Musicians. keyboard operators, data entry clerks, writers, and assembly workers perform repetitive, rapid, alternating movements of the fingers or maintained fine motor movements of the fingers under conditions of high demand and high productivity (6,18,42). These workers are at risk to develop musculoskeletal problems, including tendinitis, fascitis, and postural strain, or neurological problems, such as neuritis, nerve entrapments, or occupational hand cramps (6,9,18,22,42). These types of cumulative trauma syndromes are reaching epidemic levels in the work force and are costing millions of dollars despite management concern and ergonomic changes (6).Rapid repetitive movements under high levels of tension and force can interfere with the circulation and deprive the tissues of oxygen, leading to pain, inflammation, and muscle spasm (18.42). Although the body will naturally attempt to repair the tissues, other factors seem to increase the risk for continued symptoms (9,51,57).

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Some individuals with repetitive strain injury (RSI) develop focal dystonia of the hand (FDh), a disorder of motor control manifested in a specific context during skilled, hand movements. This descriptive study was designed to determine if musicians with FDh had reduced tactile discrimination. Ten healthy adults and ten patients with FDh participated in the study. From the standardized Sensory Integration and Praxis Test, five subtests were selected to measure tactile discrimination. The Paired Wilcoxon Test was used to analyze, meaningful, planned pairwise differences by side and by group. The two groups performed similarly on the three tests measuring tactile motor perception (Finger Identification, Localization and Kinesthesia). However, those with FDh performed significantly worse than the healthy comparison group on two tactile perceptual tasks: (1) Graphesthesia, right affected (P < 0.003) and left unaffected (p < 0.005); and (2) Manual Form Perception (stereognosis) on the right affected (P < 0.002) and left unaffected (P < 0.002). It is possible that the somatosensory differences as measured by tactile discrimination tasks represent some degradation of the hand representation following prolonged, repetitive, near simultaneous sensory stimulation of adjacent digits. Tactile discrimination should be tested in patients with RSI to detect potential risks for developing FDh. Effective treatment of patients with RSI including FDh may need to target the somatosensory deficits in order to restore stress-free motor movements.