"Slow Down Exercise" para la distonía focal del pianista profesional.

Naotaka Sakai, M.D., Ph.D.
Biomechanics Laboratory, Utsunomiya University. Orthopedic Surgery, Yokohama City University School of Medicine. Japan.

Twenty professional pianists with the focal hand dystonia (10 males and 10 females 28.0 years old on the average) were treated with successful result by means of an program called -Slow Down Exercise-.
The -Slow Down Exercise" consisted of 5 steps:
(1) The patient pianists chose the music piece which produced a dystonic hand movement. Short passages or specific technique were chosen for purpose of playing repetitions.
(2) Patients steadily lowered the performance speed until the dystonic hand movement disappeared, and recorded the slow speed using the metronome.
(3) Playing at the recorded speed, patients practised the piece a half an hour per day for two weeks. In addition to the Slow Down Exercise, they were allowed to practice playing the piano freely.
(4) After two weeks, patients began increasing speed from 10 to 20 If with increased speed the symptom did not reappear, patients proceeded to practice at the new speed for another two weeks. In the case of reappearance of dystonic motion, patients went back to prior speed.
(5) After two weeks. Step 4 was repeated and the performance speed was gradually increased.

The performance speed was decreased to an average of 12.4 of normal. Clinical result evaluated by the ADDM scale was 2 = moderate difficulty in 4 cases and 3 - marked difficulty in 16 cases before the Slow Down Exercise. After the exercise, the symptom was improved to 0 = normal in 12 cases and 1 = mild difficulty in 8 cases. The result by TCS was improved from 1.8 to 4.6 and all cases were satisfied.

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