Intensive training programme improves handwriting in a community cohort of people with Parkinson's disease

<strong>Background</strong>: People with Parkinson’s disease (PwP) often report problems with their handwriting before they receive a formal diagnosis. Many PwP suffer from deteriorating handwriting throughout their illness, which has detrimental effects on many aspects of their quality of life. <strong>Aims:</strong> To assess a 6-week online training programme aimed at improving handwriting of PwP. <strong>Methods</strong>: Handwriting samples from a community-based cohort of PwP (n=48) were analysed using Systematic Detection of Writing Problems (SOS-PD) by two independent raters, before and after a 6-week remotely-monitored Physiotherapy-led training programme. Inter-rater variability on multiple measures of handwriting quality was analysed. The handwriting data was analysed using pre/post design in the same individuals. Multiple aspects of the handwriting samples were assessed, including writing fluency, transitions between letters, regularity in letter size, word spacing, and straightness of lines. <strong>Results</strong>: Analysis of inter-rater reliability showed high agreement for total handwriting scores, letter size, as well as speed and legibility scores, whereas there were mixed levels of inter-rater reliability for other handwriting measures. Overall handwriting quality (p=0.001) and legibility (p=0.009) significantly improved, while letter size (p=0.012), fluency (p=0.001), regularity of letter size (p=0.009) and straightness of lines (p=0.036) were also enhanced. <strong>Conclusions</strong>: The results of this study show that this 6-week intensive remotely-monitored Physiotherapy-led handwriting programme, improved handwriting in PwP. This is the first of its kind study using this tool remotely and it demonstrated that the SOS-PD is reliable for measuring handwriting in PwP. <strong>Background</strong>: People with Parkinson’s disease (PwP) often report problems with their handwriting before they receive a formal diagnosis. Many PwP suffer from deteriorating handwriting throughout their illness, which has detrimental effects on many aspects of their quality of life. <strong>Aims:</strong> To assess a 6-week online training programme aimed at improving handwriting of PwP. <strong>Methods</strong>: Handwriting samples from a community-based cohort of PwP (n=48) were analysed using Systematic Detection of Writing Problems (SOS-PD) by two independent raters, before and after a 6-week remotely-monitored Physiotherapy-led training programme. Inter-rater variability on multiple measures of handwriting quality was analysed. The handwriting data was analysed using pre/post design in the same individuals. Multiple aspects of the handwriting samples were assessed, including writing fluency, transitions between letters, regularity in letter size, word spacing, and straightness of lines. <strong>Results</strong>: Analysis of inter-rater reliability showed high agreement for total handwriting scores, letter size, as well as speed and legibility scores, whereas there were mixed levels of inter-rater reliability for other handwriting measures. Overall handwriting quality (p=0.001) and legibility (p=0.009) significantly improved, while letter size (p=0.012), fluency (p=0.001), regularity of letter size (p=0.009) and straightness of lines (p=0.036) were also enhanced. <strong>Conclusions</strong>: The results of this study show that this 6-week intensive remotely-monitored Physiotherapy-led handwriting programme, improved handwriting in PwP. This is the first of its kind study using this tool remotely and it demonstrated that the SOS-PD is reliable for measuring handwriting in PwP.