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

다국어 초록 (Multilingual Abstract)

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.

참고문헌 (Reference)

1 이한솔 ; 윤진영 ; 조진환 ; 안종현 ; 윤지혜 ; 나덕렬, "파킨슨병의 쓰기 특성: 필압, 크기, 속도를 중심으로" 한국언어청각임상학회 25 (25): 63-74, 2020

2 장윤원 ; 조성래 ; 윤지혜 ; 김향희, "파킨슨병의 소자증 특성: 가로쓰기와 세로쓰기의 비교" 한국언어청각임상학회 21 (21): 683-694, 2016

3 김선우 ; 윤지혜 ; 이승진, "파킨슨병 환자의 교대운동속도 과제에서 관찰된 ‘말 뭉침’의 음향학적 특성" 한국음성학회 7 (7): 55-62, 2015

4 유연환 ; 박진혁 ; 이주현, "파킨슨병 환자의 Handwriting 기능 향상을 위한운동학습 전략에 대한 문헌 고찰" 대한신경계작업치료학회 4 (4): 29-38, 2015

5 김선우 ; 윤지혜 ; 장수은 ; 손영호 ; 조성래 ; 김향희, "말 산출에서 피질하 구조의 역할" 대한신경과학회 30 (30): 1-9, 2012

6 Hamman, R. G., "Training effects during repeated therapy sessions of balance training using visual feedback" 73 (73): 738-744, 1992

7 Sabes, P. N., "The planning and control of reaching movements" 10 (10): 740-746, 2000

8 Kim, J. U., "The function of basal Ganglia &Parkinson’s disease" 9 (9): 159-170, 2002

9 Wu, T., "The cerebellum in Parkinson's disease" 136 (136): 696-709, 2013

10 Weismer, G., "The Dysarthrias: Physiology, Acoustics, Perception, Management" College-Hill Press 101-130, 1984

11 Morris, M. E., "Stride length regulation in Parkinson’s disease : Normalization strategies and underlying mechanisms" 119 (119): 551-568, 1996

12 Smits, E. J., "Standardized handwriting to assess bradykinesia, micrographia and tremor in Parkinson’s disease" 9 (9): e97614-, 2014

13 Goerendt, I. K., "Reward processing in health and Parkinson’s disease : Neural organization and reorganization" 14 (14): 73-80, 2004

14 Kent, R. D., "Prosodic disturbance and neurologic lesion" 15 (15): 259-291, 1982

15 Jankovic, J., "Parkinson’s disease: Clinical features and diagnosis" 79 (79): 368-376, 2008

16 Wu, T., "Neural correlates of dual task performance in patients with Parkinson’s disease" 79 (79): 760-766, 2008

17 Sharpe, M. H., "Motor planning in Parkinson patients" 21 (21): 455-462, 1983

18 Nieuwboer, A., "Motor learning in Parkinson’s disease : Limitations and potential for rehabilitation" 15 (15): S53-S58, 2009

19 Kim, E. J., "Micrographia on free writing versus copying tasks in idiopathic Parkinson's disease" 11 (11): 57-63, 2005

20 Oliveira, R. M., "Micrographia in Parkinson’s disease: The effect of providing external cues" 63 (63): 429-433, 1997

21 Yoon, J. H., "Korean agraphia subsequent to right hemispheric lesion" 13 (13): 121-132, 2006

22 Eckert, T., "Increased pre-SMA activation in early PD patients during simple self-initiated hand movements" 253 (253): 199-207, 2006

23 Playford, E. D., "Impaired mesial frontal and putamen activation in Parkinson’s disease : A positron emission tomography study" 32 (32): 151-161, 1992

24 National Institutes of Health, "Image J" National Institutes of Health

25 Wouters, P., "How to optimize learning from animated models : A review of guidelines based on cognitive load" 78 (78): 645-675, 2008

26 Rosenblum, S., "Handwriting as an objective tool for Parkinson’s disease diagnosis" 260 (260): 2357-2361, 2013

27 이찬녕 ; 엄광문 ; 박건우 ; 고성범 ; 김병조 ; 오경미 ; 김호정 ; 이대희, "Foot Scan System을 이용한 파킨슨병 환자의 역동적 족압 분석" 대한신경과학회 25 (25): 172-179, 2007

28 Taleb, C., "Feature Selection for an Improved Parkinson’s Disease Identification Based on Handwriting" IEEE 2017

29 Olanow, C. W., "Etiology and pathogenesis of Parkinson’s disease" 22 (22): 123-144, 1999

30 Kim, H., "Efficacy of languageappropriate cueing on micrographia in Korean patients with Parkinson’s disease" 15 (15): 647-651, 2015

31 Contreras-Vidal, J. L., "Effects of Parkinsonism on motor control" 58 (58): 165-176, 1996

32 Wu, T., "Effective connectivity of brain networks during self-initiated movement in Parkinson’s disease" 55 (55): 204-215, 2011

33 Kim, S. Y., "Dementia with Parkinsonism : Parkinson’s disease dementia" 1 (1): 73-76, 2002

34 Mallol, R., "Compensatory cortical mechanisms in Parkinson's disease evidenced with fMRI during the performance of pre-learned sequential movements" 1147 : 265-271, 2007

35 Middleton, F. A., "Cerebellar projections to the prefrontal cortex of the primate" 21 (21): 700-712, 2001

36 Lee, J. Y., "Brief screening for mild cognitive impairment in elderly outpatient clinic : Validation of the Korean version of the Montreal Cognitive Assessment" 21 (21): 104-110, 2008

37 Yoon, J. H, "Brief agraphia test"

38 Lange, K. W., "Brain dopamine and kinematics of graphomotor functions" 25 (25): 492-509, 2006

39 Bryant, M. S., "An investigation of two interventions for micrographia in individuals with Parkinson’s disease" 24 (24): 1021-1026, 2010

40 Van Galen, G. P., "Advances in Handwriting and Drawing: A Multidisciplinary Approach" Europia 403-419, 1994

41 Lee, Y. H., "A study of the reliability and the validity of the BDI, SDS, and MMPI-D scales" 10 (10): 98-113, 1991

42 Christensen, K. J., "A cognitive battery for dementia : Development and measurement characteristics" 3 (3): 168-, 1991