Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 May 1:16:1386273.
doi: 10.3389/fpsyg.2025.1386273. eCollection 2025.

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

Cobi Ashkenazi  1 , George Waddell  1 , Aaron Williamon  1
Affiliations

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

Cobi Ashkenazi et al. Front Psychol. .

Abstract

Aims: 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.

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: PRNDs; biomechanics; co-contraction; human movement; piano technique.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

Figures

Figure 1
Figure 1
Search process for each resource.
Figure 2
Figure 2
PRISMA 2020 flow diagram for new systematic reviews [adapted from Page et al. (2021)].
Figure 3
Figure 3
Characteristics of antagonistic muscular co-contraction (network).
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Aagaard P., Simonsen E. B., Andersen J. L., Magnusson S. P., Bojsen-Møller F., Dyhre-Poulsen P. (2000). Antagonist muscle coactivation during isokinetic knee extension: antagonist coactivation. Scand. J. Med. Sci. Sports 10, 58–67. doi: 10.1034/j.1600-0838.2000.010002058.x, PMID: - DOI - PubMed
    1. Al-Khlaifat L., Herrington L. C., Hammond A., Tyson S. F., Jones R. K. (2016). The effectiveness of an exercise Programme on knee loading, muscle co-contraction, and Pain in patients with medial knee osteoarthritis: a pilot study. Knee 23, 63–69. doi: 10.1016/j.knee.2015.03.014, PMID: - DOI - PubMed
    1. Allsop L., Ackland T. (2010). The prevalence of playing-related musculoskeletal disorders in relation to piano players’ playing techniques and Practising strategies. Music Perform. Res. 3, 61–78.
    1. Andison C. (2011). EMG-based assessment of active muscle stiffness and co-contraction in muscles with primary and secondary actions at the wrist during piano playing’. Master of Applied Science. Ottawa, Ontario: Carleton University.
    1. Ascenso S., Perkins R., Williamon A. (2018). Resounding meaning: a PERMA wellbeing profile of classical musicians. Front. Psychol. 9:1895. doi: 10.3389/fpsyg.2018.01895, PMID: - DOI - PMC - PubMed

Publication types

LinkOut - more resources