Abstract
Introduction: Writing is a complex functional activity that involves motor, sensory and cognitive skills. It is an important part of a person's daily occupations.
Impairments in qualitative and quantitative parameters of writing are common in patients after stroke. There is a lack of evidence-based therapeutic procedures and programmes for writing re-education and graphomotor training in patients with hemiparesis.
Aim: The aim of the pilot study was to determine the feasibility of a 4-week therapeutic program of hand function and handwriting skills and its acceptability for patients after stroke in an outpatient occupational therapy program. Methods: A descriptive design was chosen for the pilot study.
A 4-week intensive therapeutic program focusing on hand function and handwriting skills was designed and implemented. The 4-week intervention included a total of 20 hours of 30-minute sessions led by an occupational therapist and an additional 30 minutes of home-based exercise.
The therapy included repetitive training with elements of the CIMT (constraint-induced movement therapy) method, task-oriented training (functional writing) and handwriting training. The progress of the home program was recorded by the patient in a diary.
A total of seven adults with stroke were enrolled in the pilot program. The upper extremity range of motion was assessed by goniometry at the beginning and at the end of the programme, hand function was assessed by the Frenchay Arm Test (FAT) and the Jebsen-Taylor Hand Function Test (JTHFT).
Handwriting skills were assessed using the Handwriting Assessment Battery for Adults. Results: The results obtained in FAT and JTHFT scores indicate a positive effect of the therapy on hand function in all patients.
In the area of writing, an improvement in writing legibility was demonstrated. Patients were satisfied with the intensity, content and level of difficulty of the tasks in the therapy program.
Conclusion: The proposed therapeutic program of hand function and handwriting skills is feasible and acceptable for stroke patients according to the set conditions and criteria. It can serve as a recommendation for training fine motor skills in patients with writing disorders.