, M. (2020). Prevalence, Disability and Associated Factors of Playing-Related Musculoskeletal Pain among Musicians: A Population-Based Cross-Sectional Descriptive Study. International Journal of Environmental Research and Public Health, 17(11), 3991. https://doi.org/10.3390/ijerph17113991

González-Gálvez, N., Carrasco-Poyatos, M., Vaquero-Cristóbal, R., & Marcos-Pardo, P. J. (2022). Dolor de espalda en adolescentes: Factores asociados desde un enfoque multifactorial (Back pain in adolescents: associated factors with a multifactorial approach). Retos, 43, 81–87. https://doi.org/10.47197/retos.v43i0.87389

Granell, J., Granell, J., Ruiz, D., & Tapias, J. A. (2011). El estudio de instrumentos de viento se asocia con un patrón obstructivo en la espirometría de adolescentes con buena capacidad de resistencia aeróbica. Atencion Primaria, 43(3), 134–139. https://doi.org/10.1016/j.aprim.2010.03.013

Hartvigsen, J., Hancock, M. J., Kongsted, A., Louw, Q., Ferreira, M. L., Genevay, S., … Woolf, A. (2018). What low back pain is and why we need to pay attention. The Lancet, 391(10137), 2356–2367. https://doi.org/10.1016/S0140-6736(18)30480-X

James, C. E., Schmid, A., Nguyen-Danse, D. A., & Bruyneel, A.-V. (2023). Identifying physical and psychological risk factors for musculoskeletal pain in student musicians to tailor the curriculum: A cross-sectional study protocol. BMJ Open, 13(8), e073294. https://doi.org/10.1136/bmjopen-2023-073294

Kaufman-Cohen, Y., & Ratzon, N. Z. (2011). Correlation between risk factors and musculoskeletal disorders among classical musicians. Occupational Medicine, 61(2), 90–95. https://doi.org/10.1093/occmed/kqq196

Kok, L. M., Huisstede, B. M. A., Voorn, V. M. A., Schoones, J. W., & Nelissen, R. G. H. H. (2016). The occurrence of musculoskeletal complaints among professional musicians: A systematic review. International Archives of Occupational and Environmental Health, 89(3), 373–396. https://doi.org/10.1007/s00420-015-1090-6

Leaver, R., Harris, E. C., & Palmer, K. T. (2011). Musculoskeletal pain in elite professional musicians from British symphony orchestras. Occupational Medicine, 61(8), 549–555. https://doi.org/10.1093/occmed/kqr129

Lee, H.-S., Park, H. Y., Yoon, J. O., Kim, J. S., Chun, J. M., Aminata, I. W., … Jeon, I.-H. (2013). Musicians’ medicine: Musculoskeletal problems in string players. Clinics in Orthopedic Surgery, 5(3), 155–160. https://doi.org/10.4055/cios.2013.5.3.155

Lima, R. C., Pinheiro, T. M. M., Dias, E. C., & de Andrade, E. Q. (2015). Development and prevention of work related disorders in a sample of Brazilian violinists. Work, 51(2), 273–280. https://doi.org/10.3233/WOR-141904

Lockwood, A. H. (1989). Medical Problems of Musicians. New England Journal of Medicine, 320(4), 221–227. https://doi.org/10.1056/NEJM198901263200405

Macdonald, H. M., Lavigne, S. K., Reineberg, A. E., & Thaut, M. H. (2022). Playing-Related Musculoskeletal Disorders, Risk Factors, and Treatment Efficacy in a Large Sample of Oboists. Frontiers in Psychology, 12, 772357. https://doi.org/10.3389/fpsyg.2021.772357

Mann, S., Paarup, H. M., & Søgaard, K. (2023). Effects of different violin playing techniques on workload in forearm and shoulder muscles. Applied Ergonomics, 110, 103999. https://doi.org/10.1016/j.apergo.2023.103999

Mansfield, K. E., Sim, J., Jordan, J. L., & Jordan, K. P. (2016). A systematic review and meta-analysis of the prevalence of chronic widespread pain in the general population. PAIN, 157(1), 55. https://doi.org/10.1097/j.pain.0000000000000314

Mizrahi, J. (2020). Neuro-mechanical aspects of playing-related mobility disorders in orchestra violinists and upper strings players: A review. European Journal of Translational Myology, 30(3), 9095. https://doi.org/10.4081/ejtm.2020.9095

Möller, D., Ballenberger, N., & Zalpour, C. (2018). The German version of the musculoskeletal pain intensity and interference questionnaire for musicians (MPIIQM-G): Translation and validation in professional orchestral musicians. Musculoskeletal Science and Practice, 37, 1–7. https://doi.org/10.1016/j.msksp.2018.05.005

Morales-Espinoza, E. M., Kostov, B., Salami, D. C., Perez, Z. H., Rosalen, A. P., Molina, J. O., … CPSGPC Study Group. (2016). Complexity, comorbidity, and health care costs associated with chronic widespread pain in primary care. Pain, 157(4), 818–826. https://doi.org/10.1097/j.pain.0000000000000440

Nawrocka, A., Mynarski, W., Powerska, A., Grabara, M., Groffik, D., & Borek, Z. (2014). Health-oriented physical activity in prevention of musculoskeletal disorders among young Polish musicians. International Journal of Occupational Medicine and Environmental Health, 27(1), 28–37. https://doi.org/10.2478/s13382-014-0224-5

Nicholas, M., Vlaeyen, J. W. S., Rief, W., Barke, A., Aziz, Q., Benoliel, R., … The IASP Taskforce for the Classification of Chronic Pain. (2019). The IASP classification of chronic pain for ICD-11: Chronic primary pain. Pain, 160(1), 28–37. https://doi.org/10.1097/j.pain.0000000000001390

Orlandini Robert, L. (2012). La interpretación musical. Revista Musical Chilena, 66(218), 77–81. https://doi.org/10.4067/S0716-27902012000200006

Paarup, H. M., Baelum, J., Holm, J. W., Manniche, C., & Wedderkopp, N. (2011). Prevalence and consequences of musculoskeletal symptoms in symphony orchestra musicians vary by gender: A cross-sectional study. BMC Musculoskeletal Disorders, 12(1), 223. https://doi.org/10.1186/1471-2474-12-223

Park, K., Kwon, O., Ha, S., Kim, S., Choi, H., & Weon, J. (2012). Comparison of Electromyographic Activity and Range of Neck Motion in Violin Students with and without Neck Pain During Playing. Medical Problems of Performing Artists, 27(4), 188–192. https://doi.org/10.21091/mppa.2012.4035

Portnoy, S., Cohen, S., & Ratzon, N. Z. (2022). Correlations between body postures and musculoskeletal pain in guitar players. PLOS ONE, 17(1), e0262207. https://doi.org/10.1371/journal.pone.0262207

Rajaeih, S., Kolyaie, F., Emamdjomeh, H., Feizabad, E., & Ghanbari, H. (2022). An Evaluation of Maximum Safe Practice Time of Iranian Musical Instruments to Protect Noise-Induced Hearing Loss in Professionals. Medical Journal of the Islamic Republic of Iran, 36, 76. https://doi.org/10.47176/mjiri.36.76

Rodríguez-Gude, C., Sousa, C. M., Taboada-Iglesias, Y., & Pino-Juste, M. (2023). Musculoskeletal pain in musicians: Does playing more than one instrument have more effect? International Journal of Occupational Safety and Ergonomics. (world). Retrieved from https://www.tandfonline.com/doi/full/10.1080/10803548.2022.2120260

Rodríguez-Gude, C., Taboada-Iglesias, Y., & Pino-Juste, M. (2023). Musculoskeletal pain in musicians: Prevalence and risk factors – a systematic review. International Journal of Occupational Safety and Ergonomics. (world). Retrieved from https://www.tandfonline.com/doi/abs/10.1080/10803548.2022.2086742

Rodríguez-Leyva, J. A., & Nava-Bringas, T. I. (2013). Utilidad del mapa de dolor en la evaluación clínica del paciente con dolor de columna.

Rodríguez-Romero, B., Pérez-Valiño, C., Ageitos-Alonso, B., & Pértega-Díaz, S. (2016). Prevalence and Associated Factors for Musculoskeletal Pain and Disability Among Spanish Music Conservatory Students. Medical Problems of Performing Artists, 31(4), 193–200. https://doi.org/10.21091/mppa.2016.4035

Rojas, V. E. A., Pluma, A. F., Pecos-Martín, D., Achalandabaso-Ochoa, A., Fernández-Matías, R., Martinez-Merinero, P., … Gallego-Izquierdo, T. (2021). Relationship between Neuromuscular Mechanosensitivity and Chronic Neck Pain in Guitarists: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 18(5), 2673. https://doi.org/10.3390/ijerph18052673

Ross, M. H., Charness, M. E., Lee, D., & Logigian, E. L. (1995). Does ulnar neuropathy predispose to focal dystonia? Muscle & Nerve, 18(6), 606–611. https://doi.org/10.1002/mus.880180607

Rotter, G., Noeres, K., Fernholz, I., Willich, S. N., Schmidt, A., & Berghöfer, A. (2020). Musculoskeletal disorders and complaints in professional musicians: A systematic review of prevalence, risk factors, and clinical treatment effects. International Archives of Occupational and Environmental Health, 93(2), 149–187. https://doi.org/10.1007/s00420-019-01467-8

Rousseau, C., Taha, L., Barton, G., Garden, P., & Baltzopoulos, V. (2023). Assessing posture while playing in musicians—A systematic review. Applied Ergonomics, 106, 103883. https://doi.org/10.1016/j.apergo.2022.103883

Silva, A. G., Lã, F. M., & Afreixo, V. (2015). Pain Prevalence in Instrumental Musicians: A Systematic Review. Medical Problems of Performing Artists, 30(1), 8–19. https://doi.org/10.21091/mppa.2015.1002

Sluka, K. A., & Clauw, D. J. (2016). Neurobiology of fibromyalgia and chronic widespread pain. Neuroscience, 338, 114–129. https://doi.org/10.1016/j.neuroscience.2016.06.006

Sousa, C. M., Machado, J. P., Greten, H. J., & Coimbra, D. (2017). Playing-Related Musculoskeletal Disorders of Professional Orchestra Musicians from the North of Portugal: Comparing String and Wind Musicians. Acta Medica Portuguesa, 30(4), 302–306. https://doi.org/10.20344/amp.7568

Stanhope, J., & Weinstein, P. (2021). Should musicians play in pain? British Journal of Pain, 15(1), 82–90. https://doi.org/10.1177/2049463720911399

Steinmetz, A., Scheffer, I., Esmer, E., Delank, K. S., & Peroz, I. (2015). Frequency, severity and predictors of playing-related musculoskeletal pain in professional orchestral musicians in Germany. Clinical Rheumatology, 34(5), 965–973. https://doi.org/10.1007/s10067-013-2470-5

van Selms, M. K. A., Wiegers, J. W., van der Meer, H. A., Ahlberg, J., Lobbezoo, F., & Visscher, C. M. (2020). Temporomandibular disorders, pain in the neck and shoulder area, and headache among musicians. Journal of Oral Rehabilitation, 47(2), 132–142. https://doi.org/10.1111/joor.12886

von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., & Vandenbroucke, J. P. (2008). Declaración de la iniciativa STROBE (Strengthening the Reporting of Observational Studies in Epidemiology): Directrices para la comunicación de estudios observacionales. Revista Española de Salud Pública, 82(3), 251–259.

Wesseldijk, L. W., Mosing, M. A., & Ullén, F. (2021). Why Is an Early Start of Training Related to Musical Skills in Adulthood? A Genetically Informative Study. Psychological Science, 32(1), 3–13. https://doi.org/10.1177/0956797620959014

Woldendorp, K. h., Boonstra, A. m., Tijsma, A., Arendzen, J. h., & Reneman, M. f. (2016). No association between posture and musculoskeletal complaints in a professional bassist sample. European Journal of Pain, 20(3), 399–407. https://doi.org/10.1002/ejp.740

Wolfe, F., Butler, S. H., Fitzcharles, M., Häuser, W., Katz, R. L., Mease, P. J., … Walitt, B. (2019). Revised chronic widespread pain criteria: Development from and integration with fibromyalgia criteria. Scandinavian Journal of Pain, 20(1), 77–86. https://doi.org/10.1515/sjpain-2019-0054

World Medical Association. (2013). World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053

Yang, N., Fufa, D. T., & Wolff, A. L. (2021). A musician-centered approach to management of performance-related upper musculoskeletal injuries. Journal of Hand Therapy, 34(2), 208–216. https://doi.org/10.1016/j.jht.2021.04.006

Zamorano, A. M., Kleber, B., Arguissain, F., Boudreau, S., Vuust, P., Flor, H., & Graven-Nielsen, T. (2023). Extensive Sensorimotor Training Predetermines Central Pain Changes During the Development of Prolonged Muscle Pain. The Journal of Pain, 24(6), 1039–1055. https://doi.org/10.1016/j.jpain.2023.01.017

Zaza, C., Charles, C., & Muszynski, A. (1998). The meaning of playing-related musculoskeletal disorders to classical musicians. Social Science & Medicine, 47(12), 2013–2023. https://doi.org/10.1016/S0277-9536(98)00307-4

Downloads

Published

2024-06-01

How to Cite

Cheuquel Jara, O., Rodríguez Alegría, J., Carvajal-Parodi, C., Arias-Álvarez, G., Mendoza, C., Soto-Martínez, A., & Guede-Rojas, F. (2024). Musculoskeletal pain and upper quadrant disability in stringed-instrument students: A cross-sectional pilot study. Retos, 55, 679–689. https://doi.org/10.47197/retos.v55.104062

Issue

Vol. 55 (2024)

Section

Original Research Article

License

Copyright (c) 2024 Retos

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
  2. Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
  3. Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).

This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.

Most read articles by the same author(s)