Comparison of Strength and Dexterity in Professional and Student Violinists: Setting Foundations to Guide Rehabilitation.

The musician's hand represents a complex system, which requires important motor skills. Although several studies have already investigated rehabilitation outcomes and techniques in musicians after hand lesions, none have been addressed specifically to objectively quantifiable functional parameters. The purpose of our study was to study hand functionality in violinists in order to provide foundations on which to establish and develop more appropriate rehabilitation protocols. An observational cross-sectional cohort study consisting of 34 subjects, including 23 students and 11 professional violinists who were either studying or working at a conservatory. Results were compared to a data set of a non-musician control group. Nine-hole peg test and hand test system (HTS) were used to perform the study. A hand-held dynamometer was used to measure hand grip and tripod pinch maximal isometric voluntary contraction of both hands. Hand strength did not significantly differ on either side between professional and student violinists. A significant difference was seen when comparing violinists as a whole versus the non-musician control group. HTS highlighted significant differences in dexterity. Violinists develop better overall motor performances of the left hand, and their performance is better than normal "non-musician" controls. Dexterity and precision of execution positively correlate to years of practice. We conclude that rehabilitation of a violinist's hand should be aimed at enhancing motor performance of the left hand and should be focused to maximize dexterity of both hands.