Publications by authors named "J Matt McCrary"

94 Publications

Performing arts as a health resource? An umbrella review of the health impacts of music and dance participation.

PLoS One 2021 10;16(6):e0252956. Epub 2021 Jun 10.

Institute for Music Physiology and Musicians' Medicine, Hannover University for Music, Drama and Media, Hannover, Germany.

An increasing body of evidence notes the health benefits of arts engagement and participation. However, specific health effects and optimal modes and 'doses' of arts participation remain unclear, limiting evidence-based recommendations and prescriptions. The performing arts are the most popular form of arts participation, presenting substantial scope for established interest to be leveraged into positive health outcomes. Results of a three-component umbrella review (PROSPERO ID #: CRD42020191991) of relevant systematic reviews (33), epidemiologic studies (9) and descriptive studies (87) demonstrate that performing arts participation is broadly health promoting activity. Beneficial effects of performing arts participation were reported in healthy (non-clinical) children, adolescents, adults, and older adults across 17 health domains (9 supported by moderate-high quality evidence (GRADE criteria)). Positive health effects were associated with as little as 30 (acute effects) to 60 minutes (sustained weekly participation) of performing arts participation, with drumming and both expressive (ballroom, social) and exercise-based (aerobic dance, Zumba) modes of dance linked to the broadest health benefits. Links between specific health effects and performing arts modes/doses remain unclear and specific conclusions are limited by a still young and disparate evidence base. Further research is necessary, with this umbrella review providing a critical knowledge foundation.
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June 2021

Temporal organochlorine profiles in young-of-the-year bluefish (Pomatomus saltatrix) in the Hudson River Estuary.

Mar Pollut Bull 2021 Apr 10;165:112128. Epub 2021 Feb 10.

Albany State University, East Campus, BCBB 228, Department of Biological Sciences, 504 College Drive, Albany, GA 31705, United States of America.

The use of "chemical fingerprinting" or "profiling" has been suggested as a means to identify habitat use by young-of-the-year (YOY) bluefish (Pomatomus saltatrix). In this study, seasonal and interannual trends were examined over a 3-year period of 31 polychlorinated biphenyl (PCB) congeners and 23 chlorinated pesticides in 176 YOY bluefish collected in the Hudson River Estuary, New York State. Principal component analysis identified distinct and coherent clustering of bluefish according to sampling year. Seasonally, PCB patterns were similar among weight classes, regardless of date of capture. Throughout the study period, there was a consistent seasonal shift toward the heavier chlorinated homologs as size increased even though different congeners contributed to the overall PCB profile in Year 3. Unlike PCBs, there was no consistent pesticide accumulation pattern, which varied seasonally and interannually. The results show the first generalized interannual accumulation profiles of organochlorines during the rapid growth stage of age-0 bluefish. As knowledge of temporal changes in different ecosystems improves, this will improve an understanding on how exposure to chemicals in different ecosystems can affect the long-term health of bluefish.
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April 2021

Self-Report Fatigue Management for Instrumental Musicians: A Delphi Survey.

Med Probl Perform Art 2020 Dec;35(4):208-213

University of Music, Drama, and Media Hannover, Institute of Music Physiology and Musicians' Medicine, Neues Haus 1, 30161 Hannover, Germany. Tel +49(0)511/3100-552.

Background: Mismanagement of fatigue and playing load have been consistently identified as risk factors for playing-related pain and injuries. Studies in sport demonstrate that fatigue management strategies can predict and prevent overuse syndromes and related injuries through consistent assessment of playing load and physical/psychological stress. Self-report strategies show particular responsiveness to both the short and long-term impacts of training. No equivalent fatigue management strategies exist for musicians. Establish key items and feasibility parameters to inform the development of a self-report fatigue management tool for musicians.

Methods: A working party of international experts in musicians' medicine was invited to complete a two-phase Delphi survey. In Phase I, working party members rated established items from sport (REST-Q subscales with demonstrated responsiveness to both acute and chronic training stresses) with respect to relevance and prospective utility for musicians. Members could also propose additional items and were asked to indicate a maximum feasible questionnaire length. In Phase II, working party members ranked top performing items from Phase I. Consensus best items were determined based on Phase II rankings.

Results: A 28-member working party was assembled (15 clinicians, 13 researchers). Of 20 researcher proposed items and 58 working party proposed items, 5 items met consensus criteria: I had pain; I had to play too much; I felt physically fit; I did not get enough sleep; I recovered well physically. A strong majority (89%) of working party members indicated that regular use of a fatigue questionnaire with up to 10 items is feasible.

Conclusions: Key questionnaire items and feasibility parameters for a novel fatigue management tool for musicians are established. Future research in musicians is needed to validate study results and this novel fatigue management tool.
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December 2020

Balance Deficits and Functional Disability in Cancer Survivors Exposed to Neurotoxic Cancer Treatments.

J Natl Compr Canc Netw 2019 08;17(8):949-955

Prince of Wales Clinical School, University of New South Wales, Kensington.

Background: Chemotherapy-induced peripheral neuropathy (CIPN) persists after treatment in up to 40% of cancer survivors and has been linked with increased balance deficits, disabilities, and fall occurrences. This study aimed to comprehensively assess the links between CIPN, balance deficits, and functional disability and to inform the development of clinical screening tools for patients at risk of these events.

Patients And Methods: A total of 190 cancer survivors exposed to neurotoxic chemotherapies (age, 57 ± 13 years; average time from completion of neurotoxic therapy, 12 ± 11 months) attended a neurology research clinic for a single cross-sectional assessment of patient-reported and objective CIPN, standing balance in 4 conditions of increasing difficulty, and functional disability.

Results: Most patients (68%) reported CIPN symptoms at assessment. Symptomatic patients displayed increased functional disability (F=39.4; P<.001) and balance deficits (F=34.5; P<.001), with degree of balance impairments consistent with a healthy elderly population (age ≥65 years) reporting multiple falls over the subsequent year. Increasing CIPN severity correlated with increasing functional disability (clinically assessed R2=0.46; patient-reported R2=0.49; P<.001) and balance deficits (clinically assessed R2=0.41; patient-reported R2=0.30; P<.001). A 5-factor model of key independent correlates-patient-reported numbness/tingling, weakness, and balance deficit; age; and vibration perception-was strongly linked to balance deficits (R2=0.46; P<.001) and functional disability (R2=0.56; P<.001).

Conclusions: This study confirms links between increasing CIPN severity and increasing balance deficits and functional disability using comprehensive CIPN assessment methodology. The extent of balance deficits in patients with CIPN underscores the functional consequences of neurotoxicity. A 5-factor model provides a foundation for clinical screening tools to assess balance deficits and functional disability in patients exposed to neurotoxic chemotherapies.
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August 2019

Optimizing Clinical Screening for Chemotherapy-Induced Peripheral Neuropathy.

J Pain Symptom Manage 2019 12 30;58(6):1023-1032. Epub 2019 Jul 30.

Prince of Wales Clinical School, University of New South Wales, Kensington, Australia; Brain and Mind Centre, The University of Sydney, Camperdown, Australia. Electronic address:

Context: Efficient and accurate clinical screening for treatment-related toxicities is a critical component of optimal patient management. A number of alternate screening tools for chemotherapy-induced peripheral neuropathy (CIPN) have been proposed in response to demonstrated limitations with standard clinical screening, although their relative diagnostic value is unclear.

Objectives: The aim of this study is to evaluate the relative construct validity and discriminant properties of available CIPN screening tools.

Methods: Patients treated with known potentially neurotoxic therapies underwent CIPN evaluation at one or multiple timepoints (N = 316 patients; age = 56 ± 13 years). At each testing session (N = 644 testing sessions), patients were evaluated using screening tools and comprehensive CIPN assessments. Comprehensive assessments were clinician-rated (Total Neuropathy Score, reduced) or patient-reported outcome (PRO; Functional Assessment of Cancer Therapy-Gynecologic Oncology Group/Neurotoxicity questionnaire). Similarly, screening tools were clinician-rated (National Cancer Institute Common Terminology Criteria for Adverse Events [NCI-CTCAE]) or PRO (Patient Neurotoxicity Questionnaire, PRO-CTCAE).

Results: Analyses revealed moderate-to-high correlations between screening tools and comprehensive assessments (0.55 ≤ rho ≤ 0.75; P < 0.001) and similar discriminant properties across screening tools (P > 0.01). Screening tool grading corresponding to clinically significant (grade 2/3) vs. low-grade (grade 0/1) CIPN would correspond to greater ratings of CIPN severity by more comprehensive assessments in a predicted 77%-91% of cases (c-statistic = 0.77-0.91; P < 0.01).

Conclusions: PRO screening tools provide adequate CIPN screening while avoiding potential biases demonstrated to limit currently used clinician-rated screening tools. Addition of a brief objective test did not add value to PRO screening. Up to 23% of patients would be misidentified through screening, providing quantitative evidence of the limitations of available screening tools. More extensive CIPN evaluations are critical in patients at risk of serious neurotoxicity.
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December 2019