Efficacy of language‐appropriate cueing on micrographia in<scp>K</scp>orean patients with<scp>P</scp>arkinson's disease

Kim, HyangHee; Yoon, Ji Hye; Nam, Hyo Suk

doi:10.1111/ggi.12313

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…Parkinsonism Micrographia in patients with PD may improve with visual (eg, writing within large predetermined square grids) or auditory cues (eg, verbally reminding patients to write bigger letters). 118,132,133 A pen that provides real-time verbal feedback during writing may be useful. 134 FOG is probably the most convincing illustration of how sensory cueing and attentional strategies may be used to temporally overcome symptoms.…”

Section: Interventions That May Improve Functioning In Everyday Situamentioning

confidence: 99%

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Variability of Movement Disorders: The Influence of Sensation, Action, Cognition, and Emotions

et al. 2020

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A BS TRACT: Patients with movement disorders experience fluctuations unrelated to disease progression or treatment. Extrinsic factors that contribute to the variable expression of movement disorders are environment related. They influence the expression of movement disorders through sensory-motor interactions and include somatosensory, visual, and auditory stimuli. Examples of somatosensory effects are stimulus sensitivity of myoclonus on touch and sensory amelioration in dystonia but also some less-appreciated effects on parkinsonian tremor and gait. Changes in visual input may affect practically all types of movement disorders, either by loss of its compensatory role or by disease-related alterations in the pathways subserving visuomotor integration. The interaction between auditory input and motor function is reflected in simple protective reflexes and in complex behaviors such as singing or dancing. Various expressions range from the effect of music on parkinsonian bradykinesia to tics. Changes in body position affect muscle tone and may result in marked fluctuations of rigidity or may affect dystonic manifestations. Factors intrinsic to the patient are related to their voluntary activity and cognitive, motivational, and emotional states. Depending on the situation or disease, they may improve or worsen movement disorders. We discuss various factors that can influence the phenotypic variability of movement disorders, highlighting the potential mechanisms underlying these manifestations. We also describe how motor fluctuations can be provoked during the clinical assessment to help reach the diagnosis and appreciated to understand complaints that seem discrepant with objective findings. We summarize advice and interventions based on the variability of movement disorders that may improve patients' functioning in everyday life.

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Section: Interventions That May Improve Functioning In Everyday Situamentioning

confidence: 99%

“…Micrographia in patients with PD may improve with visual (eg, writing within large predetermined square grids) or auditory cues (eg, verbally reminding patients to write bigger letters) 118,132,133 . A pen that provides real‐time verbal feedback during writing may be useful 134 …”

Section: Clinical Relevance Of Movement Disorders Variabilitymentioning

confidence: 99%

Variability of Movement Disorders: The Influence of Sensation, Action, Cognition, and Emotions

et al. 2020

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“…외적 단서 중에서는 특히 시각적 단서를 통해 손상 을 받지 않은 시각-운동 경로를 활용함으로써 손상된 기저핵 조 절 회로를 우회하는 방법의 하나로 제시되기도 한다. PD 환자의 보행과 관련된 외적 단서의 효과를 확인한 연구 (Morris et al, 1996) (Chang et al, 2016;Kim et al, 2015a).…”

Section: Introductionunclassified

“…이에 소자증을 보이는 PD 환자에게 평행선, 사각형의 방안선, 또는 점선 등의 시각적 단서나 "크게 쓰세요"라는 청각적 단서를 제시하여 글자 크기를 개선시킨 연구 결과들이 보고되면서 쓰기 수행에서도 외적 단서의 활용 가능성이 제안되었다 (Van Galen et al, 1994). 국내에서는 한글을 사용하는 PD 환자를 대상으 로 연구자가 불러주는 단어를 듣고 받아쓰는 과제를 시행한 후, 시각적 단서로서 음절별로 구분된 사각형 칸과 청각적 단서로 "크게 쓰세요"라는 지시를 동시에 제시하였을 때 모든 음절의 글 자 크기가 증가하였다고 보고하였다 (Kim et al, 2015a). 국외에 서는 알파벳을 사용하는 PD 환자를 대상으로 스스로 쓰기와 위 아래 평행선을 제시한 쓰기 과제를 비교하여 평행선 단서를 제시 하였을 때 글자 크기가 증가한 것을 보고하였다 (Bryant et al, 2010).…”

Section: Introductionunclassified

Changes in Pen Pressure, Letter Size, and Writing Speed According to Visual Cues in Patients with Parkinson’s Disease

et al. 2022

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Purpose: Writing performance can be improved in patients with Parkinson’s disease (PD) by providing the visual cues. This study aimed to investigate the changes in pen pressure, letter size, and writing speed as per levels of visual cues.Methods: Sixty-three participants (38 PD patients and 25 normal adults) performed tasks, including sentence writing along visual cue levels using a tablet personal computer, digital pen, and software that could measure the pen pressure, stroke length, and duration.Results: First, the PD group’s pen pressure and letter size were improved when the visual cue was provided. Second, the effect of visual cues was shown more in the performance of ‘writing within square blanks’ than in the performance of ‘copying’ and ‘writing between parallel lines’. Especially, there were no significant differences between the groups in terms of the letter size in ‘writing within square blanks’.Conclusion: Despite movement disorders in PD patients, our findings suggest that pen pressure and letter size can be improved when the patients are provided visual cues. Our results indicate that providing visual cues hierarchically and objectively confirms changes in writing performance.

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“…그럼에도 불구하고, 지금까지 진행된 파킨 슨병 연구들 가운데, 이에 대한 연구는 2% 내외에 불과하다 (Yazawa, Kawasaki, & Ohi, 2003). 또한 소자증에 대한 연구 분야도 해당 질환에 대한 병리학적인 설명이나 인지적 부담의 경중에 따른 상관 성 (Kim et al, 2005;Rosenblum, Samuel, Zlotnik, Erikh, & Schlesinger, 2013;Van Gemmert, Teulings, & Stelmach, 2001) 혹은 근 육의 경직이나 운동상의 불협응 (Van Gemmert et al, 1998) (Kim et al, 2015;Kim, Cho, Lee, Na, & Lee, 1999)를 차지하고 있으므로, 해당 분야에 대한 연구가 요구되고 있다. 최근 Ma, Hwang, Chang과 Wang (2013) (1) 전체 구의 크기 변화율에 유의한 차이가 있는가?…”

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Micrographia in Parkinson’s Disease: Comparison between Horizontal and Vertical Handwritings

Chang

Cho²,

Yoon³

et al. 2016

Commun Sci Disord

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This paper was summarized from the master's thesis of the first author (2015). Objectives: Purposes of the study are to compare the degree of change in horizontal and vertical handwriting size between idiopathic Parkinson's disease (IPD) patients with progressive micrographia and a control group, and to determine if vertical handwriting can reduce the severity of micrographia. Methods: Eleven IPD patients who were at Hoehn and Yahr (H&Y) stages 2 and beyond with progressive micrographia were matched to a control group by such factors as age, gender, educational background and handedness. The tasks included horizontal as well as vertical writings of a palindrome ("yeobogejeogijeogeboyeo") and a single-syllable sequence ("bobobobobobo"). Results: In the PD group, upon writing vertically, the handwriting size of the whole phrase, of one syllable, and of 3-syllable words in palindrome was significantly larger in comparison to the horizontal handwriting. Similarly, in case of the single-syllable sequence, the vertical handwriting size of the whole sequence, of one syllable, and of 3-syllable words was found to be significantly greater in comparison to horizontal writing. Conclusion: Vertical writing instead of horizontal writing may help IPD patients to overcome micrographia. In the absence of external cues (e.g., parallel lines, square grids, auditory cues), vertical writing would assist the patients in maintaining a constant handwriting size in their daily lives.

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Efficacy of language‐appropriate cueing on micrographia inKorean patients withParkinson's disease

Cited by 7 publications

References 17 publications

Variability of Movement Disorders: The Influence of Sensation, Action, Cognition, and Emotions

Variability of Movement Disorders: The Influence of Sensation, Action, Cognition, and Emotions

Changes in Pen Pressure, Letter Size, and Writing Speed According to Visual Cues in Patients with Parkinson’s Disease

Micrographia in Parkinson’s Disease: Comparison between Horizontal and Vertical Handwritings

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