title: Handwriting Rehabilitation in Parkinson Disease: A Pilot Study.
abstract: OBJECTIVE
  To assess the utility of handwriting rehabilitation (HR) in Parkinson disease (PD) patients who experienced difficulties with handwriting and signing.
  
  
  METHODS
  Sixty PD patients were prospectively studied with graphological evaluations. Thirty PD patients were assigned to HR for 9 weeks. At the end of this training, all patients were evaluated again and results of basal vs. final evaluations were compared.
  
  
  RESULTS
  At final evaluation, the group assigned to HR showed significantly larger amplitude of the first 'e' in the phrase, larger signature surface area, and superior margin. A trend of increase in letter size was also observed. Handwriting with progressively decreasing size of letters and ascending direction with respect to the horizontal were prominent findings in both groups of patients and they did not change after HR.
  
  
  CONCLUSIONS
  Rehabilitation programs for handwriting problems in PD patients are likely to be helpful. Larger randomized studies are needed to confirm these results.
authors.affiliation: Parkinson's Disease and Other Movement Disorders Unit, Hospital de Clinicas "Jose de San Martin", University of Buenos Aires, Argentina.
authors.forename: Adriana
authors.initials: A
authors.lastname: Ziliotto
authors.affiliation: Parkinson's Disease and Other Movement Disorders Unit, Hospital de Clinicas "Jose de San Martin", University of Buenos Aires, Argentina.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Cersosimo
authors.affiliation: Parkinson's Disease and Other Movement Disorders Unit, Hospital de Clinicas "Jose de San Martin", University of Buenos Aires, Argentina.
authors.forename: Federico E
authors.initials: FE
authors.lastname: Micheli
keywords: Handwriting; Micrographia; Parkinson disease; Rehabilitation; Signature