背景:显微照相,或者小笔迹,是帕金森病(PD)的常见症状。以前建议使用加权笔来改善笔迹,但支持其有效性的研究有限。此外,先前的研究表明,音乐作为听觉线索可以减少精细运动运动的变异性,但它对PD患者笔迹的影响仍然未知。
目的:这项研究通过评估加重笔和听觉提示对笔迹的有效性,探索了对PD患者的潜在笔迹干预措施。
方法:这是一项初步队列研究。
方法:八个患有PD的老年人使用标准笔和加重笔在1.5厘米的衬纸上写下连续的草书“l”,总共10秒钟,同时在4种情况下聆听听觉提示:控制(静音),节拍器,激活音乐,放松的音乐。运动数据是用连接在每支笔尖上的传感器测量的,并使用粘附在趾伸肌和第一骨间背侧的肌电图传感器测量肌肉活动。
结果:用标准笔书写时,节拍器中的峰到峰时间减少(对照=0.807±0.121秒,节拍器=0.701±0.100秒,p=0.024)和激活(控制=0.807±0.121秒,激活=0.691±0.113秒,p=0.009)与对照条件相比的条件。此外,与标准笔相比,加权笔增加了字母峰之间距离的变异性(标准=0.187±0.010,加权=0.482±0.065,p=0.033)和完成每个字母所需时间的变异性(标准=0.176±0.010,加权=0.187±0.016,p=0.042).最后,节拍器中指伸肌的曲线下面积减少(节拍器=66.03±25.74mV,control=88.98±30.40mV,p=0.034)和激活音乐(激活=66.49±26.02mV,control=88.98±30.40mV,p=0.012)条件与用标准笔书写时的对照相比。
结论:这些结果表明,加权笔可能无法改善新手用户的笔迹,但是听觉线索似乎是有益的。这可以为PD患者的手写干预的研究和临床应用提供未来的方向。
BACKGROUND: Micrographia, or small handwriting, is a common symptom of Parkinson\'s disease (PD). Weighted pens have previously been recommended to improve handwriting, but there is limited research supporting their effectiveness. Additionally, previous research has demonstrated that music as an auditory cue can reduce variability in fine motor movements, but its effect on handwriting in people with PD remains unknown.
OBJECTIVE: This study explored potential handwriting interventions for people with PD by evaluating the effectiveness of weighted pens and auditory cues on handwriting.
METHODS: This was a pilot cohort study.
METHODS: Eight older adults with PD used a standard pen and a weighted pen to write continuous cursive \"l\"s on 1.5-cm-lined paper for a total of 10 seconds while listening to auditory cues in 4 conditions: control (silence), metronome, activating music, and relaxing music. Kinematic data were measured with sensors attached to the tip of each pen, and muscle activity was measured with electromyography sensors adhered to the extensor digitorum communis and first dorsal interosseous.
RESULTS: When writing with the standard pen, peak-to-peak time was reduced in the metronome (control = 0.807 ± 0.121 seconds, metronome = 0.701 ± 0.100 seconds, p = 0.024) and activating (control = 0.807 ± 0.121 seconds, activating = 0.691 ± 0.113 seconds, p = 0.009) conditions compared to the control condition. Furthermore, the weighted pen increased the variability of distance between letter peaks (standard = 0.187 ± 0.010, weighted = 0.482 ± 0.065, p = 0.033) and the variability of time needed to complete each letter (standard = 0.176 ± 0.010, weighted = 0.187 ± 0.016, p = 0.042) compared to the standard pen. Finally, area under the curve of the extensor digitorum communis was reduced in the metronome (metronome = 66.03 ± 25.74 mV, control = 88.98 ± 30.40 mV, p = 0.034) and activating music (activating = 66.49 ± 26.02 mV, control = 88.98 ± 30.40 mV, p = 0.012) conditions compared to control when writing with the standard pen.
CONCLUSIONS: These results suggest that weighted pens may not improve handwriting in novice users, but auditory cues appear beneficial. This can inform future directions in the research and clinical application of handwriting interventions for persons with PD.