出版社：Japanese Association of Occupational Therapists
摘要：Objective: Handwriting, which consists of multiple joint movements in the upper extremity, is a suitable model to investigate motor control after hemiplegic stroke. We analyzed pen tip movement during handwriting in relation to the finger and wrist to reveal tightening and joint linkage that control writing movements done by a hemiplegic hand. Methods: Thirteen right-handed individuals with right-sided mild hemiplegia after a stroke and 14 age-matched, right-handed controls were included. Movements of the pen tip, finger, and wrist were recorded using a three-dimensional movement analyzer. We investigated their writing performance by measuring writing time, variabilities of pen tip kinematics and trajectory. Movement linkage of the joints during writing was quantified by calculating the ratio of the trajectory size at the finger or wrist to that at the pen tip. Results: The time needed for writing and the kinematic variability did not differ between the hemiplegic and control groups. The tight linkage of the pen tip with the finger and wrist joint movement was found in hemiplegic handwriting, which was similar to nondominant hand use in the controls. The linkage parameter of hemiplegic handwriting significantly correlated with writing time and kinematic variability of the pen tip movement. Conclusion: Individuals with dominant-hand hemiplegia, in an attempt to produce consistently legible writing, may tighten the joint linkage of the finger and wrist to reduce the freedom of motion to control writing and simultaneously slow their writing speed, potentially resulting in increased kinematic variability of the pen tip movement.
关键词：handwriting;stroke;hemiplegia;three dimensional movement analysis;manual function
