Influence of visible or invisible handwriting on drawing the Archimedes spiral in tremor disease patients

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  • 振戦疾患患者におけるアルキメデス螺旋描写動作への筆跡有無の影響

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Abstract

There are patients with Parkinson's disease (PD) or Essential tremor disease (ET), whose hands and/or feet tremble involuntarily. Because they cannot control their tremors daily life, including routine activities such as writing a letter or pouring tea into a cup, is difficult. We chose biofeedback as a method of controlling these tremor diseases and we constructed a tremor measurement system with 3-axis accelerometers, a digitizing tablet and a laptop to collect basic data. Using this system, we investigated whether the patient's movements during writing or drawing were influenced by the presence of handwriting. The subjects were 10 PD patients (PD group) and 8 ET patients (ET group). Beforehand, all patients were classified according to degree of tremor by a doctor. All patients sat on a chair and traced an Archimedes spiral on a digitizing tablet. We instructed the subjects to trace the spiral correctly. An accelerometer was attached to the index finger on each subject's writing hand. The subjects drew the spiral under the following two conditions: with handwriting and without it. In this study, we have found a positive correlation between the amplitude of the acceleration of drawing and the degree of the tremor. In both the ET group and PD group, the amplitude of the acceleration of drawing was significantly increased by the presence of the handwriting. Also, in the PD group, a disturbance in the figure was significantly increased by the presence of the handwriting. This result suggests that the index of the acceleration is effective in a biofeedback training system for patients with tremor disease.

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