Antagonistic muscular co-contraction for skilled, healthy piano technique: a scoping review

This scoping review aimed to generate a novel evidence-based model of antagonistic muscular co-contraction (AMCC)'s effects on human movement. The review applies this model to the context of skilled, healthy piano playing to enable advances in pedagogy and research that can aid pianists in developing and maintaining skill and task-related health.

Piano playing is a challenging, complex activity that carries significant risk of playing-related neuromusculoskeletal disorder (PRNDs). AMCC is a contentious, terminologically problematic topic in pedagogical and scientific literature, and has scarcely been studied in relation to piano technique.

Adhering to PRISMA-ScR guidelines, the review adopted the search terms "co-contraction," "piano," "co-activation," and "antagonist," consulting 36 aggregated resources and 100 individual journals. After screening, 188 studies published between 1982 and 2021 were included. From these studies, AMCC-related content was extracted, analyzed in relation to piano technique, and categorized. The resultant categories were synthesized into a model representing the characteristics and effects of AMCC in movement.

AMCC is a prevalent, complex, and learnable phenomenon, exhibiting the capacity for both positive and negative effects on performance and health. These effects are highly relevant to the task-specific challenges of skilled, healthy piano playing. AMCC can affect sensorimotor task control, accuracy, efficiency, coordination, internal model generation, proprioception, range of motion, individuation, neuromuscular signal-to-noise ratio, speed, power, stability, task-related injury, pain, and rehabilitation.

The review and corresponding model suggest that AMCC is a fundamental characteristic of human movement with broad and unique effects on sensorimotor task performance, including piano playing. Of the 188 publications reviewed, none were found to have robust methods investigating AMCC in healthy, skilled pianists; this review underpins ongoing research targeting the nature of AMCC in piano technique.