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PubMed1998

A new method for the analysis of simple and complex planar rapid movements.

Recent developments in the field of simple human movement modelling provide new ways in which to view complete models for analysing and understanding complex movements. Based on a kinematic theory and a vectorial delta-lognormal model recently proposed by Plamondon (1993a); Plamondon (1995a); Plamondon (1995b); Plamondon (1995c) and Plamondon (1998), a new method for exploring and understanding the inherent mechanisms that govern planar movement generation and predict human behaviour is presented here. This paper describes an approach for analysing simple as well as complex movements such as cursive handwriting. It highlights some difficulties encountered in the analysis of complex movements. Problems such as the development of robust approaches to solve the reverse engineering problem of automatic parameter extraction of a succession of time-overlapped nonlinear functions are discussed. The analysis of natural cursive handwriting shows many interesting properties of the model and proposes new ways to study perturbed movement phenomena.

Cues↗
PubMed1991

Effects of vertical vibration on passenger activities: writing and drinking.

Two laboratory studies have investigated how handwriting ability and holding a cup of liquid depend on the characteristics of whole-body vertical vibration. The effects of vibration magnitude (0.16 to 2.5 ms-2 r.m.s.), vibration frequency (0.5 to 10 Hz), and vibration duration (2 cycles to 10 s) on handwriting were studied with 20 subjects. Subjects were asked to copy letters of the alphabet by writing on a hand-held surface. Writing speed decreased and subjective ratings of writing difficulty increased with increasing vibration magnitude, particularly in the frequency range 4 to 8 Hz. Writing difficulty also increased with increasing duration of vibration. A 10 s exposure to 5 Hz vibration at 2.0 ms-2 r.m.s. resulted in subjective estimates corresponding to 'extremely difficult'. The effects of vibration magnitude (0.63 to 1.6 ms-2 r.m.s.), vibration frequency (0.5 to 10 Hz), and vibration duration (2 cycles to 10 s) on the spilling of liquid from a hand-held cup were also investigated in a group of 20 subjects. The probability of spilling the liquid, the quantity of liquid spilt, and subject's estimates of the probability of spillage were determined for all conditions. Greatest interference with the task occurred at 4 Hz, with the lowest vibration magnitude (0.63 ms-2 r.m.s.) causing measured and estimated spillage probabilities of approximately 85%. The interference was much less at other frequencies, with 0.63 ms-2 r.m.s. causing less than 10% measured probability of spillage below 3 Hz and above 5 Hz. The estimated probability of spillage was generally greater than the observed probability of spillage when the spillage probability was low, but less than the observed probability when the spillage probability was high. Increasing the duration of vibration increased the probability of spillage, and also increased the volume of liquid spilt.

Adult↗
PubMed2004

An X-linked three allele model of hand preference and hand posture for writing.

This paper describes a genetic model of hand preferences for writing and for handwriting posture (HWP). The challenge of devising an X-linked model for these aspects of human handedness was posed by the results of a large family handedness study (McKeever, 2000) that showed evidence of such linkage. Because X-linkage for handedness has been widely regarded as untenable, the prospects for developing such a model were not initially encouraging, but ultimately a viable model did suggest itself. Family studies of handedness and leading theories of handedness are briefly described, as is some of the research on HWP motivated by the theory of Levy and Nagylaki (1972). It is argued that there is evidence that HWP reflects a biological dictate and not just individual "choices" or "adaptations" to writing in a left-to-right direction with the left hand. The model proposes that inverted handwriting posture is not necessarily highly related to speech and language lateralities of sinistrals, but that it reveals an interhemispheric mediation of writing. It is hypothesised that it reflects a specialisation of the left angular gyrus (with some possible extension into the supramarginal gyrus) for the storage of movement and timing sequences of cursive writing, and right hemisphere motor programming of the motor output of writing. It is also argued that no family handedness study conducted to date is adequate for testing the predictions of extant handedness theories, and the often wide variations between the results of family handedness studies are noted. It is suggested that fMRI studies could definitively test the HWP hypotheses of the model and that the hypothesis of X-linkage could be tested definitively should studies of the human genome identify a gene for handedness.

Chromosomes, Human, X↗
PubMed2001

Stereotactic lesional surgery for the treatment of tremor in multiple sclerosis: a prospective case-controlled study.

The effect of stereotactic lesional surgery for the treatment of tremor in multiple sclerosis was examined in a prospective case-controlled study. Surgery was not undertaken in 33 patients (72% of 46 cases referred for stereotactic surgery), two of whom died within 4 months of referral. Twenty-four multiple sclerosis patients were included in the study; 13 underwent surgery and were matched against 11 controls on the basis of age, sex, expanded disability system scores (EDSS) and disease duration. Assessments were carried out at baseline/preoperatively, and then 3 and 12 months later; these included accelerometric and clinical ratings of tremor, spirography, handwriting, a finger-tapping test, nine-hole peg test, tremor-related disability, general neurological examination, Barthel Activities of Daily Living (ADL) Index of general disability, EDSS, a 0-4 ataxia scale, Mini-Mental State (MMS) examination, speech and swallowing assessments and grip strength. Postoperative MRI scans demonstrated that tremor could be attenuated by lesions centred on the thalamus in seven cases, on the zona incerta in five cases and in the subthalamic nucleus in one case. Two patients developed hemiparesis and in two cases epilepsy recurred. Two surgical patients and one control patient died between the 3 and 6 months assessments. Both groups had a significant deterioration in EDSS but not Barthel ADL Index scores at 1 year, but the difference between the groups was not significant. Similarly, no differences between the groups' rates of deterioration of speech or swallowing or MMS were found. Significant improvements in contralateral upper limb postural (P2) and kinetic tremors, spiral scores and head tremor were detected at 3 and 12 months after surgery (but not handwriting or nine-hole peg test performance). Tremor-related disability and finger-tapping speed were also significantly better 12 months after surgery, the latter having significantly worsened for the control group. A 3 Hz 'filter' for postural (P2) upper limb tremor was detected by accelerometry/spectral analysis above which tremor was always abolished and at or below which some residual tremor invariably remained. Criteria for selecting multiple sclerosis patients for this form of surgery are discussed.

Activities of Daily Living↗
PubMed2004

Subthreshold low-frequency repetitive transcranial magnetic stimulation over the premotor cortex modulates writer's cramp.

Writer's cramp, or focal hand dystonia, is characterized by involuntary coactivation of antagonist or unnecessary muscles while writing or performing other tasks. Although the mechanism underlying this muscle overactivation is unknown, recent studies of changes in cerebral blood flow during writing have demonstrated a reduction in the activation of the primary motor cortex (MC) and hyperactivity of parts of the frontal non-primary motor areas. Therefore, any measures that decrease the activities of non-primary motor areas such as the premotor cortex (PMC) and the supplementary motor area (SMA) might improve dystonic symptoms. To explore this possibility, we studied nine patients with writer's cramp and seven age-matched control subjects, using subthreshold low-frequency (0.2 Hz) repetitive transcranial magnetic stimulation (rTMS), which exerts an inhibitory action on the cortex. Previous studies have demonstrated shortened cortical silent periods in dystonia, suggesting deficient cortical inhibition in the MC. We compared the silent periods and computer-assisted ratings of handwriting before and after rTMS applied to the MC, SMA or PMC. We also used the sham coil for control runs. Stimulation of the PMC but not the MC significantly improved the rating of handwriting (mean tracking error from the target, P = 0.004; pen pressure, P = 0.01) and prolonged the silent period (P = 0.02) in the patient group. rTMS over the other sites or using a sham coil in the patient group or trials in the control group revealed no physiological or clinical changes. This increased susceptibility of the PMC in dystonia suggests that the lack of inhibition in the MC is secondary to the hyperactivity of PMC neurons. Inhibition of the PMC using rTMS could provide a therapeutic measure of writer's cramp.

Adult↗
PubMed1995

Micrographia in Parkinson's disease.

A computational neural model of movement production in normal and Parkinson's disease (PD) is used to provide a neural account for the source of micrographia in PD handwriting. It is hypothesized that smaller than normal pallido-thalamic signals, due to dopamine depletion, are responsible for the observed overall smallness, slowness and variability in PD handwriting. Experimental data from PD patients that show micrographia support this hypothesis and imply the functional segregation of basal ganglia neural populations.

Adult↗
PubMed1992

Relationship of finger function to beginning writing: application to diagnosis of writing disabilities.

Finger function tasks designed to elicit soft neurological signs or to measure sensory-motor integration were administered to 100 first-, 100 second- and 100 third-grade children as part of a multivariate study of normal writing acquisition in an unreferred sample. The finger-succession task--a measure of motor planning and programming of complex, sequential movements--had the best reliability and validity for assessing handwriting and composition. However, of the developmental measures, the alphabet task--requiring the child to retrieve and produce alphabet letters in sequence, thereby integrating orthographic symbols and motor output--had the best concurrent validity for assessing handwriting, spelling and composition. The authors recommend that clinicians use the finger-succession and alphabet tasks for early identification of 'at-risk' children in order to prevent severe writing disabilities later in development.

Age Factors↗
PubMed2003

Effectiveness of neuromotor task training for children with developmental coordination disorder: a pilot study.

The aim of this pilot study was to evaluate the effectiveness of a Neuromotor Task Training (NTT), recently developed for the treatment of children with Developmental Coordination Disorder (DCD) by pediatric physical therapists in the Netherlands. NTT is a task-oriented treatment program based upon recent insights from motor control and motor learning research. Ten children with DCD (intervention group) were tested before and after 9 and 18 treatment sessions on the Movement ABC and a dysgraphia scale in order to measure the effectiveness of treatment on gross and fine motor skills in general and handwriting in particular. Five children (no-treatment control group) were tested twice with a time lag of nine weeks on the Movement ABC in order to measure spontaneous improvement. No improvement was measured for the children in the no-treatment control group, whereas a significant improvement was found for children in the intervention group for both quality of handwriting and performance on the Movement ABC after 18 treatment sessions.

Agraphia↗
PubMedDate not supplied

Learning disabilities and adolescent suicide.

To investigate the hypothesis that learning disabilities (LD) play a part in adolescent suicide, all available suicide notes (n = 27) from 267 consecutive adolescent suicides were analyzed for spelling and handwriting errors. The suicide notes were dictated to adolescents with LD and adolescent non-LD controls. The results showed that 89% of the 27 adolescents who committed suicide had significant deficits in spelling and handwriting that were similar to those of the adolescents with LD, and they were significantly more impaired than the non-LD adolescents and older adults (65 and older) who had committed suicide in the same time period and in the same geographical area.

Adolescent↗
PubMed1977

A reply to "Validity and student acceptance of a graphoanalytic approach to personality" by Vestewig, Santee, and Moss.

Vestewig, Santee, and Moss have interpreted their 1976 study of graphoanalysis as wholly offensive to the validity of this system of personality assessment. But re-examination of their data reveals that some findings actually support the validity of graphoanalysis in spite of the fact that their methodology stacked the cards against the handwriting experts. Suggestions are made as to how this study could have been made comparable to those studies which show validity of handwriting analysis by the "global" or "holistic" method, and it is noted that under these conditions the results might have been quite different.

Evaluation Studies as Topic↗
PubMed2005

A writing device improves writing in primary writing tremor.

Primary writing tremor (PWT) is task-specific and interferes with handwriting. Several reports have shown a beneficial response of this disorder to stereotactic functional neurosurgery. Significant improvement with a writing device was demonstrated with blind rating of handwriting and spiral drawing samples collected before and during its use in nine patients with PWT, suggesting that this therapeutic modality should be tried before considering chronic pharmacotherapy or functional neurosurgery.

Adult↗
PubMed1994

[Writing tremor: report of a case].

Primary writing tremor is induced by a specific motor activity, generally the handwriting. The case is analyzed under clinic and therapeutic points of view. The patient had a tremor elicited by handwriting without any other concurrent neurologic alteration. He neither presented familiar antecedents nor metabolic, endocrine, iatrogenic, toxic and traumatic ones. As to the therapeutic approach, the tremor did not respond satisfactorily neither to propranolol nor to primidone. But with anticholinergics improvement of the tremor was verified.

Aged↗
PubMedDate not supplied

Effect of an occupational intervention on printing in children with economic disadvantages.

OBJECTIVE: The purpose of this study was to evaluate whether an occupational therapy intervention improved an academic outcome (D'Nealian printing) in a school setting. The study specifically examined improvement in printing skills in economically disadvantaged first graders who were at risk academically and socially. The intervention was based on an occupational framework including biomechanical, sensorimotor, and teaching-learning strategies. METHOD: The final sample consisted of 59 first-grade children from a low socioeconomic urban elementary school-based health center who were randomly assigned to an occupational therapy intervention or a control condition. In addition to regular academic instruction, the intervention group received 10 weeks of training twice a week for 30-minute sessions. The control group received only regular academic instruction. Subjects were pretested and posttested on the Minnesota Handwriting Test, which assesses legibility, space, line, size, and form (the main variables in this study) as well as speed. RESULTS: Multivariate analysis of variance confirmed that the gain scores in the occupational therapy intervention group were significantly greater than those in the control group. The Hotelling-Lawley Trace value was 0.606, with F(5, 53) = 6.43, p < .0001). The estimated effect size (eta2) was .378, with an observed power of .994. Largest gains for the intervention group were in the areas of space, line, and size. CONCLUSION: The intervention group demonstrated a significant increase in scores on the posttest of the Minnesota Handwriting Test when compared to the scores of the control group. Occupational intervention was effective in improving the academic outcome of printing in children who are economically disadvantaged.

Child↗
PubMed1999

The prescribing pattern of outpatient polyclinic doctors.

OBJECTIVE: This study aims to analyse the prescribing pattern of doctors working in a government outpatient polyclinic in Singapore. DESIGN: Retrospective study of 1 week of prescription scripts in 1996. MAIN OUTCOME MEASURES: Number, types and duration of drugs prescribed; combination of drugs; age distribution; bad handwriting. RESULTS: Two thousand six hundred and seventy-nine scripts were analysed. The age of patients ranged from 1 to 93 years with a mean of 43.8 years. There were 44.0% males and 56.0% females. The overall mean of 'total number of drugs prescribed' was 2.8 items. The means of 'number of drug items prescribed for more than 1 week' by age-group were: < 20 years = 0.2, 20 to < 40 years = 0.5, 40 to < 60 years = 1.3 and > 60 years = 2.4. One way analysis of variance showed significant difference between the means of each age-group. Post hoc analysis revealed that the oldest age group accounted for most of this significant result. The top 10 drugs prescribed in descending order were: antihistamines, paracetamol, throat medications (eg. lozenges, gargles, etc), nifedipine, beta-blockers, antacids, mist benadryl expectorant, Procodin cough syrup (containing codeine and promethazine), amoxycillin and vitamin B. Nifedipine and beta-blockers were the most commonly prescribed anti-hypertensives. Non-steroidal anti-inflammatory drugs were usually prescribed with antacids. One hundred and twenty (4.5%) scripts were illegible. CONCLUSION: This study provides a baseline data for monitoring future prescribing trends. There may be a need to re-evaluate the appropriateness of nifedipine as the first line anti-hypertensive drug and the usefulness of NSAID-antacid and amoxycillin-cloxacillin combinations. The prevalence of illegible handwriting was high.

Adolescent↗
PubMed1992

PureMD: a Computerized Patient Record software for direct data entry by physicians using a keyboard-free pen-based portable computer.

This paper describes the data acquisition features of the PureMD Computerized Patient Record (CPR) software designed specifically for physicians. The physician uses a stylus to point, draw and handwrite on a Dynamic Dialog Interface that provides the same flexibility as the paper record and numerous other advantages. The clinical data thus entered is highly organized, easily legible and retrievable in many ways. The underlying Medical Knowledge Base (MKB) was optimized for rapid, intuitive and consistent data entry and automatic coding with minimum handwriting.

Handwriting↗
PubMed1997

Comparisons of altitude tolerance and hypoxia symptoms between nonsmokers and habitual smokers.

BACKGROUND: Increased levels of carboxyhemoglobin (COHb) in smokers are blamed for inducing pre-hypoxic tendency classified as anemic hypoxia. If COHb can be simply converted to altitude, there should be significant differences between smokers and nonsmokers with respect to hypoxia tolerance. However, the studies of the effects of carbon monoxide and/or smoking habit on the physiological functions at altitude do not have consistent conclusions, and many pilots still have smoking habits. This study was designed to assess whether there is a definite significant difference for time of useful consciousness (TUC), subjective symptoms, or performance degradation between nonsmokers and smokers. METHODS: During the hypoxia experience of routine physiological training, TUC and 12 typical subjective symptoms were examined at the chamber altitude of 25,000 ft (7620 m) in 589 nonsmokers and 582 smokers in Study 1. The time until the deterioration of handwriting was assessed by 6 physiological training observers in 51 nonsmokers and 70 smokers in Study 2. The results were compared between the groups. RESULTS: Smokers revealed significantly fewer subjective symptoms in 5 out of 12 symptoms. There were no significant differences in TUC and the rate of handwriting deterioration between the groups. CONCLUSIONS: Paradoxically, smokers are slightly resistant to hypoxia with respect to emerging subjective symptoms. However, bluntness to hypoxia could postpone the detection of the possible hypoxic occurrence in pilots.

Adult↗
PubMed2003

Corticobasal degeneration as a cognitive disorder.

The presence of cognitive impairment in corticobasal degeneration (CBD) is now widely recognised. Our review of the literature reveals that, although the pattern and severity of neuropsychological impairments can be highly variable across patients, several general trends can be identified. The most characteristic impairments are limb apraxia (usually ideomotor), constructional and visuospatial difficulties, acalculia, frontal dysfunction, and nonfluent aphasia. The limb apraxia is associated with deficits in drawing, copying, and handwriting, but there is emerging evidence that the problems with handwriting are not due exclusively to the apraxia. The findings with respect to episodic memory are more variable, but when there is impairment in this area, it tends to be milder than that seen in Alzheimer's disease. Semantic memory functioning appears relatively preserved but has been poorly studied. Problems with speech are common, and may be due to dysarthria or buccofacial apraxia. Aphasia, although initially considered rare, is in fact a common accompaniment of CBD, may be the presenting feature, and is typically nonfluent in type. More systematic investigation of the clinical and neuropathological overlap between progressive nonfluent aphasia (generally considered to be a form of frontotemporal dementia) and CBD is needed.

Aphasia↗
PubMed1993

The measurement of handedness by preference and performance tests.

Hand preference and hand proficiency were compared on 50 male subjects (30 self-classified left-handers and 20 self-classified right-handers) according to their responses to a 20 item questionnaire and their performances on a handwriting and a grip-strength task. Performance differences between the two sides for each group were not related to overall preference assessments but were positively associated with hand preferences on corresponding questionnaire items. Distributions of the performance differences between the two sides for the right- and left-handers were well separated for handwriting but completely overlapped for grip strength. Significant correlations between the performances on each side were recorded on both tasks. The results stress the importance of using the same criteria in making preference vs. performance comparisons and highlight the need to recognize and control the influence of previous training or experience.

Adolescent↗