The effects of pencil grip posture and different desk designs on handwriting performance in children with hemiplegic cerebral palsy

Abstract

Objective: The aim of this study was to investigate the effect of different ergonomic desk designs and pencil grip patterns on handwriting performance in children with hemiplegic cerebral palsy and healthy children. Methods:Twenty-six children with left hemiplegic cerebral palsy and 32 typically developing children were included. The Minnesota Handwriting Assessment was used to evaluate handwriting abilities. Pencil grip posture was assessed with a 5-point rating system. Specifically designed adjustable desks and chairs were used. Four different desk types were used in this study: 1) regular desk; 2) regular desk with a 20º inclination; 3) cutout desk; and 4) cutout desk with a 20º inclination.Results: Statistically significant differences were found between both groups in terms of handwriting ability (p < 0.001). There was no significant difference regarding grip scores between children with cerebral palsy and healthy children (p > 0.05). We found that children with cerebral palsy had better performance using cutout desks in relation to rate and spacing parameters of handwriting (p < 0.05). Conclusion:The results of our study demonstrated that the pencil grip patterns have no effect on the handwriting parameters in both children with cerebral palsy and healthy children. It is recommended that a cutout table be used to provide more upper extremity support in handwriting activities for students with cerebral palsy.J Pediatr (Rio J). 2009;85(4):346-352: Handwriting, cerebral palsy, ergonomics. ResumoObjetivo: O objetivo deste estudo foi investigar o efeito de diferentes modelos ergonômicos de mesa e dos padrões de pega do lápis sobre o desempenho na caligrafia de crianças com paralisia cerebral hemiplégica e de crianças saudáveis.Métodos: Vinte e seis crianças com paralisia cerebral hemiplégica esquerda e 32 crianças com desenvolvimento normal foram incluídas. O Minnesota Handwriting Assessment foi utilizado para avaliar as habilidades de caligrafia. A postura de pega do lápis foi avaliada por meio de um sistema de avaliação de 5 pontos. Mesas e cadeiras ajustáveis especificamente projetadas foram utilizadas. Quatro tipos diferentes de mesas foram usados neste estudo: 1) mesa padrão; 2) mesa padrão com 20º de inclinação; 3) mesa recortada; e 4) mesa recortada com 20º de inclinação.Resultados: Diferenças estatisticamente significativas foram encontradas entre os dois grupos no que se refere à habilidade de caligrafia (p < 0,001). Não houve diferença significativa com relação aos escores de pega entre as crianças com paralisia cerebral e as crianças saudáveis (p > 0,05). Constatamos que as crianças com paralisia cerebral tiveram melhor desempenho utilizando as mesas recortadas nos parâmetros velocidade e espaçamento da caligrafia (p < 0,05). Conclusão:Os resultados de nosso estudo demonstraram que os padrões de pega do lápis não têm efeito sobre os parâmetros da caligrafia tanto das crianças com paralisia cerebral quanto das crianças saudáveis. Recomenda-se que mesas recortadas sejam usadas para oferecer mai...

Mudança na Destreza Manual do Aluno com Paralisia Cerebral Frente ao Mobiliário Escolar Adequado

“…The data indicated a significant difference in the activity execution time and in the Vertical Velocity Peak when the participants used appropriate furniture to their anthropometric measurements, but there was no significant difference in the performance in relation to the vertical acceleration. The use of a table with a 20º slope has been efficient in the parameters of speed and calligraphy size of children with CP and in speed for healthy children, since this furniture can offer a better visuomotor organization (Kavak & Bumin, 2009). Increased speed in writing or drawing means improvement or automatism of the motor act; however, it does not mean improvement in fluency because the student can automate his/her writing and worsen readability (Gimenez, 2006).…”

Harf Çizgilerini Çizme Yönü ile Çizme Hızı ve Çizgi Niteliği Arasındaki İlişki

“…(Alston, 1986;Halıcı, 2019), yazı biçemi (Bara, 2013), yaş, okul, sınıf, cinsiyet, kullanılan el, kağıdın duruşu, kalem tutuş, vücudun duruşu, yazılan metnin türü, yerleşim yeri, okul öncesi eğitim alma (Arslan ve Bağcı, 2017;Arslan ve Ilgın, 2010;Çevik, 2006;Doğan, 2007;Duran, 2011;Erdoğan, 2012;Höbek ve Taşkaya, 2018;Vlachos ve Bonoti, 2006;Yıldız vd. 2015), sınıf öğretmeni Bayraktar, 2006) sıra tasarımı (Kavak ve Bumin, 2009;Medwell ve Wray, 2007) görsel algı (Memiş ve Harmankaya, 2012) kalemi sıkma gücü (Schneck, 1991;Schneck ve Henderson, 1990;Summers ve Catarro, 2003) ve öğrenme güçlüğü (Blöte ve Hamstra, 1991;Fatemeh vd., 2008;Hamstra ve Blöte, 1993; Overlede vd. 2011) arasındaki ilişki üzerinde durulmuştur.…”

An investigation of the factors affecting handwriting articulation of school aged children with cerebral palsy based on the international classification of functioning, disability and health

“…One study found that 81.3% of children with cerebral palsy were found to write incorrect, uneven and unrecognizable letters 1 ) . Previous studies 1 , 2 , 3 , 4 , 5 ) of handwriting related factors of children with cerebral palsy have been carried out, but these studies had limitations regarding the identification of comprehensive relevant factors and the selection of efficient priorities. In the last ten years, perspectives on outcome assessments of cerebral palsy have been influenced and shaped by the World Health Organization’s International Classification of Functioning, Disability, and Health (ICF) 6 ) , as a guiding principle.…”