Sensory motor retuning: a behavioral treatment for focal hand dystonia of pianists and guitarists.
OBJECTIVE
To evaluate the long-term effectiveness of sensory motor retuning (SMR), a new treatment for focal hand dystonia in musicians.


METHODS
Prospective case series with an (adventitious) comparison group with 3- to 25-month follow-up in piano and guitar and 0- to 4-month follow-up in flute and oboe players.


METHODS
General community in Germany.


METHODS
Eleven professional musicians.


METHODS
Immobilization by splints of 1 or more digits other than the focal dystonic finger. This finger carried out repetitive exercises in coordination with 1 or more of the other digits for 1(1/2) to 2(1/2) hours a day for 8 consecutive days under therapist supervision. The subjects then were instructed to continue practice for 1 hour daily for 1 year.


METHODS
Spectral analysis of the output of a dexterity-displacement device that continuously recorded digital displacement during finger movements and a dystonia evaluation scale on which patients rated how well they had just performed dystonic movement sequences and repertoire passages.


RESULTS
The 3 wind players (adventitious placebo controls) did not improve substantially. However, each pianist and guitarist showed marked and significant improvement in spontaneous repertoire performance without the splint. The first subject is now 25 months posttreatment.


CONCLUSIONS
Results suggest that SMR is of value for the treatment of focal hand dystonia in pianists and guitarists.
Candia
Victor
V
Department of Psychology, University of Konstanz, Konstanz, Germany. victor.candia@uni-konstanz.de
Schäfer
Thomas
T
Taub
Edward
E
Rau
Harald
H
Altenmüller
Eckart
E
Rockstroh
Brigitte
B
Elbert
Thomas
T
D000328:Adult; D000368:Aged; D004421:Dystonia / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006225:Hand; D006801:Humans; D008297:Male; D008875:Middle Aged; D009146:Music; D009784:Occupational Diseases / Q000534:rehabilitation*; D013165:Splints; D016896:Treatment Outcome