Related Experiment Video
Updated: Jun 23, 2026
Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
Effects of modified pen grip and handwriting training on writer's cramp
Barbara Baur1, Waltraud Fürholzer, Isabelle Jasper
1Clinical Neuropsychology Research Group, Klinikum München-Bogenhausen, Munich, Germany. Barbara.Baur@extern.lrz-muenchen.de
Objective:
To evaluate the use of a modified pen grip and subsequent handwriting training in patients with writer's cramp (WC).
Design:
Handwriting performance with normal and modified pen grip was examined once in healthy controls and repeatedly in patients with WC (2 baseline tests before training, directly after training, after a 3-month follow-up).
Setting:
Ambulatory care for motor writing disorders.
Participants:
Patients with WC (n=26) and healthy controls (n=14).
Intervention:
Seven sessions of handwriting training with various motor exercises were conducted by an occupational therapist. During training, the patients always used a modified pen grip (stabilized between index and middle finger).
Main Outcome Measures:
Writing frequency and fluency, grip force on the pen, writing pressure, Fahn dystonia scale, visual analog scales for impairment and pain.
Results:
Patients with WC showed increased writing pressure and grip force before training. Using the modified pen grip caused in both patients with WC and controls a decrease in pressure and grip force. Handwriting training resulted in a further improvement of both parameters in patients with WC. Grip force reduction remained stable over follow-up.
Conclusions:
Results suggest that patients with WC benefit from the use of the modified pen grip in combination with handwriting training.
