Contributions
Abstract: P1315
Type: Poster
Abstract Category: RIMS - Multi-disciplinary rehabilitation
Writing is a mean of communication which requires complex motor, perceptual and cognitive skills. Although handwriting deficits are common in people with Multiple Sclerosis (PwMS), there are only few studies on this matter in the literature. To date there is not a standardized method to assess adults´ handwriting and it is still unclear what impairment mostly affects writing ability in PwMS.
The present study is a part of a project granted by the Italian Multiple Sclerosis Foundation (grant N° 2014/R/5) and aims at investigating the relation between clinical evaluation of different domains (e.g., strength, fatigue, cognition) and handwriting parameters in PwMS.
At present, 13 PwMS (9 females, mean age±SD: 46±11 years, mean EDSS±SD: 3.1±1.5) participated in the study and were evaluated with: dynamometer evaluation for pinch strength, Nine Hole Peg Test (NHPT), Visual Analog Scale (VAS) for self-perception of upper limb disability, Modified Fatigue Impact Scale (MFIS) and Symbol Digit Modalities Test. Moreover, PwMS were tested by means of the DGM-P test to assess grapho-motor impairments during writing. They were required to write a sentence twice, as accurate and as fast as possible. As outcome parameters time to write the sentence, inaccuracy of the tract (dysmetria), distance from the line (fluctuation), ascending/descending tracts disproportion and variability in letters height were measured. Analysis included Pearson´s or Spearman´s correlation coefficient between clinical tests and writing parameters, depending on data distribution.
Results showed a significant correlation between dysmetria and MFIS (R= -0.67, p< 0.05), fluctuation and pinch strength (R= -0.59, p=0.003), fluctuation and NHPT (R= 0.58, p< 0.05), tracts disproportion and pinch strength (R= -0.62, p< 0.05), tracts disproportion and VAS on perceived weakness (R= 0.85, p< 0.05), and variability and NHPT(R= 0.68, p< 0.05).
We can conclude that upper limb weakness plays a crucial role in writing dysfunction, since pinch deficit and VAS higher values were related to increased handwriting fluctuation and tracts disproportion. Moreover, patients reporting higher fatigue showed decreased handwriting dysmetria. This apparent paradox was previously reported in the literature, and can be an index of a greater effort (causing fatigue) needed to reach higher performance. Finally, tests evaluating manual dexterity, such as NHPT, seem to be reliable tools to assess handwriting in PwMS.
Disclosure: Ludovico Pedullà: nothing to disclose.
Ambra Bisio: nothing to disclose.
Laura Bonzano: nothing to disclose.
Andrea Tacchino: nothing to disclose.
Giampaolo Brichetto: nothing to disclose.
Marco Bove: nothing to disclose.
Abstract: P1315
Type: Poster
Abstract Category: RIMS - Multi-disciplinary rehabilitation
Writing is a mean of communication which requires complex motor, perceptual and cognitive skills. Although handwriting deficits are common in people with Multiple Sclerosis (PwMS), there are only few studies on this matter in the literature. To date there is not a standardized method to assess adults´ handwriting and it is still unclear what impairment mostly affects writing ability in PwMS.
The present study is a part of a project granted by the Italian Multiple Sclerosis Foundation (grant N° 2014/R/5) and aims at investigating the relation between clinical evaluation of different domains (e.g., strength, fatigue, cognition) and handwriting parameters in PwMS.
At present, 13 PwMS (9 females, mean age±SD: 46±11 years, mean EDSS±SD: 3.1±1.5) participated in the study and were evaluated with: dynamometer evaluation for pinch strength, Nine Hole Peg Test (NHPT), Visual Analog Scale (VAS) for self-perception of upper limb disability, Modified Fatigue Impact Scale (MFIS) and Symbol Digit Modalities Test. Moreover, PwMS were tested by means of the DGM-P test to assess grapho-motor impairments during writing. They were required to write a sentence twice, as accurate and as fast as possible. As outcome parameters time to write the sentence, inaccuracy of the tract (dysmetria), distance from the line (fluctuation), ascending/descending tracts disproportion and variability in letters height were measured. Analysis included Pearson´s or Spearman´s correlation coefficient between clinical tests and writing parameters, depending on data distribution.
Results showed a significant correlation between dysmetria and MFIS (R= -0.67, p< 0.05), fluctuation and pinch strength (R= -0.59, p=0.003), fluctuation and NHPT (R= 0.58, p< 0.05), tracts disproportion and pinch strength (R= -0.62, p< 0.05), tracts disproportion and VAS on perceived weakness (R= 0.85, p< 0.05), and variability and NHPT(R= 0.68, p< 0.05).
We can conclude that upper limb weakness plays a crucial role in writing dysfunction, since pinch deficit and VAS higher values were related to increased handwriting fluctuation and tracts disproportion. Moreover, patients reporting higher fatigue showed decreased handwriting dysmetria. This apparent paradox was previously reported in the literature, and can be an index of a greater effort (causing fatigue) needed to reach higher performance. Finally, tests evaluating manual dexterity, such as NHPT, seem to be reliable tools to assess handwriting in PwMS.
Disclosure: Ludovico Pedullà: nothing to disclose.
Ambra Bisio: nothing to disclose.
Laura Bonzano: nothing to disclose.
Andrea Tacchino: nothing to disclose.
Giampaolo Brichetto: nothing to disclose.
Marco Bove: nothing to disclose.