The development and use of an anatomy-based retraining program (MusAARP) to assess and treat focal hand dystonia in musicians–A pilot study

Ackermann, Bronwen J.; Altenmüller, Eckart

doi:10.1016/j.jht.2021.05.007

Cited by 5 publications

(3 citation statements)

References 18 publications

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“…Firstly, many of them emphasized that apart from the affected fine motor skills, the overall body mechanics and posture also need careful attention. This aligns with several documented treatment approaches, for example, both Tubiana (2003) and Ackermann and Altenmüller (2021) stressed the importance of including larger structures (e.g., torso, scapula, spine) in the rehabilitation, while other documented rehabilitation protocols use general fitness exercises as part of the treatment (Byl et al, 2009).…”

Section: Somatic Approachessupporting

confidence: 70%

“…The outcome of these therapeutic approaches is not satisfactory: while some improvement in the movement control of the affected body part is often observed, none of them can fully and reliably rehabilitate the lost skill (Sadnicka et al, 2016). More recently, the practice of somatic rehabilitation programs emerged, observing the effects of various protocols, such as constraint-induces therapies (Candia et al, 1999;Berque et al, 2010), neuromuscular re-education programs (for a review of the literature, see Enke and Poskey, 2018), slow practice (Sakai, 2006), and postural corrections (Tubiana, 2003;Ackermann and Altenmüller, 2021), or the combination of these. These therapies help the musicians to improve the impacted skill through targeted movement exercises and while they appear to be more successful than purely medical approaches, the efficiency is still moderate (Enke and Poskey, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Treating the musician rather than the symptom: The holistic tools employed by current practices to attend to the non-motor problems of musicians with task-specific focal dystonia

Détári

2023

Front. Psychol.

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Musicians Focal Dystonia (MFD) is a task-specific movement disorder affecting highly skilled musicians. The pathophysiology is poorly understood, and the available treatments are unable to fully and reliably rehabilitate the affected skill. Recently, the exclusively neurological nature of the condition has been questioned, and additional psychological, behavioral, and psychosocial contributing factors were identified. However, very little is known about how these factors influence the recovery process, and how, if at all, they are addressed in ongoing practices. For this study, 14 practitioners with substantial experience in working with musicians with MFD were interviewed about the elements in their approach which are directed at the cognition, emotions, attitudes, and behaviors of their patients and clients. A wide variety of tools were reported in three areas: (1) creating a supportive learning environment and addressing anxiety and perfectionism, (2) using body-oriented methods to optimize the playing behaviors and (3) consciously channeling the focus of attention to guide the physical retraining exercises and establishing new habits. The study also revealed that in-depth knowledge of the instrumental technique is profitable to retrain the impaired motor patterns. Therefore, the importance of including music educators in developing new therapeutic approaches will also be highlighted.

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Section: Somatic Approachessupporting

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Treating the musician rather than the symptom: The holistic tools employed by current practices to attend to the non-motor problems of musicians with task-specific focal dystonia

Détári

2023

Front. Psychol.

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“…For dystonia patients with individual tongue movement problems, individual exercises using certain playing techniques could be created to induce specific movement patterns. Ultimately, this could lead to a scientifically based “retraining” as it has been developed for hand dystonia ( 39 ).…”

Section: Discussionmentioning

confidence: 99%

Movement patterns in tuba playing: comparison of an embouchure dystonia case with healthy professional tuba players using real-time MRI imaging

Nelkenstock,

Iltis,

Voit

et al. 2023

Front. Neurol.

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IntroductionMusculoskeletal problems in professional brass musicians are very common and often involve the muscles of the embouchure. In rare cases, embouchure dystonia (EmD), a task-specific movement disorder with a wide symptomatic and phenotypic variability, occurs. Following trumpeters and horn players, professional tuba players with and without EmD have now been studied using the latest real-time MRI technology to better understand the underlying pathophysiology.Materials and methodsIn the present study, the tongue movement patterns of 11 healthy professional artists and one subject suffering from EmD were compared. The tongue position in the anterior, intermediary and posterior oral cavity were converted into pixel positions based on seven previously generated profile lines, using the established software MATLAB. These data allow a structured comparison of tongue movement patterns between the patient and the healthy subjects, as well as between individual exercises. The main focus of the analysis was on an ascending 7-note harmonic series performed in different playing techniques (slurred, tongued, tenuto and staccato).ResultsPlaying the ascending harmonics, a noticeable ascending tongue movement could be observed in the anterior part of the oral cavity in healthy tubists. In the posterior region, there was a slight decrease in oral cavity space. In the EmD patient, hardly any movement was observed at the tongue apex, but in the middle and posterior regions of the oral cavity there was an increase in size the higher the tone became. These distinct differences are relevant for the characterization and a better understanding of the clinical presentation of EmD. Concerning different playing techniques, it was apparent, that notes played slurred or staccato resulted in a larger oral cavity when compared to notes played tongued or tenuto, respectively.ConclusionBy using real-time MRI videos, the tongue movements of tuba players can be clearly observed and analyzed. The differences between healthy and diseased tuba players demonstrate the great effects of movement disorders in a small area of the tongue. In order to better understand the compensation of this motor control dysfunction, further studies should investigate further parameters of tone production in all brass players with a larger number of EmD patients additional to the observed movement patterns.

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Embouchure Dystonia as a Network Disease

Doll-Lee,

Lee,

Mantel

et al. 2023

Advances in Neurobiology

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The development and use of an anatomy-based retraining program (MusAARP) to assess and treat focal hand dystonia in musicians–A pilot study

Cited by 5 publications

References 18 publications

Treating the musician rather than the symptom: The holistic tools employed by current practices to attend to the non-motor problems of musicians with task-specific focal dystonia

Treating the musician rather than the symptom: The holistic tools employed by current practices to attend to the non-motor problems of musicians with task-specific focal dystonia

Movement patterns in tuba playing: comparison of an embouchure dystonia case with healthy professional tuba players using real-time MRI imaging

Embouchure Dystonia as a Network Disease

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