Characteristics of Handwriting of People With Cerebellar Ataxia: Three-Dimensional Movement Analysis of the Pen Tip, Finger, and Wrist
Characteristics of Handwriting of People With Cerebellar Ataxia: Three-Dimensional Movement Analysis of the Pen Tip, Finger, and Wrist
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DOI：
10.2522/ptj.20140118
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发表时间：
2015-11-01
期刊：
影响因子：
3.2
通讯作者：
Okajima, Yasutomo
中科院分区：
文献类型：
--
作者：
Fujisawa, Yuhki;Okajima, Yasutomo
背景。有几个用于评估手动性能的功能测试；然而，对共济失调的定量手工测试，特别是对笔迹的评估，是有限的。本研究旨在通过分析笔迹来探讨小脑共济失调的特征，特别强调笔尖运动与手指或手腕运动之间的相关性。这是一项观察性研究。研究人员招募了11名患有小脑性共济失调的右撇子和17名对照组。使用《共济失调评定评定量表》对共济失调的严重程度进行评定。分析了双手的书写动作。书写一个字所需的时间，个人笔迹的可变性，以及笔尖运动与手指或手腕运动之间的相关性，对患有共济失调的参与者和对照组的参与者进行了评估。与对照组相比，共济失调组书写时间更长，笔尖运动轨迹的速度分布和形状变化更大。对于共济失调的参与者，笔尖的运动方向与手指或手腕的运动方向偏差更大，笔尖的运动轨迹形状与手指或手腕的运动轨迹差异更大。上肢共济失调评定评定量表对上肢共济失调严重程度的评定与变异性参数的相关性最大。此外，它还与笔尖与手指运动轨迹的方向偏差以及轨迹形状的不相似性增加有关。结果可能受到用于测量运动的尺度和参数的影响。运动噪音增加的共济书写的特点是不规则的笔尖运动不受手指或手腕的限制。共济失调的严重程度与这些不受约束的运动有关。
Background. There are several functional tests for evaluating manual performance; however, quantitative manual tests for ataxia, especially those for evaluating handwriting, are limited.Objective. This study aimed to investigate the characteristics of cerebellar ataxia by analyzing handwriting, with a special emphasis on correlation between the movement of the pen tip and the movement of the finger or wrist.Design. This was an observational study.Methods. Eleven people who were right-handed and had cerebellar ataxia and 17 people to serve as controls were recruited. The Scale for the Assessment and Rating of Ataxia was used to grade the severity of ataxia. Handwriting movements of both hands were analyzed. The time required for writing a character, the variability of individual handwriting, and the correlation between the movement of the pen tip and the movement of the finger or wrist were evaluated for participants with ataxia and control participants.Results. The writing time was longer and the velocity profile and shape of the track of movement of the pen tip were more variable in participants with ataxia than in control participants. For participants with ataxia, the direction of movement of the pen tip deviated more from that of the finger or wrist, and the shape of the track of movement of the pen tip differed more from that of the finger or wrist. The severity of upper extremity ataxia measured with the Scale for the Assessment and Rating of Ataxia was mostly correlated with the variability parameters. Furthermore, it was correlated with the directional deviation of the trajectory of movement of the pen tip from that of the finger and with increased dissimilarity of the shapes of the tracks.Limitations. The results may have been influenced by the scale and parameters used to measure movement.Conclusions. Ataxic handwriting with increased movement noise is characterized by irregular pen tip movements unconstrained by the finger or wrist. The severity of ataxia is correlated with these unconstrained movements.