Abstract
Piano playing is one of the most complex human activities, involving an intricate interplay between the cognitive, neural, and musculoskeletal systems. Understanding the biomechanics of piano playing could have important implications for evidence-based pedagogy, optimizing skill acquisition, increasing practice efficiency, and minimizing the risk of performance-related injuries. This systematic review synthesizes existing literature in piano biomechanics. A comprehensive search across five databases (MEDLINE, PsycINFO, SCOPUS, Music Index, and ERIC) yielded 7,671 studies, of which 53 met inclusion criteria. These studies utilized kinematic, kinetic, and electromyographic measurements during piano performance under varying task conditions, including isolated keystrokes, novel excerpts, self-selected repertoire, and standard piano literature. The results were synthesized to address (1) how variations in pianistic technique (e.g., type of touch, finger independence) influence kinematics, kinetics, and muscle activation, and (2) how task demands (e.g., tempo, loudness), and performance demands (e.g., fatigue, ergonomics) affect pianists' biomechanical characteristics. Together, current biomechanical evidence indicates that touch type, finger independence, intersegmental kinematics, and muscular activation are modulated by pianists' skill level, anthropometry, task demands, and muscular fatigue. We further discuss and link the existing literature to pedagogy, practice, and performance, thereby demonstrating that biomechanical parameters are not merely abstract descriptors of motion but are integral to pedagogy, musical expression, and sustainable performance. While there is an accumulating wealth of biomechanical data involving piano playing, its integration into standardized pedagogy remains limited. Interdisciplinary collaboration in piano biomechanics is therefore essential to advance our understanding of musical expression, communication, and wellbeing, ultimately supporting the development of sustainable playing techniques that can be effectively translated into pedagogical frameworks. Systematic review registration: Unique Identifier: 10.17605/OSF.IO/TSNY8.