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I work as a physiotherapist at a rehabilitation hospital. I am looking to help a patient get back to playing guitar. He suffered a cervical spine injury and has no control over his fingers in both hands. He has managed to strum with his right from his movement in his elbows and wrist but can't play the chords on the left.

Does anyone have any suggestions on adaptive equipment that may help?

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    A clarification: does "no control over his fingers" mean entirely no control in totality, or is it no control in moving his fingers independently of each other? Perhaps you could edit your post to add detail to the degree/nature of the limitation.
    – Aaron
    Nov 8, 2022 at 20:44
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    I remember seeing a project with actuators put on the guitar who would make a chord shape by pressing a button so that it would make guitar available for people with less ability, especially if the buttons are spaced enough. Will try to find a link to that.
    – Tom
    Nov 8, 2022 at 21:32
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    Could the player hold a finger slide? Nov 8, 2022 at 23:57
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    Another route could be an autoharp. Nov 9, 2022 at 1:56
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    Is this to rehabilitate to play a normal guitar? Or to find a replacement instrument or method to play regularly?
    – DKNguyen
    Nov 9, 2022 at 14:36

11 Answers 11

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summary: five-string banjo, open G, barre chords, light strings

I jammed with a musician at a folk festival who had suffered a stroke and could no longer make proper chords, but he was able to use a finger to fret all the strings at once. Although formerly a guitar player, he switched to banjo tuned in open G. He strummed while fretting G barre chords up and down the neck. We were joined by other musicians and listeners and everyone enjoyed his playing and singing thoroughly. I don't think anyone even noticed that he was playing any differently than is normal.

A banjo, having a narrow neck, will be easier to barre than is a guitar. The musician may also wish to use light strings to reduce the pressure needed for a barre. You could also leave off the fifth string: four should be just fine for making good sounding chords.

Source: "Mister Mike," a musician from the greater Phoenix area. Not to be confused with the rapper by the same name.

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  • There is also a bass which to my understanding doesn't have as many chords.
    – DKNguyen
    Nov 9, 2022 at 14:38
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    You could also pick up a slide, or make one - I've seen a technique involving cutting off the neck of a beer bottle (using a burning piece of string so it doesn't have sharp edges) that makes an effective slide. A slide makes barre chords much easier for people without full use of their fingers. Nov 9, 2022 at 20:19
  • @DarrelHoffman Very true! I left the mention of a slide out of my answer because... well, if you can use a slide, you can probably keep playing the guitar (using an open tuning). That's my thinking anyhow. Nov 9, 2022 at 20:47
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I wanted to add this alternative invented by a music teacher in Sweden to help students with disabilities be able to play the guitar.

Closeup of klaffguitar

Depending on the way the lever is pressed (left/right/upright) three different chords can be played. These are custom fitted by the inventor himself, and my father recently got one of these fitted to one of his guitars.

It is called a klaff-guitar which might be translated as a hinged guitar. The Swedish word klaff is a bit hard to directly translate, but is used for example to describe a heart valve or the hinged part of a drop leaf table.

Links (in Swedish):

Local news article

Home page of the inventor

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    What a wonderful idea! Can the klaff be moved easily while playing or is it screwed into one specific fret and needs to be unscrewed if one wants to move it?
    – terdon
    Nov 9, 2022 at 14:29
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    @terdon It is screwed in place and it is not possible to move it. You can re-tune the open chord, the other two are fixed relative to it. Nov 9, 2022 at 15:10
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    Surely the next step would be to produce one which worked something like some of the capos - movable?
    – Tim
    Nov 10, 2022 at 9:12
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    This is an amazing invention! Nov 11, 2022 at 14:47
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    I wonder if something like that could be enhanced by the use of an alternative tuning? If the device was mounted on rails, I think it would probably be possible to design a device that could play ten flavors of chord at each of the first seven fret positions: fifth-string-rooted major triad, minor triad, major seventh, minior seventh, and dominant seventh, and sixth-string rooted versions of those same chords. To select the root, push the device slightly toward the bass or treble side of the instrument, to select major or minor use the device either slightly above or slightly below a fret...
    – supercat
    Nov 11, 2022 at 20:04
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In my teens, my best friend suffered a gunshot injury at C5C6. He had virtually no finger control. But he figured out a way to play with the guitar in his lap like a slide guitar. He would barre open tunings with the side of his hand, and used his thumb, with a thumb pick, for strumming and picking. He got really good at it. Played many live shows that way.

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    Open tuning was the first thing that jumped to my mind too. For those that don't know, 'Open Tuning' is when the strings are tuned so that playing the strings without pressing on any frets at all makes a nice sounding chord. And to make other chords, you can simply place one finger across all/any strings at the same fret. The end result is you can still make some nice music but with way less use of the fretting hand.
    – stevec
    Nov 10, 2022 at 16:41
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There is a device called the “Chord Buddy” and other similar devices that are branded differently. It clips on the neck of the guitar and has 4 buttons that enable the user to play 4 different chords depending on the button being held down. This might work with a capo to a certain extent to allow songs to be played in a few different keys.

It would require your patient to be able to hold down a button with his left arm or hand while strumming with the right. Since fingers are not an option perhaps some type of small hook shaped device can be used to hold the buttons down.

I commend you on the work you do and the effort you are putting in to help this patient. I hope you and the medical team you work with are successful in treating him.

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    Open chords are G, D, C, Em - I, V, IV, vi in key G. This will facilitate all '4 chord wonder' songs, which amounts to thousands! Presumably it can be moved up the neck, otherwise everything would have to be played in key G! Wonder if it's possible to hold down 2 buttons to produce extra chords.
    – Tim
    Nov 9, 2022 at 8:23
  • @Tim An interesting thought, combining basic open chords. It would net some interesting and some potentially difficult or impossible to otherwise play chords. Combining an Em and D would give you an Em7,9,11 for example, E,B,E,A,D,F#. Combining C and D chords would give you a C6/9/#11, C,E,A,D,F#. Nov 10, 2022 at 5:25
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Slide guitar

Blues musicians have played slide guitar since the birth of the genre, and it's also a major part of the sound of country music. It's also often used in rock. Playing with a slide removes any requirement to fret the strings.

It can be played with the guitar held in the normal position, or with the guitar sat in your lap facing upwards. The latter is perhaps more common for country music players, and tends to involve playing with a "tone bar" held between the fingers instead of a "bottleneck" slid over one finger. This gives some ergonomic options which may help your friend.

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As an interim step, perhaps an instrument like the autoharp might help this patient get started.

The autoharp has individual keys (bars) to be pressed to create chords, while the other hand strums. In addition, it can be placed on a tabletop — as opposed to held in ones arms — if needed during the rehabilitation process.

There is also an autoharp variant called the Guitaro, which operates similarly, but is held like a guitar. This might also present an interim step between autoharp and guitar.

There is a detailed description of the autoharp on Wikipedia as well as an article about the Guitaro.

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    For those of us who were introduced to autoharp by our kindergarten teacher: it's a wonderful instrument with a lot more going for it than you may have heard as a child. Nov 10, 2022 at 20:58
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Turning everything on its head, so to speak: there are several guitarists - one born with NO arms - who play guitar using their feet. Plenty of youtubes to show that! So if the spinal injury hasn't affected legs and feet, that's another avenue to tread. Show the guy, and it might just inspire him.

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Folks have mentioned using a slide on a regular guitar. There is also lap steel (or if they really take to it, pedal steel). This and other suggestions will be all about having fun playing with different open tunings.

(your patient will also want some kind of (rubber/plastic, so as not to damage) wrench or accommodation to tune the instrument)

This would require figuring out how to hold a slide with one hand, and a pick of some kind with the other (traditionally these are multiple fingernails or finger picks, but of course you could use one and experiment)

I just wanted to add that I personally know of two guitarists in the rock scene here with hand deformities/differences who have figured out their own way of playing and make amazing music. Good luck to your patient!

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There are breath controllers out there used for adaptive situations. https://www.jamboxx.com/ and https://mybreathmymusic.com/en/ may point you to some resources (disclaimer, I helped out with the Jamboxx design, but have no financial interests). I don't believe either is available commercially at the moment.

There are other breath controllers that work with MIDI, so you can drive any MIDI synth you're comfortable with.

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Here's something we need to know...is he going to get better, in regards to finger control? Or is this essentially permanent?

I realize the goal is to get back to playing guitar, but in his current state, maybe that shouldn't be the first goal. Strumming a guitar is 100 times easier than the fingerings; if he's having trouble strumming, then the fingerings are far off. He needs something else to do to start making those connections to his fingers again. Can he play a keyboard (i.e. piano)? Can he type on a computer keyboard? What other activities can you challenge him to achieve, that will get him back on the road to playing the guitar?

I'm no physiotherapist, and barely a guitar player; but it seems there are some intermediate steps we have to climb here. If he can barely strum, I have to assume he needs a lot of other PT/OT as well.

Keep in mind, guitar playing isn't all that easy to begin with, even if we have complete control of our fingers. If he truly isn't going to get better, then some of the alternative devices/styles/instruments mentioned in other answers may be the key.

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He could play a left-handed guitar, so fretting with his right and strumming with his left.

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    Since he has no control of the fingers in either hand, how exactly will that work?
    – Aaron
    Nov 10, 2022 at 2:01

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