Potter Patrick
Physical Medicine & Rehabilitation, The University of Western Ontario, St. Joseph's Health Care London, Parkwood Hospital, London, ON, Canada.
Work. 2012;41(1):61-8. doi: 10.3233/WOR-2012-1261.
The first step in approaching task specific focal hand dystonia (TSFHD) is recognition that it is a neurological disorder and not a deficiency in practice or technique. To eliminate the enigma, TSFHD needs to be a more familiar entity. That is the objective of this paper.
This is a state of the art review in concert with 3 decades of experience providing care for musicians written to act as a reference source. It is written as an introduction to TSFHD by reviewing history, etiology and current theories, presentation and characteristics, diagnosis and treatment.
Information sources, both web-based and by consultation need to be accessible, reliable and comprehensive. Accurate diagnosis should include the diagnosis of concurrent impairments and the confirmation that the diagnosis of TSFHD is correct. Successful treatment is likely to be interdisciplinary. Successful approaches may include the administration of botulinum toxin but approaches should not be restricted to pharmaceuticals. Instrument modification, altering technique and sensory motor retraining are potential adjunctive approaches. A dichotomy exists between the therapeutic benefit achieved with treatment and the musician's need for optimum hand function. The final goal is successful return to playing at a level that meets the musician's needs.
认识到任务特异性局灶性手部肌张力障碍（TSFHD）是一种神经系统疾病而非练习或技术上的缺陷，是处理TSFHD的第一步。为消除这种谜团，TSFHD需要成为一个更为人熟知的实体。这就是本文的目的。
这是一篇结合30年为音乐家提供护理经验的最新综述，旨在作为参考资料。通过回顾历史、病因和当前理论、表现和特征、诊断和治疗，将其写成TSFHD的介绍。
基于网络和咨询的信息来源需要可获取、可靠且全面。准确的诊断应包括对并发损伤的诊断以及TSFHD诊断正确的确认。成功的治疗可能需要跨学科。成功的方法可能包括肉毒毒素的施用，但方法不应局限于药物治疗。器械改良、改变技术和感觉运动再训练是潜在的辅助方法。治疗所带来的益处与音乐家对手部最佳功能的需求之间存在二分法。最终目标是成功恢复到满足音乐家需求的演奏水平。
