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PubMed2002

Adaptation to changes in vertical display gain during handwriting in Parkinson's disease patients, elderly and young controls.

Parkinson's disease (PD) patients, matched elderly controls, and normal young subjects were tested using a visuo-motor adaptation paradigm in which the gain of the vertical component of the visual feedback of handwriting was manipulated in real-time. Handwriting was performed on a digitizer tablet and displayed in real-time on a computer screen in front of the participant. Vision of the hand and pen was occluded. Feedback could be normal (pre- and post-exposure conditions), smaller, or larger than the actual handwriting (exposure conditions). All groups showed a gradual adaptation that compensated for the distorted visual feedback during the exposure conditions. Moreover, all the groups showed significant after-effects during the post-exposure conditions suggesting that all the participants learned to compensate for the novel display gains. Taken together, these data suggest that the mechanisms for visuo-motor adaptation to changes in vertical display gain during handwriting are robust to aging and early stage of PD. These results may have implications for the treatment of micrographia in Parkinsonism.

Adaptation, Psychological↗
PubMed2005

Handwriting performance in preterm children compared with term peers at age 6 to 7 years.

Preterm infants are at high risk for developmental impairments at school age. However, the impact of these impairments on important life skills, such as handwriting, is unknown. Forty-eight first-grade children (27 males, 21 females; mean age 6y 7mo, SD 3.9mo; range 6y 1mo to 7y 3mo) born preterm (birthweight < 1250g; gestational age < 34wks), without major physical or cognitive disabilities, were matched to 69 healthy, term control children (32 males, 37 females; mean age 6y 10mo, SD 3.6mo; range 6y 3mo to 7y 4mo) by sex and school class. All children were assessed using the Evaluation Tool of Children's Handwriting-Manuscript and several sensorimotor measures. Preterm children demonstrated significantly lower legibility and slower speed scores (p < 0.01) compared with control children for most of the handwriting tasks. Factors associated with legibility were visual perception and eye-hand coordination (r < 0.50; p < 0.05) and sex (r < 0.12; p = 0.01). In-hand manipulation and finger identification (r < 0.43; p < 0.01) were significantly correlated with slow handwriting speeds. Behaviour difficulties associated with hyperactivity and poor attention (Connors Abbreviated Symptoms Questionnaire) had a confounding influence on both legibility and speed. These findings may help guide early identification efforts and medical/therapeutic interventions for preterm children.

Attention↗
PubMed2000

Closed- and open-loop handwriting performance in patients with multiple sclerosis.

Normal subjects use an open-loop motor control strategy in handwriting, but they are able to switch to closed-loop motor control when the demands on accuracy increase. These closed-loop handwriting movements of normal subjects resemble the inefficient movements found in writing-impaired patients. The hypothesis that such movement deficits may in fact reflect the use of a closed-loop strategy was tested in a group of writing-impaired patients with multiple sclerosis (MS). The handwriting movements of 10 MS patients and 20 control subjects were examined with a digitizing tablet. Three conditions were used: a standard writing task (expt 1), a closed-loop condition (expt 2), and an open-loop condition (expt 3). Individual stroke movements were analysed. Stroke duration and segmentation were increased for MS patients in the standard writing task. The same was found for control subjects when they wrote under closed-loop conditions. However, under open-loop conditions, the handwriting movements of the MS patients were as fast and fluent as that of control subjects. The results support the hypothesis that the movement characteristics of the writing-impaired MS patients reflect an inadequate use of a closed-loop motor control strategy.

Adult↗
PubMed1988

The handwriting of children with spina bifida.

As part of the Greater London Council (GLC) Spina Bifida Survey the handwriting of 131 11-year-olds with spina bifida and 56 controls was examined. The children copied the sentence "The dog sits in his box" in the course of an extensive battery of intelligence and attainment tests. Writing speed formed one scoring dimension and nine further categories were devised in collaboration with a handwriting consultant. All but one of these ten dimensions consistently discriminated between the spina bifida children and the controls, and between the spina bifida children divided according to such variables as IQ, school type, degree of disability, reading scores and presence or absence of a valve. In every case the differences were in the predicted direction, with the handwriting scores of the brighter, less damaged children, and those attending ordinary schools being higher. These findings are consistent with those obtained by other researchers and reflect an educational disadvantage in that the children with spina bifida had handwriting which was slow, with the letters being poorly formed and the words poorly spaced.

Child↗
PubMedDate not supplied

The truth about doctors' handwriting: a prospective study.

OBJECTIVES: To determine whether doctors have worse handwriting than other health professionals. DESIGN: Comparison of handwriting samples collected prospectively in a standardised 10 seconds' task. SETTING: Courses on quality improvement. SUBJECTS: 209 health care professionals attending the courses, including 82 doctors. MAIN OUTCOME MEASURES: Legibility rated on a four-point scale by four raters. RESULTS: The handwriting of doctors was no less legible than that of non-doctors. Significantly lower legibility than average was associated with being an executive and being male. Overall legibility scores were normally distributed, with median legibility equivalent to a rating between "fair" and "good." CONCLUSION: This study fails to support the conventional wisdom that doctors' handwriting is worse than others.' Illegible writing is, however, an important cause of waste and hazard in medical care, but efforts to improve the safety and efficiency of written communication must approach the problem systemically- and assume that the problems are in inherent in average human writing-rather than treating doctors as if they were a special subpopulation.

Female↗
PubMed1993

A longitudinal study on dysgraphic handwriting in primary school.

In an epidemiological study, the scripts of 121 Dutch primary-school children were evaluated annually, starting in Grade 2. The children were followed for 5 years. An evaluation scale for children's handwriting (the BHK scale) was used for rating the scripts on 13 characteristics and for measuring the speed of writing. Principal component analysis of the LONG matrix (in which the data collected on the five occasions are arranged beneath each other) yielded three clusters of items: (a) fine-motor ability, (b) structural performance, and (c) stylistic preference. It was found that the children with dysgraphic handwriting (10% scoring highest on the BHK quality items) had lower fine-motor ability and, in the higher grades, showed less preference for a personal style. Their structural performance also was poorer than that of the other writers. Children with and without dysgraphic handwriting did not differ in writing speed. Some implications of the study for handwriting instruction are discussed.

Child↗
PubMed1990

[Comparison of muscular load between normal handwriting and constrained writing forced by optical character reader (OCR) cards].

Optical character readers (OCR) were introduced into an office as input devices for a computer system. In order to input data in to the system, workers of this office had to write down the data on sheets of specially formatted paper, called OCR cards. Some workers engaged in this task complained of symptoms of occupational cervicobrachial disorders (OCD). Observation suggested that the constrained motion of writing on OCR cards may cause such symptoms. Therefore, in order to prevent OCD, the writing motion was analyzed. The electromyogram of the upper extremities and shoulders was also compared between normal handwriting and constrained writing on the OCR cards in laboratory studies. The results were as follows. 1. Writing time per letter for the OCR cards was longer than that for normal handwriting. 2. Discharge of muscles observed through electromyogram was larger per letter for the OCR cards than for the normal handwriting. 3. Discharge from the trapezius per unit time for the OCR cards was rather large. This phenomenon showed that the workload of constrained writing was heavier than that of normal handwriting. The results suggests that more careful preventive measures for OCD should be promoted in comparison with ordinary clerical tasks.

Adult↗
PubMed1978

Effects of relaxation training on cursive handwriting of fourth grade students.

A relaxation method of handwriting improvement was examined. The experimental and no-treatment control groups were composed of 10 students receiving a poor rating on handwriting characteristics and the normal control group of 10 was composed of students receiving average ratings. All three groups received nine trials of writing. Only the experimental group received relaxation training during each trial. The handwriting of the experimental group improved significantly while that of the no-treatment control group remained the same. Although the handwriting of the normal control group also improved significantly, at posttest they were no longer significantly different from the experimental group.

Child↗
PubMed1992

Handwriting and perceptual-motor skills in clumsy, dysgraphic, and 'normal' children.

Among various perceptual-motor tests, only visuomotor integration was significant in predicting accuracy of handwriting performance for the total sample of 59 children consisting of 19 clumsy children, 22 nonclumsy dysgraphic children, and 18 'normal' children. They were selected from a sample of 360 fourth-graders (10-yr.-olds). For groups of clumsy and 'normal' children, the prediction of handwriting performance is difficult. However, correlations among scores on 6 measures showed that handwriting was significantly related to visuomotor integration, visual form perception, and tracing in the total group and to visuomotor integration and visual form perception in the clumsy group. The weakest correlations occurred between tests measuring simple psychomotor functions and handwriting. Moreover, clumsy children were expected to do poorly on tests measuring aiming, tracing, and visuomotor integration, but not on tests measuring visual form perception and finger tapping. Dysgraphic children were expected to do poorly on visuomotor integration only.

Child↗
PubMed2002

Long-term consequences of switching handedness: a positron emission tomography study on handwriting in "converted" left-handers.

Until some decades ago, left-handed children who attended German schools were forced to learn to write with their right hand. To explore the long-term consequences of switching handedness, we studied the functional neuroanatomy of handwriting in 11 adult "converted" left-handers and 11 age-matched right-handers. All participants had used exclusively their right hand for writing since early childhood. Using [15O]H2O positron emission tomography, changes in normalized regional cerebral blood flow (rCBF) were assessed while participants repetitively wrote a stereotyped word with their right hand. The kinematics of handwriting did not differ between converted left-handers and right-handers. In innate right-handers, handwriting caused a preponderant left-hemispheric activation of parietal and premotor association areas. In contrast, converted left-handers demonstrated a more bilateral activation pattern with distinct activation foci in the right lateral premotor, parietal, and temporal cortex. Moreover, foci in the right rostral supplementary motor area and the right inferior parietal lobule demonstrated a positive linear relationship between the degree of "left-handedness" and normalized rCBF during right-hand writing. Functional activity in the primary sensorimotor cortex was not affected by handedness. Our findings provide evidence for persisting differences in the functional neuroanatomy of handwriting between right-handers and converted left-handers, despite decades of right-hand writing. Right-hemispheric activation in converted left-handers may reflect suppression of unwanted left-hand movements. Alternatively, this activity may represent persistent left-handedness and, as such, demonstrate a hemispheric asymmetry of hand movement representations in cortical motor association areas in relation to the direction and degree of handedness.

Acoustic Stimulation↗
PubMed1994

[Recognition of familiar handwriting after left hemisphere and right hemisphere brain damage].

The recognition of handwriting is a specific achievement of the brain which need not be connected to understanding the written text itself. The goal of this study was to determine how this ability is impaired in patients with left- or right-sided lesions. Seventeen aphasic patients with lesions in the left hemisphere, 16 patients with lesions in the right hemisphere, and 15 normal controls (without CNS illness or damage) were investigated. They were asked to recognize the handwriting of a person well-known to them among a sample of ten different handwritten texts. The aphasic patients were able to recognize the handwriting of the familiar person either immediately or after some delay in 96%, the non-aphasic patients in only 44%, and the healthy controls in 100% of the cases. Results indicate that the recognition of handwriting represents a specific achievement which is independent of other verbal and lexical tasks. It is a task which involves the recognition of figural, geometric spatial patterns and, thus, an achievement of the non-dominant hemisphere.

Adult↗
PubMedDate not supplied

Copying and handwriting ability in the screening of cognitive dysfunction in old age.

Geometric copying and handwriting tests are often assessed in the screening of cognitive deficiency in the elderly. The aim of the study was to show the regression of geometrical copying and handwriting with increasing cognitive impairment in old age. The study is population-based and includes 668 subjects aged 75 years and older, living in an inner-city area of Stockholm. The subjects were asked to copy a cube, two pentagons, a rhombus, two intersecting rectangles, and a circle. They were also asked to write a complete sentence spontaneously, a sentence from dictation and their name. Geometric copying and handwriting skills decreased in direct proportion to decreased cognitive functioning. The skills most sensitive to small changes in cognition were copying the cube and the pentagons. Other skills were less sensitive to small changes: writing a complete sentence, copying a rhombus, two rectangles and writing one's name. However, copying and handwriting appear to complement each other. Copying of the rectangles and rhombus is more useful than the other figures because these two can be discriminated throughout different stages of dementia. Sentence writing from dictation and signature can be used to evaluate severely impaired subjects because these skills seem to be retained longer than the spontaneous sentence writing.

Journal Article↗
PubMed2004

Machine printed text and handwriting identification in noisy document images.

In this paper, we address the problem of the identification of text in noisy document images. We are especially focused on segmenting and identifying between handwriting and machine printed text because: 1) Handwriting in a document often indicates corrections, additions, or other supplemental information that should be treated differently from the main content and 2) the segmentation and recognition techniques requested for machine printed and handwritten text are significantly different. A novel aspect of our approach is that we treat noise as a separate class and model noise based on selected features. Trained Fisher classifiers are used to identify machine printed text and handwriting from noise and we further exploit context to refine the classification. A Markov Random Field-based (MRF) approach is used to model the geometrical structure of the printed text, handwriting, and noise to rectify misclassifications. Experimental results show that our approach is robust and can significantly improve page segmentation in noisy document collections.

Algorithms↗
PubMed1993

Generalized representation of handwriting: evidence of effector independence.

Previous analyses of writing data have provided qualitative evidence of temporal and spatial similarities across muscle effectors. In order to further explore the notion of effector independence in handwriting a single case study approach was adopted that employed quantitative analyses. A left-handed individual who lost his left hand and forearm in an automobile accident and wore a myoelectric arm was tested. After his accident he learned to write with the right hand developing this skill for 8 years. Once he was fitted with the myoelectric arm he began again to write with the left hand. Thus, the acquired writing patterns of both hands reflect two well-learned skills which utilize different muscle effectors. Wright's NAME-EQUATION paradigm (1990) was utilized which required the subject to write his name and the equation X + Y = Z with the dominant, non-dominant hand and the elbow of the dominant arm. A control subject was also tested. For the subject wearing a myoelectric arm (primary subject), kinematic and handwriting analysis revealed astonishing similarities between the different effectors tested. For the control subject, the obtained results showed that as the effectors changed so did the handwriting kinematics. The collective findings support the hypothesis that motor programs, the directives that guide skilled movement, can be generalized across different effectors, but only after considerable practice.

Adult↗
PubMed1982

Is handwriting posture associated with differences in motor control? An analysis of asymmetries in the readiness potential.

Levy and Reid's [1] hypothesis that persons who write using the inverted posture have ipsilateral control of distal limb movements, particularly those involved in handwriting, was tested in three experiments in which asymmetries in the readiness potential (RP) were measured. In the first experiment, each subject executed a self-paced repetitive squeeze. Contralaterally larger RPs were recorded from all subjects, irrespective to handwriting posture. In two other experiments, subjects performed the self-paced squeeze in one condition and wrote a single word repetitively in an analogous condition. Larger RPs were recorded over the contralateral cerebral hemisphere in most inverted-writing subjects in both conditions. Ipsilaterally larger RPs were recorded, however, from some left-handers while writing. These findings suggest that, although control of certain movements may originate from the ipsilateral motor cortex in a small proportion of left-handers, handwriting posture does not index this difference.

Adolescent↗
PubMed2005

The influence of writing practice on letter recognition in preschool children: a comparison between handwriting and typing.

A large body of data supports the view that movement plays a crucial role in letter representation and suggests that handwriting contributes to the visual recognition of letters. If so, changing the motor conditions while children are learning to write by using a method based on typing instead of handwriting should affect their subsequent letter recognition performances. In order to test this hypothesis, we trained two groups of 38 children (aged 3-5 years) to copy letters of the alphabet either by hand or by typing them. After three weeks of learning, we ran two recognition tests, one week apart, to compare the letter recognition performances of the two groups. The results showed that in the older children, the handwriting training gave rise to a better letter recognition than the typing training.

Child, Preschool↗
PubMed2006

A novel instrument for quantifying grip activity during handwriting.

OBJECTIVE: To describe and exemplify a noninvasive instrumentation system that uniquely records grip forces exerted on the barrel of the writing utensil along with typical temporal and kinematic parameters. DESIGN: Exploratory case series. SETTING: A tertiary care, pediatric rehabilitation hospital. PARTICIPANTS: Convenience sample of 6 primary school children with spastic hemiplegic cerebral palsy (CP) with documented fine motor difficulties and 6 children with no known handwriting difficulties. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Grip and normal forces during handwriting. RESULTS: The instrumentation revealed nontrivial correlations between normal and grip forces (0.55 +/- 0.16), a temporal delay between normal and grip forces (97.7 +/- 16 ms), and a consistent grip-to-normal force ratio (4.3 +/- 1.5), across all participants. Grip force distributions agreed intuitively with qualitative observations of individual grasps of the writing utensil. Further, 5 new parameters derived from grip force measures statistically differentiated between able-bodied children and those with hemiplegic CP. CONCLUSIONS: The proposed instrumentation provides new insight into grip and normal force coordination and has the potential to uncover discriminatory grip force characteristics between writers with and without handwriting difficulties. Further study with larger populations is required to define functional ranges for the new grip measures.

Biomechanical Phenomena↗
PubMed1989

Inverted handwriting posture in left handers is related to familial sinistrality incidence.

McKeever (1979) reported that left handers who wrote with an inverted handwriting posture (IHP) had a higher incidence of left handedness in their families than did left handers who wrote with a non-inverted handwriting posture (NHP). Parlow and Kinsbourne (1981), however, failed to find a relationship between handwriting posture (HWP) and positive familial sinistrality (FS+). McKeever had classified his left handed subjects according to whether they had several, one, or no left handers among their first degree relatives and biologically-related second degree relatives. Parlow and Kinsbourne classified subjects as FS- or FS+ on the basis of first degree relatives and did not inquire about the handedness of second degree relatives. In the present study, handedness for writing of all first and second degree relatives was recorded for 216 NIP and 255 IHP left handers. Results showed a significant association of HWP and FS factors when second degree relatives were considered, but not when second degree relative handedness was ignored. The relationship was strongest within the maternal family line, where the proportion of left handers was more than twice as high for the IHP as for the NHP group. These findings suggest that HWP may well be of some importance for a complete understanding of the cerebral organization of left handers.

Adult↗