jwilzewske: assistive

Showing posts with label assistive. Show all posts

Thursday, December 15, 2011

Making an Ergonomic Holder for eReader Tablets for Piano

M y wife gave me a Samsung Galaxy Tab 10.1 Android tablet for my birthday. I use it for lots of things, but one of its best purposes is as a music reader on our piano.

A irTurn’s Bluetooth-based BT-105 is out--it has many nice, new features.

F or the BT-105, I've used an inexpensive Levenger Dovetail bookstand as a cradle, accessorized with a bit of Sugru® silicone to keep the tablet or the cradle from moving around with the vibration from vigorous playing/pedaling. I use that mostly with our MIDI keyboard.

B ut I still like and use my original AT-104 with its proprietary RF communication between the pedal transmitter and the USB dongle receiver. For one thing, there are no long-range Bluetooth interference/security issues with the AT-104.

T he 1280x800 pixel resolution of the 10.1-inch Widescreen HD WXGA TFT on the Galaxy is noticeably better than the 1024x768 resolution of the iPad 2’s 9.7-inch screen. (The screen on the Samsung tab has a 16:9 aspect ratio, compared to 4:3 on the iPad 2. In the landscape orientation, which is how I position the tablet on the piano music stand, the Galaxy display is only 4% more pixels vertically, but it’s got 25% more res than the iPad 2 horizontally.)

S o if I’m going to stick with my AT-104 AirTurn, then I need to get the USB receiver dongle attached to the Galaxy Tab, and the USB port is at middle of the bottom edge of the tablet. (I could rotate the Tab 180-degrees to be upside-down, so the USB port is on top. But then I’d have an unsightly dongle or pigtail cable coming out up there.)

T he Samsung USB adapter dongle is okay, but it sticks out 3cm beyond the edge of the tablet, and a male USB connector terminating a typical cable-end sticks out 5cm beyond that. You need some way to elevate the tablet about 10cm for the short male-to-female USB passthru/extender cable to the AirTurn Dongle to connect to the Samsung USB dongle.

E levating the tablet that much is actually an improvement in terms of good visual ergonomics. But you need to keep the tablet secure and level in that position.

A nd there’s another issue—which is the same as the issue that's affected the usability of laptop-based music eReaders for pianists: the front-to-back depth. It may be too deep for some piano music stands. And it’s definitely too deep for harpsichord or organ music stands. Or the rail on the music stand that is fine for 60 gm of paper sheetmusic is too wimpy for a shiny, slippery tablet that weighs 600 gm. There is a significant risk that the tablet will shimmy its way to a bad fall.

A further issue for me, at least, is the visually small form-factor of the tablet--specifically, the fact that the active display area of the 10.1-inch screen comes so close to the edge of the device—makes me want to have slightly wider “margins” framing the visual field that I’m looking at. With the tablet on the Dovetail bookstand, the “near-far” field at the left-hand and right-hand edge of the displayed music interferes with my eyes’ focus. Maybe that is not an issue for you, but it is for me.

S o I cut a 12x14-inch piece of black 3/16-inch Delrin acetal, put some 1/2-inch Delrin brackets on it with Sugru® to cushion them (see photo). You slide the tablet into the lower brackets and press the top edge in past the pan-head “crowns” of the 3 Sugru® bumpers--each one is about 1 mL of Sugru® that is molded to stand proud of the 5/16-inch hole by about 0.03-inch. The Sugru® is just the right Shore-A/durometer hardness to “give” just a little as the tablet edge moves inward and seats flat against the acetal sheet. The mechanical “detent” of the Sugru® is just enough to hold the tablet securely in place but still allow the tablet to be easily plucked out again with gentle finger force.

M y kluged black acetal stand leaves a nice visual margin all around, similar to the whitespace from the staves to the edges of normal sheetmusic paper, in the same focal plane as the image on the tablet. It makes it easier to read the Tab’s display, and it’s compatible with any piano, organ, harpsichord, etc., including ones that have only a tiny, narrow rail/groove for music to stand up in.

H ugh Sung’s Airturn site has plenty of nice stands and brackets to hold tablets and laptops on various types of mic stands or other uprights. Those are great for string players, wind instruments, singers, and other kinds of musicians. But if you’re a pianist and you’ve done ‘home-brew’ things yourself, to enhance the mounting of your tablet on your piano's music stand, please leave a comment below or email me!

Thursday, December 11, 2008

Before We Go: Luigi Nono, Omissions, Silence, & The Rhetoric of Wee Hours

Y ou know, you are mistaken in the translation of this Khlebnikov poem. ‘When they are dying, horses feel profoundly relieved / When they are dying, shrubberies become sad / When they are dying, suns cease to shine / When they are dying, men sing’ is a more apt rendering of the sense of the Russian. Your ‘When horses die, they breathe / When grasses die, they wither / When suns die, they go out / When people die, songs are sung’ is badly wrong. Seriously in error. Every line. You should fix it. Otherwise, schmexy.”
— M. Vladov, email to CMT.

A very interesting point. The CMT post that M. Vladov was commenting on was actually an essay I wrote last year while stuck in an airport with a long flight delay. It was on the Kronos Quartet performance of Henryk Górecki’s ‘and songs are sung…’ and how its meaning, for me, is closely tied to progressive disability and terminal decline to the end of life, as fundamental/inescapable parts of the human condition. The epigram at the top of that CMT post was actually someone else’s (Górecki’s?) rendering of the Khlebnikov poem into English, not my own.

And yet I very much like and appreciate M. Vladov’s clarification/correction. He/she says it’s not the survivors who sing on the occasion of the loved-one’s death. That comes later. It’s instead the one who is dying who, if lucky enough to have time and lucid moments so late in the game, “sings” an intimate, extemporized ‘epilogue’ of his/her life’s story, to anyone—anyone—who is nearby. Having worked for years in palliative medicine and hospice, I can say that that is true: the poignant, urgent need to create meaning by saying and singing to other members of our species—it is almost as strong as the need the heart has to beat and beat, or our hunger for air until, finally, the need collapses and we let go of that beating, breathing hunger and depart the planet. That is what Khlebnikov’s poem is about—or at least that’s what M. Vladov’s email makes me think, and what I believe he/she meant by ‘every line wrong’.

And the stars/suns don’t ‘fade out’ in the way that some English translations have it. This, in M. Vladov’s view, is just as outrageously wrong, same as the one in the liner of the Kronos CD. Instead, the stars/suns utterly cease! The light stops, they implode never to shine again—whatever. No dwindling, no dimming and fading, just sudden nuclear darkness.

Когда умирают кони - дышат,
Когда умирают травы - сохнут,
Когда умирают солнца - они гаснут,
Когда умирают люди - поют песни...
— Хлебников, 1912.

Further, it isn’t trivial grasses that wither and rot, prosaically, soullessly … in a manner that merits only passing regard from untouched humankind. Instead, the entire biosphere, vegetables and shrubberies and all, is ensouled and its members of all species have moral standing and have a capacity for sorrow, albeit implemented with very different nervous systems than we mammals have. And, oh, by the way, you will not get out unscathed by the death of the plants…

And horses, M. Vladov says, are relieved at the end—which I first-hand also know to be true, as I once owned horses and have seen them euthanized. The death rattle and last exhalation of a horse is louder than that of a human being. It’s a large animal with large lungs and big vital capacity and a tidal volume that is 10 to 15 mL/kg, or 6 liters compared to an adult human’s 750 mL. Horses are obligate nose-breathers. For those reasons, it is more likely that you will hear their dying breath and, if you hear it, more likely that you will hear it in enough detail that you will be able to grasp its several musical stages, millisecond by millisecond, until it is gone. You will not then doubt (if you ever did—) that the animal has a soul. It is not a stupid, empty moment. You can sense the animal’s relief as it lets go of the mortal body and flies away.

It is enough to, maybe, make you nostalgic for the time before you were born. No. Scratch that. For the time before you were conceived. [goes away from PC, listens to owls in moonlight, returns to desk, looks at a humorous photo of Luigi Nono]

Luigi Nono, if a trombonist falls in a woodwind forest and there are only not-hearing musicians there, does it make a sound?

I believe that more than ever before humankind has the opportunity and the ability to study; to open up new routes; to reach for peaks; to discover peaks that are beyond the heavens—different spaces, different worlds! Different abysses! Different fantasies!”
— Luigi Nono.

Da capo… There is besides the Górecki, of course, another composition that referenced the same famous Khlebnikov poem and took it as an inspiration and point of departure: Luigi Nono’s ‘Quando stanno morendo’—the Italian for ‘When they are dying’. I’m not sure what M. Vladov will make of the Nono piece. Nono composed it for the Warsaw Music Festival of 1985, but the festival was cancelled. Some of Nono’s friends were in exile, some were in prison, and some were resisting the Russian ‘invasion that never happened’. Written in 1985 in Baden-Baden; ‘Quando stanno morendo No. 2’ is a chamber work that is scored for four female voices, plus flute, cello and live electronics. There are some analysts and historians who insist that this is a ‘political’ piece, but I think a valid personal, individualistic reading is also possible—in the same vein as the Gorecki. Anyone, I think, who has worked with the dying would think so…

L isten to this moment: a weak power thinking bringing to a [mortal] halt.”
— Luigi Nono, Chorus, Prometeo.

Pure anxiety and beauty coexist in the vocal intervals that incarnate them. Nono was in those days experimenting with what one might call ‘timbral particle physics’, splitting the acoustic ‘atom’, combining different sonorities of instruments and instrumentalists’ breathing… anatomical sound-art of the human body, with instruments as prosthetic devices, crutches. For B-flat clarinet and C flute, dozens of tones are familiar to us; the contrabass flute, and contrabass clarinet ones, less so. The amplified flute here sounds like Khlebnikov’s expiring horse … my expiring cancer patient … evolving into gentle breath sounds and harmonics/gasps, followed by solo voices accompanied by low-pitched electroacoustics.

The finale has the singers again in restrained Khlebnikovian agony.

La Lontananza Nostalgica Utopica Futura’ takes us on a path that Nono suspects leads to a utopia—or at least something different than what we have now. Change we can believe in, not because we have any desire for or knowledge of the destination, but rather because we realize that our present location is no longer habitable. Our air is exhausted, our position here no longer tenable. It is patently obvious that it is untenable now; we have no choice but to depart this planet.

Luigi Nono

Arrived: 29-JAN-1924, Venice, Italy
Departed: 8-MAY-1990, age 66, Venice, Italy
Cause of death: undisclosed
Politics: Socialist
Nationality: Italy
Precis: Composer of serialist, electronic, and aleatoric music.
Education: B.Mus, Venice Conservatoire (1941); JD, University of Padua (1946); studied composition under Gian Francesco Malipiero, Bruno Maderna, Hermann Scherchen
Father: Mario Nono (civil engineer)
Mother: Maria Manetti
Significant other: at age 31 married Nuria Schoenberg, daughter of Arnold Schoenberg
Daughters: Silvia Nono (b. 1959), Serena Bastiana (b. 1964)

[50-sec clip, Schreck Ensemble, Luigi Nono, ‘Fabbrica Illuminata’, 1.2MB MP3]

[50-sec clip, Schreck Ensemble, Luigi Nono, ‘La Lontananza Nostalgica Utopica Futura’, 1.2MB MP3]

L uigi Nono’s only score for string quartet, ‘Fragmente-Stille, an Diotima’ [Hushed Fragments for Diotima] already expresses at the very beginning of the 1980s, with its ample phrases made up of fragments mingled with long-held notes and drawn-our silences, that ‘tragedy of listening’ that haunts the composer’s last works—a world both crepuscular and ethereal, shot through with shadows and fleeting sensations, and a meditation on the ‘eternal, silent brightness’ of the poet Friedrich Hölderlin.”
— Arditti CD case blurb.

But beyond what must be said and beyond what we are so hungry to say at the end—beyond what occurs to us to sing just before we finally go—is that which is unsaid or unsayable, or unsung, unsingable. Luigi Nono’s composition for orchestra and electronics, ‘Prometeo’, is the epitome of that. John Wollaston gives a fine essay on the London Sinfonietta performance of ‘Prometeo’ earlier this year here. Prometheus was the Greek mythical figure who is symbolic of the belief in progress, and symbolic of unconditional love and hubris at the same time. [Hell, the idea of ‘unconditional love’ is hubristic all by itself, progress or no progress.] Prometheus also culminates Luigi Nono’s composerly thinking: extreme sound-art, predictable and unpredictable panning of sound fields within the performance space, and aleatoric compositional and performance processes—disembodied, spectral.

Prometeo’ as Luigi Nono’s answer to Schoenberg’s ‘Moses und Aron’? Nono’s ‘Quando stanno morendo’ is his answer to Schoenberg’s ‘A Survivor from Warsaw’? Well, no. To me, Nono seems more particular, more highly personal—more specific about the plight of the individual, rather than about the political plight of a class of people…

Rehearsal before first performance of Prometeo in the Church of San Lorenzo, Venice; photo: Graziano Arici)

The estrangement of this body from its soul and the fragmentation of the sense of sight from the sense of sound that Nono achieves in ‘Prometeo’—especially if it is performed or recorded in a spacious performance hall—are remarkable. As Wollaston notes, “At this stage in Nono’s later musical theatre, sight no longer has a purpose. As he considered the visual realm a site for the most dangerous sorts of dictatorial manipulations, of both audience and source material, Nono aimed to rescue his musical theatre from visual elements. This anti-visual syndrome was developed in order that the fusion of the point of view might be a delicate one taking place within a craft of intricate networks upon magnified sonic elements.” Reflecting on the immediately prior CMT post on macular degeneration, I am led to wonder how low-visioned or blind people experience ‘Prometeo’. The uncertainties in ‘Prometeo’ are unnerving for us who still have good vision…

It’s an aleatoric-antiphonal chamber piece with four instrumental ensembles scattered to the four winds, with a choral ensemble on-stage, plus five solo singers deployed up on high platforms and scaffolding. Also distributed high in upper balcony/box locations on both sides of the auditorium are smaller groups of musicians and two narrators, along with tubas, a contrabass clarinet, and custom-made glass instruments. Electroacoustic parts are done via a speaker array that is deployed overhead and around the walls of the room. Wollaston says that this geometry “inscribe[s] several horizons, artificial or electronically produced, and actual. Each space has its chant; all together constitute the sky. And in these skies we might ‘rediscover the possible’.”

A mplified echoes play explicit formal roles in the present sound, the electronics enable precisely defined constructions in the course of the now-time of hearing with shapes and resources of a previously articulated event. This re-enunciated remnant is made mobile to such extent in a multiplicity of movement that the listener becomes lost in a kind of unitary perception. … A tension exists between a sense of circling the ultimate fragmentation, not the highest but the last, as sound director André Richard said at a pre-concert discussion, ‘the last before dying’, between this ultimate finality and an open possibility is compassable, the realm of infinitely variable potentialities where we ought ‘rediscover the possible’. Nono’s sound unravels a paradoxical seamlessness between the collapse into silence and extreme fragments of sonic event, pregnant and intensive. In this way, silence becomes a principle motivating force within the music.”
— John Wollaston, review of London Sinfonietta performance of ‘Prometeo’.

W achtel’s nice book talks about the ‘transfiguration’ elements in Khlebnikov poems and others’ experiments with wordless ululations and ‘Zaum Gedichte’ (‘sound-poetry’; ‘beyond-sense-poetry’)—the organic, alinguistic simplicity of it; the association-free vocality of words sung, detached from human minds and intentions; emblems of Hölderlin’s tragedy as ‘the understanding in misfortune, the dreaming naive... to depict man’s understanding as wandering below the unthinkable.’

Vledimir Khlebnikov manifesto, quoted in Michael Wachtel, p.42

Semi-comprehending what they sing, we hear the experiences of the about-to-depart and imagine our own, sometime in the indefinite future. Long, sustained notes: a fragile, tenuous thread on which the spirit is suspended—in several different layers in musical space and in several layers of register/pitch. Fitting that I should happen to listen to this in the wee hours, on the basis of thoughts triggered by an email from an M. Vladov somewhere halfway around the planet…

Comments and emails are a delight when you send them to me here at CMT. I invariably learn something and often make new friends. If I make mistakes, please forgive me. Thank you! [goes back to listening to Arditti Quartet recording of Nono, Great Horned owls outside in the trees still howling aleatorically]

M usically, the work is luminous. Nono is a serialist, but one who knows how to make music sing and make music dramatic. The piece is full of powerful moments. Much was made of the inclusion of worker's songs including the Internationale when the piece was premiered. The use of such straightforward tonal material in an avant-garde piece was against the grain at the time. After 25 years, this doesn’t shock anymore. What does stay with you is how well integrated the tonal material is with the serial material. Nono uses similar procedures on the workers’ songs as he uses on his tone rows. The result gells nicely. It does not have the pastische quality that quotations in Berio’s Sinfonia have. Rather, it packs emotional punch. Nono was always considered to be the most politically committed of the Darmstadt set of the 50s and 60s. (Though Xenakis certainly was as well.) This may explain why his music retains such a powerful impact. Where Boulez was looking for an almost mathematical approach to composition, and Stockhausen was alternatively a musical explorer and a mystic, Nono was motivated by deep love for people. As a result his music retains a humanity that is more readily apparent than in other Darmstadters.”
— Christopher Forbes, Brooklyn.

Tuesday, December 9, 2008

Assistive Technologies for Musicians with Low Vision and/or Tremor: AirTurn, Tablet PCs, MusicReader

I am a pianist and about six months ago I was diagnosed with Age-related Macular Degeneration (AMD)—in both eyes. Actually, the two eyes are pretty different in how big the blind spot is. My right eye has a blurred area that makes music staves bend and notes blurry when I try to look directly at them. Dots disappear or blur into adjacent note-heads, 32nd beams look the same as 16th beams, and so on. The left eye is much worse, so what I see in the field that is affected relies almost entirely on what I’m seeing through my right eye. In spite of this, I can see almost well enough to read the page of music, so long as I am not looking directly at it—in other words, so the measures are off to the side of my ‘blind spot’. In the periphery, my vision is still pretty good. This adaptation—using my non-central visual fields for detailed seeing (I call them ‘non-central’; it seems wrong to call them ‘peripheral’, since it’s only a few degrees away from the central blind spot.) Also I find it works better for me to play on my MIDI keyboard with the chair raised higher, so I am looking down at the music instead of looking a bit upward, above eye-level, which is where the music is on my piano. It’s a far-from-ideal posture from a performance point of view. But looking downward at the music seems—for me, at least—to enable me to use parts of my field of vision that are less affected than other areas, which is a trade-off I’m happy to make.”
— Anonymous email to CMT.

Thank you, to the several people who emailed me about the CMT post about Pianoteq as a prosthetic ‘aid’, to enable people whose physical impairments would otherwise limit what they can do at the keyboard, to continue to perform on keyboard in the satisfying ‘manner to which they were accustomed’. Thank you, too, to the emailer above, for asking about visual impairments. There have been several other CMT readers who have had similar questions over the past several months, so now is as good a time as any to respond.

Y ou should know that you are not alone in your search for solutions to your visual acuity problems and your efforts to continue playing. According to current U.S. statistics, about 7% of all pianists between age 40 and 100 have AMD. Pianists who have (had) AMD include:

Arthur Rubinstein (1887-1982)
Helen Kolozsvary (1922-2007)
J. Wayne Streilein (1935–2004)
Madeleine Titus (1914-2008)
Earl Wild (1915-)
Jennie Lois Windle (1915-)
Sylvia Zaremba (1931-2005)

Age-related macular degeneration is the leading cause of blindness and visual impairment in the developed world. ‘Blindness’ as defined by the U.S. definition is a best-corrected visual acuity of 20/200 or worse (20/200 in the better-seeing eye, where the acuity of left eye and right eye are substantially different). ‘Low vision’ is defined as a best-corrected visual acuity worse than 20/40 but better than 20/200 (in the better-seeing eye, if left and right are different).

AMD is the leading cause of blindness in Americans 50 and older, and its prevalence in the U.S. is expected to increase to 18 million by 2020. There are similar epidemiologic statistics in Europe and elsewhere.

M acular degeneration is a disease of the eye causing the light-sensing cells of the macula to malfunction resulting in partial or complete blindness. The macula is the central portion of the retina directly opposite the lens. The retina is the portion of the eye responsible for receiving light and sending electrical impulses to the brain that precipitates with sight. Specifically, the macula is responsible for the sharp, straight-ahead vision used in seeing fine detail, reading printed material, driving, watching television, reading things at normal magnification on computer screens, and recognizing faces.

Loss of vision with age-related macular degeneration (AMD) normally occurs gradually and will usually affect both eyes, although not necessarily at the same rate or to the same extent in each eye. Macular degeneration is most often found in people over 60 years of age, although there are some hereditary forms of macular degeneration that affect children.

Gradual decline of central vision which tends to progress at different rates in the two eyes
Difficulty reading or performing tasks that require the ability to see detail
Straight lines appear distorted
Center of vision appears distorted compared to the rest of the scene.
A dark, blurry area or "white out" appears in the center of vision
Color perception changes or diminishes.

Y ou can test yourself with the Amsler Grid below. If you need reading glasses, put them on while you look at the Amsler Grid. The grid should be at about the same distance from your eyes that any other reading material would be. Cover one eye, then focus on the dot in the center.

Do any of the lines look wavy, blurred or distorted? (All lines should be straight, all intersections should form right angles and all the squares should be the same size.)
Are there any "missing" areas where you can't see the grid lines?
Are there any "dim" areas in the grid?
Are you unable see all corners and sides of the grid when you are focusing on the dot in the center?

Repeat the procedure with the other eye covered.

If you answered ‘Yes’ to any of the four questions above for either eye, make an appointment with your eye doctor right away. You can print the page, mark the areas of the chart/grid that you’re not seeing properly, and bring your marked-up grid with you to your eye exam.

If you’ve recently been diagnosed with AMD, there are many good books and online resources that you and your family members can take advantage of. Some of them are in the list at the bottom of this post. Laser treatments and other standard therapy alternatives are covered in those resources, and I won’t go into those here. But there are some newer things that I’ll at least mention, with some links at the bottom to enable you to explore on your own.

Over the past several years, people who have severe AMD have received off-label treatment with Avastin™ (bevacizumab), an anti-VEGF drug made by Genentech that was the first anti-angiogenic therapy approved for treating colorectal cancer. Ophthalmologists reasoned that if Avastin could block blood vessel growth in tumors, it might also affect angiogenesis in “wet” AMD. Genentech’s Lucentis™ (ranibizumab) was recently FDA-approved specifically for the treatment of “wet” AMD, and it is similar in molecular structure and action to Avastin. In a large, two-year study, this drug stopped vision loss in more than 90 percent of patients studied and restored vision in 33 percent. Scientists are now comparing the efficacy of Lucentis and Avastin, since Avastin is much less expensive than Lucentis.

The recently introduced anti-vascular endothelial growth factor (VEGF) intravitreal injections of Genentech’s ranibizumab (Lucentis™) and bevacizumab (Avastin™) generated a heated research argument: on the one hand Lucentis was proven effective and relatively safe in large prospective double-blinded studies, albeit this drug is expensive and might cost up to $1,000 per injection into the eye. Eyetech Inc’s pegaptinib (Macugen™) has the same anti-VEGF mechanism of action and is also quite expensive. On the other hand, Avastin is widely used worldwide as a low cost alternative for Lucentis, with an estimated cost of about $120 per injection, although its effectiveness and side effects were previously investigated only in smaller retrospective studies and only recently have been studied in larger prospective ones.

But those medications are used mostly in AMD that is already severe/advanced. They generally are not (currently) used in a pre-emptive or preventive fashion, or in early or mild cases of AMD. This may be in the process of changing, insofar as these medications—in clinical trials and in off-label observational studies—are evidently able to stop the progression of the disease, for two years or longer. How much longer is not known, since the clinical trials have not followed the patients for much longer than that yet.

L ooking to the right slightly seems to be better than putting the music in the center or putting it where I have to look a little off toward the left. I can’t imagine why this is, except maybe it has something to do with what parts of each eye are damaged by the AMD. My adjustments almost make it possible to play pieces that are very familiar to me. But I don’t know how much longer this trick will be adequate. I can imagine a couple of years from now the AMD might be worse and these little tricks won’t be enough anymore, and I’ll have to stop playing. Even now, it’s next to impossible for me to get a new piece and try to learn it. My sketchy non-central vision is good enough to remind me of what my fingers and mind already learned years ago, but it’s not good enough to enable me to learn an entirely new piece. But it seems to me that if I could just magnify things a bit—like I do on my PC when I’m reading an Acrobat document or something—then I would be able to manage. Increasing the size of the music would enable me to make-do with what I’ve got and the non-central vision would be enough if only the music were way bigger. Increasing the wattage of the music lamp doesn’t seem to help; just makes the glare worse. Does this make sense? Is there something different I should by trying? I saw the things you wrote about ‘assistive’ uses of Pianoteq for pianists with disabilities, and I thought you might have suggestions about pianists with AMD.”
— Anonymous email to CMT (continued).

Interestingly and in regard to the remark in the email above about ‘non-central’ visual fields mitigating the deficits in the foveal/central field, earlier this year Lingnau and colleagues at the Technical University of Braunschweig studied training people to use a parafoveal retinal location for reading. The study was designed to find out which part of the visual field is best suited to take over functions of the fovea during early stages of macular degeneration. A region to the right of the area you are needing to read leads to best (most accurate; quickest) reading performance and the most natural gaze behavior (so that the eyes do not get tired right away).

By contrast, reading performance was severely impaired when Lingnau and the other researchers asked the subjects to use a region to the left or below the area of visual fixation. An analysis of the underlying eye-muscle behavior revealed that ‘practice effects’ were accompanied by a larger number of ‘saccade’ eye movements in the text direction and decreased the visual fixation durations. Their journal article explained the observed performance differences at different retinal locations in terms of the neurophysiology of the interplay of attention and eye movements. The research has important implications for the development of training methods for AMD patients who aim to retain the ability to read detailed material such as sheetmusic. Most specifically, the research suggests that it is beneficial for AMD patients to use a region to the right of their central blind-spot, much as the CMT emailer has independently discovered.

W hat other non-medical, non-pharmacological things can a musician with AMD do, to compensate for the visual deficit?

Increase the contrast between light and dark objects;
Reduce glare with proper lighting (halogen bulbs are better than low-energy fluorescent, which in turn are better than incandescent);
Use curtains or shades to reduce ambient glare from light-sources near your piano;
Play for short periods, taking breaks that do not involve other visually-intense activity before returning to the keyboard;
Follow the nutrition (with vitamin supplements recommended in books and professional society / AMD support group websites; see links below) and lifestyle recommendations of ophthalmologists and other experts;
Replace your music with nice, high-contrast magnified sheet music—either photocopy and enlarge it yourself, or use a PC-based means to display digital sheet music (usually as Acrobat pdf files, either purchased or obtained free online or scanned using an inexpensive scanner-printer-fax attached to your PC).

M agnifying the music, either in hardcopy by enlarging it in a copier or by doing it digitally on your computer? As shown by Chung and colleagues in Houston, there is no need to increase the spacing between staves, to normalize reading speed in AMD patients. You just need to make the staves and notes and markings bigger; the space between the staves can be the same as in a normal score. Of course, if you’re making hardcopy 200%-size photocopies and cutting-and-pasting them to create a score that will fit on your music stand, you might go to the trouble of doing the paste-up staff-by-staff. But most of us would just scan the music as pdf Acrobat files, and then the spacing between the staves will be magnified by the same percentage as the staves themselves. That means that there’s more ‘white-space’ to scroll through, to reveal the next group of staves further down the page. That’s maybe a small thing to complain about if the alternative is not being able to see/play at all. But it is a significant annoyance, as I’ve found with my own use of a tablet PC for displaying my own music. Here is a little table that shows the amount of magnification you would need, depending on what visual acuity you have with your glasses or contact lenses on. In other words, the left-hand column is the ‘best-corrected’ acuity you have, not your visual acuity without corrective lenses.

Visual Acuity and Magnification Required

The thing that I like best about playing from digitized music on a tablet PC (or, for a bit more money, the MuseBook) is that you can set and adjust the magnification exactly how best suits you and the particular score you are reading. You can adjust the display contrast to be extra bright and contrasty if you want. You can tweak the RGB color controls on the monitor, to compensate for any color issues that your AMD is causing. You can’t do any of those things with hardcopy paper music.

Landscape-oriented PC vs. portrait-oriented paper

By far the most extensive source of information on tablet PC-based music and practical technology and techniques to use it is on pianist Hugh Sung’s website and blog. His site has many practical tips and video demonstrations that explain how to do various things.

Please also consider getting an electronic pedal page-turning device for your PC. The AirTurn™ device is one that I recently bought. I find that it is very well built—sturdier than other options that are available. I like the Boss FS-6 dual pedal version of AirTurn™ a lot. The FS-6 pedal has a nice ‘feel’ and the pedals are spaced at a distance that makes it convenient to click pages forward and backward without risking a mistake and advancing too far. Other pedals that I have tried over the past ten years are either too dainty or too industrial/stiff and take your concentration away from your playing; this FS-6 pedal is non-intrusive and easy to get used to. Here is a photo of Hugh Sung at Curtis Institute, holding one of the Boss FS-6 pedals...

The AirTurn™ AT-104 is an RF device, so there are no wires snaking up from the pedal up to the piano. Attached to the pedal you have a little battery-powered transceiver that sits on the floor. (Mostly, its power consumption from the battery occurs when the device is transmitting pedal events to the PC, so the battery lasts quite a long time, even with active pedaling and prolonged use.) And the other part of the transceiver ‘pair’ is a tiny dongle that plugs into a USB port on your computer, much like dongle you use with an RF mouse. It receives the signals from its mate on the floor, enabling the software in your PC to scroll or jump down the page or page-forward or -backward. The AirTurn™ system has 65,000 RF pairing IDs available; you select an unused ID so the AirTurn™ will not interfere with your RF wireless mouse or other 2.4GHz RF computer accessories you have.

The ability to mark-up and save annotated copies of your sheet music—save them as different filenames so your original music remains ‘clean’—is a great advantage. And you can keep changing your annotations—no erasing! Very nice.

Annotation of digitized sheet music, Hugh Sung

I am using my AirTurn™ with MusicReader™ software with my 1920x1200 and 1680x1050 monitors oriented in ‘landscape’ mode, and that works fine with my big “piano reading glasses” and even my bifocals. But MusicReader can be used with iRotate™ or other software to rotate the display to a vertical ‘portrait’ format instead of the default ‘landscape’ horizontal format.

I’m hoping at some point to try a dual-display monitor. Those are extensively used in financial trading—including people who do day-trading of stocks and commodities (or options and futures) at home—and by some gamers. The prices of dual-display monitors and the associated screen-splitting software have come down quite a lot over the past several years, due to their popularity. For music reading with diabetic retinopathy or other conditions that do not primarily involve a central macular deficit, maybe dual portrait-oriented displays—like the Zenview DuoPortrait 20 Pro pictured below—would be an advantage. But for other CMT readers—and maybe especially ones with early- to intermediate AMD where you are relying on ‘non-central’ visual fields—two landscape-oriented monitors may be better. In either instance, you will probably have to work out a different type of ‘stand’ for the monitors, because the ones that come with them from the factory (a) will not sit nicely on your Steinway and (b) will vertically position the centers of the monitors too high in your visual field. You will need either to go without a stand (monitors sitting on the piano in their bezel but without a stand) or find something that is squattier than the desktop-style stand that these products come with.

Note that the digitized sheetmusic is moved forward or backward by each pedal press; it doesn’t ‘jump’ across many pages to follow D.C. or al segno or other ‘marks’. In such cases you may want to make your own pdf (using a ‘full’ Acrobat license, not just AcrobatReader) that replicates each section that is to be repeated, and assemble the replica page/pages sequentially, so that instead of doing multiple pedal presses to jump backward you are doing a single pedal press to go forward into the repeat, or a single pedal press to skip forward over a section to the segno.

These products are not just for musicians with visual impairments. I do think that AirTurn™ and related products will significantly help older pianists who have ‘essential tremor’ or arthritis or other conditions that make reaching and turning music pages difficult. To quickly and easily and reliably navigate your digitized music by pressing pedal footswitches is a joy, compared to struggling and often failing to turn the paper pages accurately and with confidence.

One last thing. I put together a little spreadsheet that shows the AREDS scoring method that ophthalmologists use to assess the severity of your AMD and estimate prognosis for disease progression on a 5-year timescale. If you wish, you can click on the screenshot below and download the Excel file and play with it. Discuss with your ophthalmologist the specific findings and changes that she/he observes in your eyes and ask about what changes you might expect over the next 5 years based on the AREDS studies. Overly-quick office exams are not what you want. You want to go to the eye doctor prepared with questions to ask, so you can get specific answers and good prognostic advice.

Please have a look at the links below. Email me with comments, questions, or suggestions you may have. If there is enough interest, I will compile them into future CMT posts on ‘assistive technologies’ for musicians. Thank you!