As epidemiologic research demonstrates health concerns for hand problems among pianists, scientists are measuring historic piano keyboards and realizing that much of the piano literature was composed for and played on pianos with smaller keys compared to what is used on the modern piano. Having to play this literature on a larger keyboard is especially difficult for small-handed piano students and professionals. Fortunately, smaller keyboards are now available for use with standard pianos - and research shows that this ergonomic adjustment does reduce piano-related hand pain for small-handed musicians. Major universities are now offering this option to students, but only a few music schools possess these keyboards and not many people know about them. There are no known research studies to address people's awareness and attitude toward ergonomically scaled piano keyboards (ESPKs). The purpose of this study was to assess perception and attitude toward ESPKs and help to raise its awareness. To examine pianists' perception, two surveys was composed. First one was conducted on UNT campus in which ESPKs are available for their students, and the second survey was carried out on schools of music in the United States. The results reveal that substantial number of people already know about the existence of ESPKs, but they are not totally aware specific information about ESPKs. Subjects who are aware of ESPKs report significantly higher positive attitude compared to those have not known about ESPKs. Results from this study may have implications for health education initiatives within NASM schools of music.

Playing‐related pain is a common and serious problem among pianists. Information on cause and prevention is extremely limited due to a lack of scientific research. The purpose of this study was to (1) review and describe risk factors for piano‐related pain among college students and piano teachers that were reported in my previous two research studies, (2) justify the use of an ergonomically modified keyboard as a potential solution for reducing playing‐related pain, and (3) test and evaluate the effectiveness of an ergonomically modified keyboard for alleviating pianists' pain. Both study populations reported high prevalence rates for playing‐related pain: 86 % for college students (n = 35), 91 % for piano teachers (n = 47). For both populations, statistical analyses confirmed that pianists with small physical size (hand size) were more prone to pain. This finding helped rationalize the use of an ergonomically modified keyboard (the key width is 1/16 narrower than the standard) for small‐handed pianists as an ergonomic intervention. To test the effectiveness of an ergonomically modified keyboard, 35 college students played identical music on both the reduced-sized keyboard and the standard keyboard. Observations of video‐recorded performances revealed that small-handed pianists can avoid extreme stretching of their hands when playing on the modified keyboard. Statistical analysis of questionnaire data confirmed that the modified keyboard helped small‐handed pianists to play with less pain and tension. These results warrant the serious consideration of adopting ergonomic principals into the world of piano.