title: Feasibility study: Effect of hand resistance exercise on handwriting in Parkinson's disease and essential tremor.
abstract: METHODS
  A single group, repeated measures design was used.
  
  
  BACKGROUND
  Tremor can lead to impaired hand function in patients with Parkinson's disease (PD) and essential tremor (ET). Difficulty with handwriting is a common complaint in these patients suffering from hand tremors. The effect of hand resistance exercise on handwriting is unknown.
  
  
  OBJECTIVE
  To explore the influence of 6 weeks of home-based hand resistance exercise on handwriting in individuals with PD and ET.
  
  
  METHODS
  Nine individuals with PD and 9 with ET participated in the study. The average age was 65.3 (6.0) years with an average disease duration of 7.8 years. Participants were instructed to perform a home-based, hand and arm resistance exercise program 3 times a week for 6 weeks. Samples of the area of handwriting and maximal grip strength were measured at baseline and after 6 weeks of exercise. The area of the handwriting sample and maximal grip strength measured before and after 6 weeks were compared.
  
  
  RESULTS
  Mean grip strength of the participants with PD improved after 6 weeks of hand resistance exercise (P = .031), but grip strength did not change in ET (P = .091). The size of the handwriting samples (words and sentences) did not change after exercise in either participants with PD or ET.
  
  
  CONCLUSIONS
  Micrographia in patients with PD and macrographia in patients with ET represent complex fine motor skills. More research is needed to understand what therapies could be effective in modifying the size and quality of handwriting.
  
  
  CONCLUSIONS
  The purpose of this feasibility study was to explore the influence of home-based wrist resistance exercise on handwriting in individuals with PD and ET. Despite small gains in grip strength, the size of the handwriting samples (words and sentences) did not change for patients with PD or ET following a 6-week home-based hand resistance exercise program.
authors.affiliation: Research Service, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA; Department of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA. Electronic address: msbryant@bcm.edu.
authors.forename: Mon S
authors.initials: MS
authors.lastname: Bryant
authors.affiliation: Research Service, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Department of Health and Human Performance, University of Houston, Houston, TX, USA.
authors.forename: Craig D
authors.initials: CD
authors.lastname: Workman
authors.affiliation: Parkinson's Disease Research Education and Clinical Center, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: Fariha
authors.initials: F
authors.lastname: Jamal
authors.affiliation: Research Service, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Department of Health and Human Performance, University of Houston, Houston, TX, USA.
authors.forename: Hao
authors.initials: H
authors.lastname: Meng
authors.affiliation: Parkinson's Disease Research Education and Clinical Center, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA; Department of Neurology, Baylor College of Medicine, Houston, TX, USA.
authors.forename: George R
authors.initials: GR
authors.lastname: Jackson
mesh_terms: D000368:Aged; D020329:Essential Tremor / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D005240:Feasibility Studies; D005260:Female; D018737:Hand Strength; D006236:Handwriting; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D055070:Resistance Training
keywords: Essential tremor; Exercise; Handwriting; Parkinson's disease; Rehabilitation