title: Feasibility of a home-based program to improve handwriting after stroke: a pilot study.
abstract: OBJECTIVE
  To test the feasibility of a handwriting retraining program with adults after stroke; specifically the feasibility of: (i) recruiting people with stroke to the study, (ii) delivering the handwriting retraining program and (iii) outcome measures of handwriting performance.
  
  
  METHODS
  A quasi-experimental pre-test post-test design was used. A four-week, home-based handwriting retraining program was delivered by an occupational therapist using task-specific practice. Legibility, speed, pen control and self-perception of handwriting were measured at baseline and completion of the program. Legibility was scored by a blinded rater.
  
  
  RESULTS
  Seven adults with stroke were recruited (eligibility fraction 43% of those screened, and enrolment fraction 78% of those eligible). There were no dropouts. Although, recruitment was slow the intervention was feasible and acceptable to adults with stroke. No statistically or clinically significant changes in legibility were reported in this small sample, but a ceiling effect was evident for some outcome measures. The study was not powered to determine efficacy.
  
  
  CONCLUSIONS
  Delivery of a four-week handwriting intervention with eight supervised sessions in the community was feasible; however, recruitment of an adequate sample size would require greater investment than the single site used in this pilot.
  
  
  CONCLUSIONS
  Handwriting difficulty is common following hemiparesis after stroke, however research addressing handwriting retraining for adults with stroke is lacking. A four-week home-based handwriting program using task-specific practice and feedback was feasible to deliver and appropriate for adults with stroke. Improving handwriting legibility and neatness across a range of tasks were important goals for adults with handwriting impairment.
authors.affiliation: a Discipline of Occupational Therapy, The University of Sydney , Sydney , Australia .
authors.forename: Bronwyn
authors.initials: B
authors.lastname: Simpson
authors.affiliation: a Discipline of Occupational Therapy, The University of Sydney , Sydney , Australia .
authors.forename: Annie
authors.initials: A
authors.lastname: McCluskey
authors.affiliation: b Occupational Therapy Department, Alfred Health , Melbourne , Australia .|c School of Allied Health, La Trobe University , Melbourne , Australia .|d John Walsh Centre for Rehabilitation Research, Sydney Medical School, The University of Sydney , Sydney , Australia , and.
authors.forename: Natasha
authors.initials: N
authors.lastname: Lannin
authors.affiliation: e School of Occupational Therapy and Social Work, Curtin University , Perth , Australia.
authors.forename: Reinie
authors.initials: R
authors.lastname: Cordier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006236:Handwriting; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D009788:Occupational Therapy / Q000379:methods*; D010865:Pilot Projects; D012649:Self Concept; D057566:Self Report; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis
keywords: Legibility; occupational therapy; rehabilitation; task-specific practice; task-specific training; writing