\markup {
  \column {
  \fill-line {\bold\fontsize #3 4}
  \vspace #0.5
  \line{(3-4-5) (1) Special exercise for the 3\super{rd}, 4\super{th} and 5\super{th} fingers of the hand.}
  \vspace #0.5
}
}
\score{
  \new PianoStaff <<
    \override PianoStaff.InstrumentName #'self-alignment-X = #RIGHT
    \set PianoStaff.instrumentName = \markup{\right-align\bold\fontsize #3 4.}
    \new Staff = "up" {
      \clef treble
      \time 2/4
      \new Voice
\include "dir/rh4.ily"
    } 
    \new Staff = "down" {
      \clef bass
      \new Voice
\include "dir/lh4.ily"
    }
  >>
}