From micrographia to Parkinson's disease dysgraphia

Micrographia, an abnormal reduction in writing size, is a specific behavioral deficit associated with Parkinson's disease (PD). In recent years, the availability of graphic tablets has made it possible to study micrographia in unprecedented detail. Consequently, a growing number of studies show that PD patients also exhibit impaired handwriting kinematics. Is micrographia still the most characteristic feature of PD‐related handwriting deficits? To answer this question, we identified studies that investigated handwriting in PD, either with conventional pencil‐and‐paper measures or with graphic tablets, and we reported their findings on key spatiotemporal and kinematic variables. We found that kinematic variables (velocity, fluency) differentiate better between control participants and PD patients, and between off‐ and on‐treatment PD patients, than the traditional measure of static writing size. Although reduced writing size is an important feature of PD handwriting, the deficit is not restricted to micrographia stricto sensu. Therefore, we propose the term PD dysgraphia, which encompasses all deficits characteristic of Parkinsonian handwriting. We conclude that the computerized analysis of handwriting movements is a simple and useful tool that can contribute to both diagnosis and follow‐up of PD. © 2014 International Parkinson and Movement Disorder Society     

Performance of school-aged children on a Chinese handwriting speed test

Slow handwriting speed is one of the major problems encountered by school-aged children having handwriting difficulties. These children are often referred to occupational therapists for assessment and intervention. However, to date, no norms of handwriting speed have been published for the Chinese writing system for school-aged children. The purpose of this study was to document handwriting speed performance of Chinese children from Grades 2 to 6. The results of this study will provide occupational therapists with an objective guideline when screening children who have handwriting speed problems. Participants were 1525 children from Grades 2 to 6 from three elementary schools in the Taipei area. Participants were asked to copy texts from a Chinese textbook that they had studied in the second semester of the first grade. The test lasted for five minutes. Results showed that handwriting speed increased with age; and the rate of increase was found to be greatest among Grades 2, 3, and 4. Furthermore, girls wrote faster than boys in Grades 3, 4, and 5. This study's baseline data on handwriting speed for the Chinese writing system provide further substantial information for future research and clinical practice. Copyright © 1997 Whurr Publishers Ltd.     

认知负荷对老年脑小血管病患者书写及绘画流畅性的影响

目的分析认知负荷对老年脑小血管病(cerebral small vessel disease,CSVD)患者书写及绘画流畅性的影响。方法选择2018年11月~2019年5月解放军总医院第七医学中心神经内科就诊的脑白质损害患者59例(CSVD组),同期选择本院年龄、性别相匹配的健康体检者42例(对照组)。应用蓝牙智能笔对受试者进行书写及绘画测试的双重任务,第1任务为书写及绘画测试,第2任务为听辨的认知测试,分别进行单独任务、双重任务及双重任务成本(dual task cost,DTC)测试。结果 CSVD组双重任务书写时间较单独任务书写时间明显延长[(53.76±11.25)s vs(40.29±8.83)s,P<0.01]。CSVS组双重任务书写时间较对照组明显延长[(53.76±11.25)s vs(41.21±8.60)s,P<0.01]。CSVD组双重任务书写听辨和绘画听辨正确个数较单独听辨正确个数明显减少[(12.31±2.36)个vs(13.31±2.61)个,P<0.05;(10.98±1.81)个vs(13.31±2.61)个,P<0.01]。CSVD组双重任务书写听辨和绘画听辨正确个数较对照组明显减少[(12.31±2.36)个vs(13.52±2.97)个,P<0.05;(10.98±1.81)个vs(13.29±3.16)个,P<0.01]。CSVD组双重任务书写时间DTC和绘画听辨正确个数DTC较对照组明显增多,差异有统计学意义(P<0.01)。结论认知负荷下,老年CSVD患者书写流畅性易受到影响。双重任务条件下,更易发现老年CSVD患者上肢运动功能障碍。     

Assessment of handwriting speed and factors influencing written output of university students in examinations

Limited written output is of concern for students sitting examinations. Referral for assessment often states the problem as poor handwriting speed. This study investigated the ability of a short duration speed test to predict written output under examination conditions, and factors thought to influence written output. The number of words written per minute by 66 second-year university students was calculated for three writing tasks (Handwriting Speed Test, and two examination papers) and the relationships examined. Data were collected on pencil grasp, legibility, writing style, pain, fatigue and academic ability. The results do not support the use of a short duration speed test to predict written output in an examination ( r² =  0.072). Pencil grasp, pain and academic ability were found to have some association with written output. There is a need to establish normative data for written output in examinations and to further develop assessment techniques.