Perceived problems in movement control at the piano among Japanese conservatory-trained classical pianists: a cross-sectional questionnaire survey screening for musician's dystonia

Abstract Musician's dystonia is a devastating task-specific movement disorder that robs performers of voluntary motor control during playing and, in progressive cases, extends to daily life, severely impacting mental health and career continuity. While research on musician's dystonia is extensive, studies specifically targeting professionally trained pianists are limited, and its etiology and optimal treatment remain unclear. This study investigated the characteristics and risk factors of focal dystonia among pianists who have received specialized piano training. An anonymous questionnaire was distributed to 2,863 individuals, including members of a professional musicians’ association in Japan (Japan Federation of Musicians), as well as students, piano teachers, and performers at music universities. Individuals reporting involuntary finger or wrist movements occurring exclusively during piano performance were operationally classified as suspected dystonia, a self-reported category that does not constitute a clinical diagnosis, and underwent secondary screening. Comparative statistical analysis was performed between the suspected dystonia group and a non-dystonia group. Among 241 valid respondents, 28 (11.6%) met this criterion. Longer daily practice time and overseas study experience were significantly more frequent in this group. The fourth and fifth fingers of the right hand were most affected. Eight of these 28 respondents (28.6%) reported symptoms extending beyond piano playing into daily life. This study suggests that prolonged practice, changes in teaching methodology, and non-physiological movement patterns warrant further investigation as potential contributing factors. It emphasizes the necessity for prevention strategies and treatment frameworks tailored specifically to pianists.