Usually we’re fairly harsh towards games that’re RSI-unfriendly, but honestly the mechanic combined with the limitations of Pico-8 give it a good pass. It could be made more RSI-friendly by allowing any input for mashing (this is what prevents one-button rhythm games like ADOFAI from being wrist shredders), but with Pico-8’s limitations on input, it’ll still be pretty rough regardless.
Aside from that, this is a very charming game, and does a really good job at mechanically representing omorashi! Playing this with a full bladder after drinking an energy drink has been the most immersive experience we’ve had throughout the jam so far.