[Objective] While piano performance with KAATSU has the potential to be effective in neuromuscular adaptation, its chronic training effects have not yet been studied. In this study, we investigated the effects of 3 weeks of piano performance with or without KAATSU on the adaptation of neuromuscular mechanisms.

[Methods] The subject first participated in 3 weeks of piano performance without KAATSU (Piano-Ctrl), followed by 3 weeks of piano performance with KAATSU (Piano-KAATSU) after a sufficient period. Training sessions were performed twice daily (morning and afternoon sessions, with at least 4 hours between sessions) for 18 consecutive days (excluding one Sunday); after a 5-minute piano performance warm-up, the subject played Chopin’s “Revolutionary Etude” (Op. 10, No. 12, performance time approximately 3 minutes).

[Results] After 36 training sessions, there were significant increases in forearm and upper arm girth and forearm muscle thickness in the left arm and upper arm girth in the right arm under the Piano-KAATSU conditions. Under the Piano-Ctrl condition, significant increases were found in forearm and upper arm girth in the left arm. On the other hand, no significant changes were observed in maximal voluntary contraction (MVC) or rate of force development (RFD) in either condition.

[Conclusion] Piano performance with KAATSU may be able to induce nervous system adaptations, including muscle hypertrophy. However, training associated with fatigue or discomfort is not expected to have an adaptive effect on the nervous system. Therefore, it is necessary to examine the optimal method to avoid overtraining in the future.