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|Title: ||Feasibility of a home-based program to improve handwriting after stroke: a pilot study|
|Authors: ||Simpson, Bronwyn Ann|
|Issue Date: ||25-Mar-2015|
|Publisher: ||University of Sydney|
Faculty of Health Sciences
|Abstract: ||Background: Handwriting can be affected by hemiparesis following stroke. However, no randomised controlled trials have been published to guide this important area of stroke rehabilitation. The current study tested the feasibility of a handwriting retraining program for adults with stroke which will inform the methodology of a future randomised controlled trial.
Methods: A quasi-experimental single cohort study was adopted. A four week, home-based handwriting training program was delivered by an occupational therapist using task-specific practice. Handwriting performance was measured at baseline, and after the program using subtests of the Handwriting Assessment Battery, the modified Four Point Scale, and modified Disability of the Arm, Shoulder and Hand Scale. Legibility was scored by a blinded rater.
Results: Seven adults were recruited over 18 months (eligibility fraction 43% and enrolment fraction 78%). Although recruitment was slow, the intervention was feasible. Participants completed a mean of 7.9 hours of occupational therapy supervised handwriting practice and 10 hours of independent practice. Participants were able to complete the program and reported satisfaction with the practice tasks and feedback from the occupational therapist. Practice tasks and goals most commonly related to legibility of lists, letters, cards and messages. No statistically or clinically significant changes in legibility were reported in this small sample, but ceiling effects were evident for some measures. None of the measures evaluated handwriting neatness, an outcome that was important to participants. The study was not powered to determine efficacy.
Discussion: Recruitment of adequate numbers of people with stroke for a future randomised controlled trial would not be feasible using the same recruitment methods and settings in this study. The intervention program was feasible to deliver and acceptable to adults with stroke, and would be feasible to deliver clinically within the Australian healthcare system. The outcome measures were feasible to administer, and some detected change across time. Further research is required investigating what constitutes writing quality, and ways to objectively measure this phenomenon.|
|Type of Work: ||Masters Thesis|
|Type of Publication: ||Master of Applied Science M.App.Sc.|
|Appears in Collections:||Sydney Digital Theses (Open Access)|
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|2015_Bronwyn_Simpson_cp.pdf||Thesis||1.71 MB||Adobe PDF|
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