Handwriting performance versus arm forward reach and grasp abilities among post-stroke patients, a case-control study

Area of Science:

• Neurorehabilitation
• Motor Control
• Stroke Recovery

Background:

• Limited evidence exists on handwriting deficits post-stroke compared to arm reaching and grasping.
• Stroke often impacts fine motor skills crucial for daily activities like writing.

Purpose of the Study:

• To quantify handwriting skill damage relative to arm reach and grasp in stroke patients.
• To compare motor deficits in handwriting versus upper limb function post-stroke.

Main Methods:

• Case-control study comparing 18 stroke patients and 19 healthy subjects.
• Utilized Computerized Penmanship Evaluation Tool, surface Electromyography, and Fugl-Meyer assessment.
• Assessed motor deficits in reaching, grasping, and handwriting.

Main Results:

• Stroke patients exhibited significant handwriting performance deficits (p < 0.05).
• Muscle performance predicted sentence writing ability (63.5%, p < 0.023); pen pressure correlated with Fugl-Meyer scores (74.9%, p < 0.05).
• Handwriting impairment exceeded proximal muscle activation deficits (p < 0.05); Fugl-Meyer scores negatively correlated with in-air writing time (r = -0.819, p < 0.004).

Conclusions:

• Dexterity and handwriting skills are more affected post-stroke than arm reach.
• Motor performance differences were not significant in mildly disabled patients.
• Handwriting rehabilitation is recommended for the hemiparetic upper extremity in mildly impaired stroke survivors.