Abstract: BACKGROUND: Therapists specializing in handwriting difficulties in children often address motor problems including both proximal and distal movements in the upper extremity. Kinematic measures can be used to investigate various aspects of handwriting. This study examined differences in movement patterns in proximal and distal joints of the upper extremity during graphomotor tasks between typically developing children with and without handwriting problems. Additionally, it explored relationships between movement patterns, speed, and legibility of writing. METHODS: Forty-one children, aged 7-11 years, were assessed with the Aleph Aleph Ktav Yad Hebrew Handwriting assessment and the Beery Test of Visual Motor Integration and, based on their scores, were divided into a research group (with handwriting difficulties) and a control group (without handwriting difficulties). Upper extremity joint movement patterns were analyzed with a motion capture system. Differences in the quality of shapes traced and copied on a graphics tablet positioned horizontally and vertically were compared. Between-group differences and relationships with speed and legibility were analyzed. RESULTS: In both groups, there was greater movement in the distal compared to the proximal joints, greater movement when performing the task in a horizontal compared to a vertical plane, and greater movement when tracing than copying. Joint movements in the arm executed scaled-down versions of the shapes being drawn. While the amount of joint displacement was similar between groups, children in the research group showed greater dissimilarity between the drawn shape and the shape produced by the proximal joints. Finally, the drawing measure on the tablet was a significant predictor of legibility, speed of writing, visual motor integration and motor coordination, whereas the dissimilarity measure of joint movement was a significant predictor of speed of writing and motor coordination. CONCLUSIONS: This study provides support for the role of the distal upper extremity joints in the writing process and some guidance to assist clinicians in devising treatment strategies for movement-related handwriting problems. While we observed differences in proximal joint movements between the children with and without handwriting difficulties, the extent to which they are responsible for the differences in drawing quality remains to be determined. Further studies should use a similar methodology to examine additional tasks such as drawing shapes of varying sizes.

Abstract: People with Parkinson's disease often show deficits in dexterity, which, in turn, can lead to limitations in performing activities of daily life. Previous studies have suggested that training in playing the piano may improve or prevent a decline in dexterity in this population. In this pilot study, we tested three participants on a six-week, custom, piano-based training protocol, and quantified dexterity before and after the intervention using a sensor-enabled version of the nine-hole peg test, the box and block test, a test of finger synergies using unidimensional force sensors, and the Quantitative Digitography test using a digital piano, as well as selected relevant items from the motor parts of the MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Parkinson's Disease Questionnaire (PDQ-39) quality of life questionnaire. The participants showed improved dexterity following the training program in several of the measures used. This pilot study proposes measures that can track changes in dexterity as a result of practice in people with Parkinson's disease and describes a potential protocol that needs to be tested in a larger cohort.

Abstract: PURPOSE: Skeletal muscle echogenicity intensity (EI) is considered a measure of muscle quality, being associated with old age and pathologies. Whether EI variations can be identified in healthy adults, due to habitual shortened or elongated muscle position is unknown. Thus, this study aimed to assess the relationship between thoracic kyphosis angulation and EI scores of muscles spanning this region ((Lower Trapezius (LT), Rhomboid Major (RM), Erector Spine (ES)) in healthy young people and in addition to examine the relationship between the change in thoracic kyphosis angle from relaxed to upright position (� degrees ) and the EI of these muscles. METHODS: Thoracic kyphosis in relaxed and erect standing was measured using a digital inclinometer in 29 healthy adults (16 women, 13 men), aged 25-35 years. The thoracic kyphosis angles including the difference between relaxed and erect postures (� degrees ) were correlated to the EI scores of right and left LT, RM and ES. RESULTS: No significant differences in EI were found between the 3 muscles EI or between sides, hence they were pooled together to a total thoracic EI score (TTEI). Although the TTEI did not correlate with relaxed or erect thoracic kyphosis, it was significantly but negatively correlated with � degrees in the entire group: Pearson's correlation coefficient of r = -0.544; p = .01 and in men; r = -0.732; p = .01, failing to reach significance in women; r = -0.457. CONCLUSION: The negative association between the EI of the explored muscles and � degrees could imply a possible relationship between these muscles range of movement excursions and their composition.