Three-dimensional movement analysis of handwriting in subjects with mild hemiparesis.
OBJECTIVE
To investigate the effects of hemiparesis on handwriting using a 3-dimensional movement analyzer.


METHODS
Comparative case study.


METHODS
Ambulatory care clinic.


METHODS
Right-handed patients (n=25; mean age +/- SD, 62.3+/-10y) with mild right hemiparesis secondary to subcortical stroke, and age-matched (n=10; 65.6+/-13y) and age-unmatched (n=15; 32.4+/-10y) control subjects.


METHODS
Not applicable.


METHODS
Time required to write a Japanese character of 2 different sizes and average speed of handwriting at the pen tip. Average radii of tracks of the moving pen tip, metacarpal head of the index finger, and distal end of the forearm during writing. Correlation coefficients of the instantaneous speed-time graph of the pen tip with that of the index finger and with that of the distal forearm during writing.


RESULTS
Time for writing with the hemiparetic right hand was longer than that with the unaffected left hand (P=.05 approximately .03), while it was shorter in healthy control subjects (P=.07 approximately .05). In contrast with the left-hand writing, the track radius of the pen tip of the right-hand writing in patients with hemiparesis with normal joint position sense was significantly larger than that of the finger or distal forearm (P=.01). The finding was the same as in the young and elderly control subjects. This right-left difference disappeared in the patients with hemiparesis with position sense impairment. The correlation coefficient of speed between the pen tip and the finger was larger in right-hand than left-hand writing in the control and sensory-normative patients with hemiparesis even though the difference was significant only in the healthy elderly subjects (P=.03). Irrespective of the right or left hand use, the correlation coefficient between the pen tip and the finger or distal forearm significantly increased as the character size increased (P=.03 approximately 6 x10(-6)) in all subjects and patients. However, this size-related difference was less significant in the patients with sensory impairment.


CONCLUSIONS
The characteristics of handwriting movement by the dominant hand were preserved in patients with mild dominant-hand hemiparesis when joint position sense was normative but were lost in those with position sense impairment.
Harada
Takako
T
Department of Rehabilitation Medicine, Ome Municipal Hospital, Tokyo, Japan. secretary_reha@ks.kyorin-u.ac.jp
Okajima
Yasutomo
Y
Takahashi
Hidetoshi
H
D000328:Adult; D000368:Aged; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D005260:Female; D007839:Functional Laterality; D006236:Handwriting; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement; D010291:Paresis / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation; D026741:Physical Therapy Modalities; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications*