Opposite Effects of Visual Cueing During Writing-Like Movements of Different Amplitudes in Parkinson’s Disease

Abstract

Visual target lines of 1.0 cm improved the writing of sequential loops in contrast to lines spaced at 0.6 cm. These results illustrate that, unlike for gait, visual cueing for fine-motor tasks requires a differentiated approach, taking into account the possible increases of accuracy constraints imposed by cueing.

Relearning of Writing Skills in Parkinson's Disease After Intensive Amplitude Training

“…The different task demands of the untrained task, requiring a larger amplitude, may offer an explanation for this task effect. A recent study suggested that writing in smaller amplitudes in the presence of visual cues added accuracy constraints and led to decreased writing performance . Thus, as the untrained task required larger strokes, micrographia may have been less distinct.…”

“…Transfer was tested using a trained and an untrained sequence, performed in both the presence and the absence of visual target zones (Supplementary Fig. 1B) . The trained sequence consisted of the same continuous 3‐loop sequence and the untrained sequence of a figure‐of‐eight‐like movement.…”

“…The Systematic Screening of Handwriting Difficulties (SOS) test was used to assess daily life writing. It involved writing a text for 5 minutes continuously and was previously used in PD …”

“…Data from the tablet were filtered at 7 Hz with a fourth‐order Butterworth filter and processed using Matlab R2011b. Writing amplitude (% of target size) and the within‐patient coefficient of variation of amplitude (COV ampl ) were determined by calculating the differences between the local minima and maxima of individual strokes . The target size was determined as the distance between the bottom of the blue and top of the yellow target zone for the loop sequence and between the bottom of the blue and top of the gray target zone for the figure‐of‐eight‐like movement.…”

Physical therapy and occupational therapy in Parkinson's disease

“…Rhythmic auditory cues even seem to reduce the interference effect of a dual task on gait [93,97]. In upper limb activities, visual cues can improve handwriting [98] and self-vocalization or auditory cues can improve the kinematics of reaching [99][100][101]. In addition to external cues, attentional strategies can be used [48,50,102,103].…”