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This study explored visual perception skills and the ability to write according to standard stroke order and their links to the learning of Chinese handwriting. Thirty-seven children (aged 6-8) (15 boys and 22 girls) participated in a handwriting test and visual perception evaluation (Test of Visual Perceptual Skills-3rd Edition, TVPS-3). A computerized system was used to evaluate the stroke order accuracy, legibility, and automation of stroke movements. The stroke order accuracy was found to positively correlate with the scores of TVPS-3 (r = .498, p < .05) and to significantly correlate with handwriting legibility (r = .435, p < .05) as well as the automation of stroke movements (r = .494, p < .01). This study revealed that visual perception skill is related to stroke order accuracy and provides directions to assist students who encounter difficulties in learning Chinese handwriting.
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This study proposed a novel computational method for evaluating logographic handwriting. It can precisely evaluate both the handwriting product and the process. The measures included handwriting performance as well as the temporospatial, kinematics, and kinetics features. For examining the psychometrics of this comprehensive evaluation system, typical development children aged 6 to 9 years old (grade 1 to grade 3) (n = 641) were involved in the study of factor analysis. From twelve measuring variables, the exploratory factor analysis extracted five factors (handwriting performance, motor control, speed and automation, halt and exertion, and "in air" events). The test reliability was confirmed by further recruitment of typically developing children (n = 242). The internal consistency mostly demonstrated good to excellent results for every measure. This study further recruited children with handwriting difficulties (n = 33) for testing the discriminative validity of the evaluation system. A series of two-way ANOVA tests was conducted to test the significance of the main effects of the groups (typical development and handwriting deficit) and grades (1, 2, and 3) and their interaction effects on the handwriting measures. All the measures showed significant differences between the two groups, indicating the discriminative validity for identifying handwriting deficits. Seven of twelve measures showed significant interaction effects, indicating the different trends across the grades between the two groups. Typically-developing children demonstrated ongoing progress from grade 1 to grade 3, suggesting a developmental trend during their early school age. Implications for motor development and clinical evaluation are discussed herein in relation to the five dimensions.
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Escritura Manual , Instituciones Académicas , Fenómenos Biomecánicos , Niño , Humanos , Reproducibilidad de los ResultadosRESUMEN
Handwriting difficulties are common in children with Attention-Deficit/Hyperactivity Disorder (ADHD), and they have been associated with lower academic achievement and self-esteem. Our aim in this study was to determine if training coordination of the head, eyes, and arm and engaging in the necessary visual concentration associated with table tennis would improve executive functions and school-based handwriting among children with ADHD. We designed a randomized controlled trial to explore the therapeutic efficacy of this table tennis training and recruited 48 children with ADHD that we randomly assigned to one of three equal-sized training groups: (a) actual table tennis, (b) simulated table tennis (exergame), or (c) a control group receiving no additional training. The training intervention lasted 12-weeks in which the two different table tennis trainings (i.e., actual or simulated) were scheduled for three one-hour sessions per week. Outcome measures included a computerized handwriting evaluation, the Stroop test, and the Wisconsin Card Sorting Test (WCST). Participants in each table tennis training group showed significant improvements in handwriting performance, response time, and required time to achieve automation. Both intervention groups also showed significant improvements on the Stroop Color-Word test, but only the actual table tennis training group showed a significant improvement on the WCST. This study provided evidence of at least short-term improvements in executive functions and handwriting problems in children with ADHD through their participation in table tennis motor coordination activities.
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Trastorno por Déficit de Atención con Hiperactividad , Atención , Trastorno por Déficit de Atención con Hiperactividad/terapia , Niño , Función Ejecutiva/fisiología , Terapia por Ejercicio , Escritura Manual , HumanosRESUMEN
This study proposed a new technology to assess the accuracy of Chinese handwriting by comparing every stroke movement between a template model and a handwritten script. It tested the feasibility of a computerized evaluation in the parameterization of the handwriting deterioration caused by impaired cognitive function. This study recruited 22 participants with Alzheimer's disease (AD) and 14 with amnestic mild cognitive impairment (aMCI); 18 age- and gender-matched healthy elderly individuals made up the health control. The graphomotor tasks included drawing four straight lines (vertical, horizontal, and two diagonal) as well as writing Chinese words with simple vertical, horizontal and diagonal strokes. The temporal and spatial data were calculated to measure the motor coordination. The results in geographic drawing tests reveal significant differences among the three groups in task accuracy and movement fluency, especially in nonequivalent and wrist movements. The accuracy control of the graphic drawing in the AD and aMCI groups was significantly lower than that for the subjects in the normal group. These two groups also showed longer pauses in stroke movement with the handwriting tasks. The handwriting accuracy in the AD and aMCI groups was found to be significantly different from that of the subjects in the normal group. The results of this study can be used as an indicative reference for early detection of AD or aMCI, an objective evaluation for the effectiveness of interventions, and an assessment of disease progression.
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Disfunción Cognitiva/fisiopatología , Escritura Manual , Trastornos del Movimiento/fisiopatología , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/complicaciones , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/fisiopatología , Enfermedad de Alzheimer/psicología , Estudios de Casos y Controles , Disfunción Cognitiva/complicaciones , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/psicología , Computadoras de Mano , Diagnóstico Precoz , Femenino , Humanos , Masculino , Persona de Mediana Edad , Destreza Motora/fisiología , Trastornos del Movimiento/diagnóstico , Trastornos del Movimiento/etiología , Pruebas Neuropsicológicas , Desempeño Psicomotor , Muñeca/fisiopatologíaRESUMEN
In this paper, we introduce a newly developed multi-scale wavelet model for the interpretation of surface electromyography (SEMG) signals and validate the model's capability to characterize changes in neuromuscular activation in cases with myofascial pain syndrome (MPS) via machine learning methods. The SEMG data collected from normal (Nâ¯=â¯30; 27 women, 3 men) and MPS subjects (Nâ¯=â¯26; 22 women, 4 men) were adopted for this retrospective analysis. SMEGs were measured from the taut-band loci on both sides of the trapezius muscle on the upper back while he/she conducted a cyclic bilateral backward shoulder extension movement within 1â¯min. Classification accuracy of the SEMG model to differentiate MPS patients from normal subjects was 77% using template matching and 60% using K-means clustering. Classification consistency between the two machine learning methods was 87% in the normal group and 93% in the MPS group. The 2D feature graphs derived from the proposed multi-scale model revealed distinct patterns between normal subjects and MPS patients. The classification consistency using template matching and K-means clustering suggests the potential of using the proposed model to characterize interference pattern changes induced by MPS.
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Electromiografía/métodos , Aprendizaje Automático , Modelos Neurológicos , Músculo Esquelético/fisiopatología , Síndromes del Dolor Miofascial/fisiopatología , Adulto , Femenino , Humanos , Masculino , Músculo Esquelético/fisiología , Hombro/fisiología , Hombro/fisiopatologíaRESUMEN
This study examined the psychometric properties of motor praxis using a large school-based sample of children (n=239). We developed and evaluated the construct validity of a motor praxis assessment using confirmatory factor analysis (CFA). A model with four latent variables was evaluated for goodness of fit. CFA established that the scale was multifactorial and supported the four-factor model (motor imagery, verbal gesture production, imitative gesture production and knowledge of object-use). The internal consistency, inter-rater reliability and concurrent validity of the praxis assessment mostly demonstrated good to excellent results for the full scale and the subscales. The motor praxis demonstrated an ontogenic progression in 6-, 7- and 8-year-olds, suggesting a developmental trend during these ages, but with the exception of gestural representation on imitation. Implications for motor development and clinical evaluation are discussed herein in relation to the four instruments.
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Apraxias/diagnóstico , Gestos , Conocimiento , Movimiento , Psicometría/métodos , Niño , Análisis Factorial , Femenino , Florida , Humanos , Imágenes en Psicoterapia , Masculino , Reproducibilidad de los Resultados , Factores Sexuales , Encuestas y CuestionariosRESUMEN
We investigated a visual-perceptual and haptic-perceptual training program to enhance motor skills and Chinese handwriting performance among children with handwriting difficulties. The participants were 28 first- and second-grade children with handwriting difficulties. They were matched according to age and then randomly assigned into a control group or an experimental group. Participants in the experimental group received 12 sessions of a training program, whereas those in the control group received conventional handwriting training. The Test of Visual Perceptual Skills-Third Edition (TVPS-3), Tactual Performance Test (TPT), and Battery of Chinese Basic Literacy (BCBL) were all administered before and after 6 wk of intervention. Repeated-measures analysis of variance revealed that the experimental group showed significant improvement on the TVPS-3 but not on the TPT. Along with the improved visual-perceptual skills, the experimental group showed a significant difference in far-point copy speed and handwriting accuracy, as reflected in the BCBL.
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In this study, we explored the relationship between the clinical features and motor impairments related to the graphomotor function of individuals with Parkinson's disease (PD) and essential tremor (ET). We recruited 46 participants: 12 with PD, 13 with ET, and 21 controls. All participants were asked to perform six graphomotor tasks on a digitizer tablet: drawing straight lines, cursive-connected loops, discrete circles, and continuous circles, and making goal-aimed movements with a stylus in two different directions with three different accuracy constraints. The results showed that although participants with PD were able to draw straight lines slightly faster than controls, they produced cursive-connected loops much slower than controls. In addition, in contrast to controls and individuals with ET, PDs also drew the cursive loops progressively smaller. In the aiming task, we found that equivalent movements with high accuracy constraints were drawn slower by individuals with ET or PD than by controls. However, when performing the equivalent movements with moderate or low accuracy constraints, PDs performed similarly to controls. In contrast to the equivalent movements, PD and ET participants both performed nonequivalent movements slower than controls, no matter the demands arising from the accuracy constraints. The present study shows that simple graphic tasks can differentiate impairments in fine motor function resulting from ET and PD.
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Temblor Esencial/fisiopatología , Movimiento/fisiología , Enfermedad de Parkinson/fisiopatología , Anciano , Computadoras de Mano , Femenino , Humanos , MasculinoRESUMEN
The praxis test is a less well-documented method to determine functional manifestations of childhood dyspraxia. For this study, children aged 6-8years were recruited as follows: 17 children with DCD, 18 at risk of DCD and 35 without obvious problems in motor coordination. The Movement Assessment Battery for Children (MABC-2) was used to measure motor performance and identify the motor incoordination. This study developed a battery of tests to assess limb praxis using a praxis imagery questionnaire, gesture representation, and questions about knowledge of object use. In the comparison of subtests within the praxis test, significant differences were observed across groups on the praxis imagery questionnaire and gesture representation tests but not on knowledge of object use. Similar results were observed in the correlation analyses, in which a weak relationship between MABC-2 and praxis tests was observed. The DCD group had lower scores on the praxis imagery questionnaire, whereas the group at risk of DCD had lower scores on most gesture production tests. Our study provides a better understanding of the nature of the childhood dyspraxia and sheds light on its effect on motor coordination to identify praxis tests with specific clinical meanings in children with movement disorders.
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Ataxia/fisiopatología , Trastornos de la Destreza Motora/fisiopatología , Práctica Psicológica , Desempeño Psicomotor , Adolescente , Apraxias/fisiopatología , Apraxias/psicología , Ataxia/psicología , Niño , Femenino , Gestos , Humanos , Imaginación , Conducta Imitativa , Conocimiento , Masculino , Trastornos de la Destreza Motora/psicología , Pruebas Neuropsicológicas , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
BACKGROUND: People experiencing strong feelings of fatigue during exercise sometimes subconsciously yell to refocus their efforts and, thus, maintain exercise performance. The present study examined the influence of yelling during high-intensity exercise by analysing cardiorespiratory reactions and integrated electromyography (iEMG) changes in the vastus lateralis during a cycle ergometer test. METHODS: A total of 23 moderately trained people were recruited. The cycling test began with a resistance of 25 W/min, which was gradually increased. During the experimental trial, the participants were required to yell at least 3 times when they felt exhausted; during the controlled trial, they were not allowed to produce any yelling sounds. The testing order was randomly assigned and the 2 trials were completed within an interval between 3-10 days. Two-way repeated measures ANOVA was applied to analyse the differences within and between the trials, and interaction of trial and time. RESULTS: The peak power and time to exhaustion (p < 0.01) in the yelling trial were higher than those in the control trial. However, the vastus lateralis iEMG values of both trials at peak power were not significantly different. During the yelling period at 90%-100% of the maximal effort, a significant time-by-trial interaction (p < 0.05) was observed in oxygen consumption (VO2), CO2 production, O2 pulse, ventilation, and respiratory rate. All the above measures showed a significant between-trial difference (p < 0.02). However, heart rate, respiratory exchange ratio, end-tidal oxygen pressure, and ventilatory equivalent for oxygen showed only significant between-trial difference (p < 0.05), but without interaction of trial and time. CONCLUSION: Yelling enhances the peak O2 pulse and VO2 and maintains CO2-exclusion efficiency during high-intensity exercise. It may enable maintaining muscle activation without stronger EMG signals being required during high-intensity exercise.
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Since wrist-joint position affects finger muscle length and grip strength, we studied its biomechanical relevance in prolonged handwriting. We recruited participants from young adults, aged 18-24, and separated them into control (n=22) and in-pain (n=18) groups, based whether or not they experience pain while handwriting. The participants then performed a writing task for 30 min on a computerized system which measured their wrist-joint angle and documented their handwriting kinematics. The in-pain group perceived more soreness and had a less-extended wrist joint, longer on-paper time, and slower stroke velocity compared to control group. There was no significant difference in handwriting speed and quality between the two groups. The wrist extension angle significantly correlated with perceived soreness. Ergonomic and biomechanical analyses provide important information about the handwriting process. Knowledge of pen tip movement kinematics and wrist-joint position can help occupational therapists plan treatment for individuals with handwriting induced pain.
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Artralgia/fisiopatología , Fenómenos Biomecánicos/fisiología , Escritura Manual , Articulación de la Muñeca/fisiopatología , Adulto , Ergonomía , Femenino , Humanos , Masculino , Valores de Referencia , Articulación de la Muñeca/fisiología , Adulto JovenRESUMEN
The objective of this study was to compare the effect of computer-assisted practice with the sensorimotor approach on the remediation of handwriting problems in children with dysgraphia. In a randomized controlled trial, experiments were conducted to verify the intervention effect. Forty two children with handwriting deficit were assigned to computer-assisted instruction, sensorimotor training, or a control group. Handwriting performance was measured using the elementary reading/writing test and computerized handwriting evaluation before and after 6 weeks of intervention. Repeated-measures ANOVA of changed scores were conducted to show whether statistically significant differences across the three groups were present. Significant differences in the elementary reading/writing test were found among the three groups. The computer group showed more significant improvements than the other two groups did. In the kinematic and kinetic analyses, the computer group showed promising results in the remediation of handwriting speed and fluency. This study provided clinical evidence for applying a computer-assisted handwriting program for children with dysgraphia. Clinicians and school teachers are provided with a systematic intervention for the improvement of handwriting difficulties.
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Agrafia/terapia , Instrucción por Computador/métodos , Retroalimentación Sensorial , Escritura Manual , Práctica Psicológica , Educación Compensatoria/métodos , Agrafia/diagnóstico , Fenómenos Biomecánicos , Niño , Femenino , Humanos , Cinestesia , Masculino , Programas Informáticos , TaiwánRESUMEN
Dysgraphia of sufficient severity to interfere with the school work has been recognized as representing a distinct deficit; characterization of its movement problem is a necessary step toward offering improved intervention. From among children aged 6-8, 69 children with dysgraphic characteristics (study group) and 69 matched proficient hand-writers (control group) were recruited into this study. Four copying tests of differing complexity levels were administered using a digital tablet. The acquired data included direct measure (axial pen tip force) and derived parameters (stroke velocity, pause time, number of velocity peaks and ratio of In Air to On Paper measures). The major finding is that children with dysgraphic characteristics had increased pause time per stroke and an increased number of directional changes in velocity. Significant differences were also found between students in two different grades, especially in the control group. The parameters extracted and observed in this study can further differentiate and characterize the handwriting problems originating from fine motor deficits.
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Agrafia/fisiopatología , Escritura Manual , Trastornos de la Destreza Motora/fisiopatología , Destreza Motora/fisiología , Movimiento/fisiología , Agrafia/etiología , Fenómenos Biomecánicos , Niño , Femenino , Humanos , Masculino , Trastornos de la Destreza Motora/complicacionesRESUMEN
To solve the limitations in using the conventional parametric measures to define myofascial pain, a 3-D multi-scale wavelet energy variation graph is proposed as a way to inspect the pattern of surface electromyography (SEMG) variation between the dominant and nondominant sides at different frequency scales during a muscle contraction cycle and the associated changes with the upper-back myofascial pain. The model was developed based on the property of the wavelet energy of the SEMG signal revealing the degree of correspondence between the shape of the motor unit action potential and the wavelet waveform at a certain scale in terms of the frequency band. The characteristic pattern of the graph for each group (30 normal and 26 patient subjects) was first derived and revealed the dominant-hand effect and the changes with myofascial pain. Through comparison of individual graphs across subjects, we found that the graph pattern reveals a sensitivity of 53.85% at a specificity of 83.33% in the identification of myofascial pain. The changes in these patterns provide insight into the transformation between different fiber recruitment, which cannot be explored using conventional SEMG features. Therefore, this multi-scale analysis model could provide a reliable SEMG features to identify myofascial pain.
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Electromiografía/métodos , Fibromialgia/fisiopatología , Modelos Neurológicos , Contracción Muscular , Músculo Esquelético/fisiopatología , Unión Neuromuscular/fisiopatología , Transmisión Sináptica , Adulto , Algoritmos , Simulación por Computador , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modelos Estadísticos , Reproducibilidad de los Resultados , Sensibilidad y EspecificidadRESUMEN
This study aimed to understand the myoelectric and mechanical characteristics of muscle recovering from electrically elicited fatigue. A modified Burke fatigue protocol was delivered to activate the tibialis anterior of 13 spinal cord injured subjects for 4 min. Before and after the fatigue protocol, a series of pulse trains was delivered to induce three twitches and a fused contraction at 0, 1, 3, and 5 min and then followed every 5 min for 60 min. The recovery processes of the ankle dorsiflexion torque and the evoked electromyography (EMG) parameters were analyzed and characterized by a first-order exponential equation. The recovery process was found to be faster in regard to tetanic muscle contraction. Factors relating to low-frequency fatigue, postfatigue potentiation, and the quickly normalized relaxation rate were taken into account for the discussion of this result. During the recovery process, the disassociation was found not only between twitch and tetanic contractions but also between mechanical and myoelectric activities. After the complete normalization of EMG parameters from about 15 min post fatigue, the tetanic force recovered incompletely to an asymptotic level.
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Contracción Muscular/fisiología , Fatiga Muscular/fisiología , Músculo Esquelético/fisiopatología , Parálisis/fisiopatología , Traumatismos de la Médula Espinal/fisiopatología , Adulto , Análisis de Varianza , Estimulación Eléctrica , Electromiografía , Potenciales Evocados Motores/fisiología , Femenino , Humanos , Pierna , Masculino , Parálisis/etiología , Traumatismos de la Médula Espinal/complicaciones , Vértebras TorácicasRESUMEN
AIM: The purpose of this study was to characterize handwriting deficits in children with developmental coordination disorder (DCD) using computerized movement analyses. METHOD: Seventy-two children (40 females, 32 males; mean age 7 y, SD 7 mo; range 6 y 2 mo to 7 y 11 mo) with handwriting deficits (33 with DCD, 39 without DCD); and 22 age- and sex-matched children without handwriting deficits were asked to perform handwriting tasks on a digital tablet for the collection of kinematic and kinetic data. Practice times required to achieve automation of movement when writing an unfamiliar character were used to assess the motor learning of handwriting. The children were asked to copy three simple and three complex characters, and the velocity and axial pen force used for corresponding strokes were compared. RESULTS: The attainment of automated handwriting was markedly slower in children with handwriting deficits and DCD, who used a faster stroke velocity to write simple characters (1.22 times those without handwriting deficits), but when writing complex characters, their stroke velocity and pen force were lower (0.85 and 0.89 times those without handwriting deficits, respectively). INTERPRETATION: By linking the results with neuromotor control theories, it was determined that children with DCD have difficulties performing the open-loop and closed-loop movements required for fluent handwriting.
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Escritura Manual , Trastornos de la Destreza Motora/epidemiología , Niño , Femenino , Humanos , Masculino , Trastornos de la Destreza Motora/diagnóstico , Índice de Severidad de la Enfermedad , Encuestas y CuestionariosRESUMEN
This paper describes a pilot study investigating an assessment for Chinese handwriting performance. In an attempt to computerize the existing Tseng Handwriting Problem Checklist (Tseng Checklist), this study employed MATLAB to develop a computer program entitled the Chinese Handwriting Assessment Program (CHAP) to be used for the evaluation of handwriting performance. Through a template-matching approach, the program processed each character by using size-adjustable standard models to calculate the two-dimensional cross-correlation coefficient of a template and a superimposed handwritten character. The program measured the size control, spacing, alignment, and the average resemblance between standard models and handwritten characters. The results of the CHAP's test-retest reliability showed that the high correlation coefficients (from .81 to .94) were statistically significant. Correlations between each CHAP and Tseng Checklist item were statistically significant. As these assessment tools for handwriting performance are required for quantitative and qualitative aspects, the integration of the two tools is a promising means for accomplishing a handwriting performance assessment.
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Pueblo Asiatico/estadística & datos numéricos , Estudios de Evaluación como Asunto , Escritura Manual , Desarrollo de Programa/métodos , Desempeño Psicomotor , Programas Informáticos/estadística & datos numéricos , Algoritmos , Pueblo Asiatico/psicología , Niño , Gráficos por Computador , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Lingüística/normas , Masculino , Destreza Motora/fisiología , Multilingüismo , Proyectos Piloto , Desempeño Psicomotor/fisiología , Lectura , Interfaz Usuario-ComputadorRESUMEN
To examine the discriminant validity of the Visual Motor Integration test in screening children with handwriting dysfunction, 599 children in Grade 2, including 41 children with handwriting dysfunction identified by their teachers and 558 typically developing children, were assessed. The Visual Motor Integration test, with an area under the receiver operating characteristic curve (0.894), showed high accuracy regarding screening purposes. Judging from the values for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, hit rate, Youden's index, and odds ratio, a standard score of 85 was the best cutoff point for screening children for handwriting dysfunction.
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Escritura Manual , Tamizaje Masivo , Pruebas Neuropsicológicas/estadística & datos numéricos , Desempeño Psicomotor , Niño , Femenino , Humanos , Masculino , Psicometría/estadística & datos numéricos , Valores de Referencia , Reproducibilidad de los Resultados , TaiwánRESUMEN
This study compares the amplitude and temporal features of stimulus-evoked electromyography (EMG) of paralyzed muscle, rectus femoris (RF), in both lengthened and shortened positions of six spinal cord injured (SCI) subjects during an electrically elicited fatigue process. The torque output and evoked EMG were fitted by hyperbolic tangent functions from which their amplitude residual levels and temporal inflection times can be extracted. Furthermore, a structural EMG model of Fuglevand et al (1992 Biol. Cybern. 67 143-53) was modified to include type I (slow twitch) and type II (fast twitch) of motor unit (MU) fibers with viable parameters obtained from paralyzed muscles to observe their amplitude and temporal changes. Our results showed that the amplitude of stimulus-evoked EMG decreased earlier in the lengthened muscle with a shorter inflection time (48.53 +/- 8.7 s versus 55.13 +/- 4.03 s) than that of the shortened position during 120 s of stimulation time (p < 0.05). Similarly, the peak-to-peak duration (PTPd) of the evoked EMG increased faster at an earlier time to a higher asymptotical value in lengthened muscle (2.23 +/- 0.74 versus 1.77 +/- 0.54), compared to that of a shortened one (p < 0.05). These observations coincided with the higher rising rate and larger final value of the temporal coefficients, i.e., longer duration, in both type I and II MUs of lengthened muscles. From the observation of all parameters, the fatigue process in lengthened muscle proceeds faster than that in shortened muscle.