Sound, Stress, and Health in Youth Orchestras: Feasibility of a Multimodal Psychophysiological Health Promotion Program

Matthias A. Bertsch¹Marik Roos²Tristan Leitz¹Mona Smale¹Christoph Reuter^2*

• ¹Universitat fur Musik und darstellende Kunst Wien, Vienna, Austria
• ²University of Vienna, Vienna, Austria

Background: Young orchestral musicians face significant health risks, including psychological stress, musculoskeletal pain, and high sound pressure levels (90–100 dB SPL). Traditional music education often lacks systematic health promotion, leading to issues that compromise long-term performance. This study evaluates a comprehensive, evidence-based program to promote sustainability and resilience in young musicians. Research Question: Can a multimodal health promotion program combining acoustic, physiological, psychological, and behavioral interventions be feasibly implemented within the intense rehearsal culture of European youth orchestras, and how do musicians engage with it? Methods: A mixed-methods study was conducted during summer and autumn camps with 136 musicians (aged 14–27) from two European youth orchestras. The program included six modules: (1) orchestral soundscape mapping via 16 microphones, (2) practical interventions (daily warm-ups, ‘BodyFit’, and mental training), (3) audiometric screening (n=77), (4) Virtual Reality Exposure Training (VRET) for performance anxiety, (5) psychophysiological stress monitoring via smartwatches (n=15), and (6) quantitative pre- and post-camp surveys. Results: Acoustic mapping confirmed significant spatial variation in sound exposure, with peaks of 88–100 dB SPL, particularly among brass and percussion players. Audiometric screening revealed mostly normal thresholds, though early high-frequency mild hearing loss was already evident in brass players. Wearable monitoring identified individual stress patterns associated with challenging musical passages. Post-intervention surveys showed short-term improvements in stress management and ergonomic awareness. While the program saw high engagement (>90% across modules), inconsistent use of hearing protection remained a challenge (40% reported irregular use). Conclusion: The study demonstrates the feasibility and high acceptance of a multimodal health promotion framework in a youth orchestra setting. By combining objective measurements with practical training, the program shows how health-oriented practices can be integrated into orchestral culture, providing a foundation for future controlled intervention studies.