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The evidence supporting a need for alternatively sized keyboards, from a pianistic health perspective, is growing rapidly, and is drawn from three major types of research:

  1. Epidemiological studies linking hand size to piano-related pain and injury.
  2. Principles from the sciences of ergonomics and biodynamics.
  3. Comparative studies involving the use of alternatively sized and conventional keyboards.

Some studies focusing on various aspects of performance quality, together with considerable anecdotal evidence, also suggest that  musical and technical aspects of a performance are greatly influenced by hand span. See also: Pianist Feedback.

‘For 40 years, I have devoted my career to understanding how to prevent playing-related injury at the piano. The hallmarks of good coordination – optimal skeletal alignment and efficient muscle use – were my mantra. The only problem is, it is impossible to be “optimally” aligned on octaves and big chords if you are a small-handed pianist. Each time we play those passages at forte or fortissimo, no matter how efficient our technique, we increase our risk for injury. When that much force is repeatedly placed on small joints in hyperextension, they just wear out over time. Muscle strain and extensor tendonitis are also frequent byproducts.’  
Dr Barbara Lister-Sink, Professor and Director of the School of Music, Salem Collage, NC. 

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