Dataset Information

Handwriting training in Parkinson's disease: A trade-off between size, speed and fluency.

ABSTRACT: In previous work, we found that intensive amplitude training successfully improved micrographia in Parkinson's disease (PD). Handwriting abnormalities in PD also express themselves in stroke duration and writing fluency. It is currently unknown whether training changes these dysgraphic features.To determine the differential effects of amplitude training on various hallmarks of handwriting abnormalities in PD.We randomized 38 right-handed subjects in early to mid-stage of PD into an experimental group (n = 18), receiving training focused at improving writing size during 30 minutes/day, five days/week for six weeks, and a placebo group (n = 20), receiving stretch and relaxation exercises at equal intensity. Writing skills were assessed using a touch-sensitive tablet pre- and post-training, and after a six-week retention period. Tests encompassed a transfer task, evaluating trained and untrained sequences, and an automatization task, comparing single- and dual-task handwriting. Outcome parameters were stroke duration (s), writing velocity (cm/s) and normalized jerk (i.e. fluency).In contrast to the reported positive effects of training on writing size, the current results showed increases in stroke duration and normalized jerk after amplitude training, which were absent in the placebo group. These increases remained after the six-week retention period. In contrast, velocity remained unchanged throughout the study.While intensive amplitude training is beneficial to improve writing size in PD, it comes at a cost as fluency and stroke duration deteriorated after training. The findings imply that PD patients can redistribute movement priorities after training within a compromised motor system.

SUBMITTER: Nackaerts E

PROVIDER: S-EPMC5741263 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Handwriting training in Parkinson's disease: A trade-off between size, speed and fluency.

Nackaerts Evelien E Broeder Sanne S Pereira Marcelo P MP Swinnen Stephan P SP Vandenberghe Wim W Nieuwboer Alice A Heremans Elke E

PloS one 20171222 12

<h4>Background</h4>In previous work, we found that intensive amplitude training successfully improved micrographia in Parkinson's disease (PD). Handwriting abnormalities in PD also express themselves in stroke duration and writing fluency. It is currently unknown whether training changes these dysgraphic features.<h4>Objective</h4>To determine the differential effects of amplitude training on various hallmarks of handwriting abnormalities in PD.<h4>Methods</h4>We randomized 38 right-handed subje ...[more]

PMID: 29272301

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Project description:The quality of handwriting is evaluated from the visual inspection of its legibility and not from the movement that generates the trace. Although handwriting is achieved in silence, adding sounds to handwriting movement might help towards its perception, provided that these sounds are meaningful. This study evaluated the ability to judge handwriting quality from the auditory perception of the underlying sonified movement, without seeing the written trace. In a first experiment, samples of a word written by children with dysgraphia, proficient children writers, and proficient adult writers were collected with a graphic tablet. Then, the pen velocity, the fluency, and the axial pen pressure were sonified in order to create forty-five audio files. In a second experiment, these files were presented to 48 adult listeners who had to mark the underlying unseen handwriting. In order to evaluate the relevance of the sonification strategy, two experimental conditions were compared. In a first 'implicit' condition, the listeners made their judgment without any knowledge of the mapping between the sounds and the handwriting variables. In a second 'explicit' condition, they knew what the sonified variables corresponded to and the evaluation criteria. Results showed that, under the implicit condition, two thirds of the listeners marked the three groups of writers differently. In the explicit condition, all listeners marked the dysgraphic handwriting lower than that of the two other groups. In a third experiment, the scores given from the auditory evaluation were compared to the scores given by 16 other adults from the visual evaluation of the trace. Results revealed that auditory evaluation was more relevant than the visual evaluation for evaluating a dysgraphic handwriting. Handwriting sonification might therefore be a relevant tool allowing a therapist to complete the visual assessment of the written trace by an auditory control of the handwriting movement quality.

Dataset Information

Handwriting training in Parkinson's disease: A trade-off between size, speed and fluency.

Publications

Handwriting training in Parkinson's disease: A trade-off between size, speed and fluency.

Similar Datasets

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