Finger Movement Discrimination in Focal Hand Dystonia: Case Study of a Cellist

Abstract

Focal hand dystonia in musicians has received increasing attention in recent years due to the debilitating and career-threatening nature of this condition. In cellists, focal hand dystonia is reported only infrequently in the existing literature, as compared to the rate in other instrumentalists, such as pianists and violinists. Although relatively less common, it has similarly devastating effects for those with this disorder. In the pilot study presented here, a 47-year-old male professional cellist experiencing left focal hand dystonia underwent pretests and posttests when he attended a 10-day period of intensive sensorimotor retraining. To monitor the effects of treatment, a pseudo-cello was designed that used the principles of psychophysical methodology to test active finger movement discrimination. This test was designed to evaluate whether this cellist could perceive the relative position of his left fingers in as task-specific a manner as possible. The pseudo-cello results showed a reduced ability to discriminate the height and tension of a string in the fingers most affected by the dystonia. Following the 10-day period of intensive physiotherapy, discrimination of finger movements had improved in the fingers that had been worked on with the rehabilitation program, and this corresponded with an improvement in the dystonia rating scale. The positive results obtained here suggest that this form of testing in focal hand dystonia warrants further research.