May 06, 2022
Rehabilitation interventions for impaired handwriting in people with Parkinson’s disease: a protocol for a scoping review
- Andrea Gardoni1,2,
- Elisabetta Sarasso1,2,3,
- Federica Agosta1,4,3,
- Massimo Filippi1,4,3,5,6,
- Davide Corbetta2,3
- 1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy;
- 2Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy;
- 3Vita-Salute San Raffaele University, Milan, Italy;
- 4Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy;
- 5Neurorehabilitation Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy;
- 6Neurophysiology Service, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Physio
Protocol Citation: Andrea Gardoni, Elisabetta Sarasso, Federica Agosta, Massimo Filippi, Davide Corbetta 2022. Rehabilitation interventions for impaired handwriting in people with Parkinson’s disease: a protocol for a scoping review. protocols.io https://dx.doi.org/10.17504/protocols.io.5jyl891z8v2w/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it’s working
Created: May 06, 2022
Last Modified: May 06, 2022
Protocol Integer ID: 62104
Keywords: Handwriting, Writing, Rehabilitation, Parkinson, Review, Micrographia, parkinsonian handwriting, characteristics of parkinsonian handwriting, impaired handwriting in people, impaired handwriting, review handwriting abnormalities in people, scoping review handwriting abnormality, measures of handwriting, altered fluency of the writing stroke, possible handwriting alteration, handwriting, handwriting in people, writing stroke duration, writing stroke, parkinson, impairment, dysgraphia, altered fluency, stroke duration, rehabilitative training, rehabilitative program, writing task, fine motor skill, few study, kinematic feature, pd, micrographia
Funders Acknowledgements:
Italian Ministry of Health (MoH) Grant
Grant ID: Ricerca Finalizzata 2018 (GR-2018-12366005)
Abstract
Handwriting abnormalities in people with Parkinson’s disease include several dynamic and kinematic features such as increased writing stroke duration, reduced velocity and altered fluency of the writing strokes. “Dysgraphia” is a term that includes all the possible handwriting alterations and the “micrographia”, that defines an impairment of a fine motor skill manifesting mainly as a progressive or stable reduction in amplitude during a writing task, is only one of the characteristics of parkinsonian handwriting. Few studies investigated the effects of a rehabilitative training on handwriting or used measures of handwriting as an outcome in people with PD.
We aim to conduct a scoping review to answer the following question: “What are the effects of a rehabilitative program on handwriting in people with PD?”
Materials
INTRODUCTION
Handwriting abnormalities in people with Parkinson’s disease (PD) include several dynamic and kinematic features such as increased writing stroke duration, reduced velocity and altered fluency of the writing strokes [1, 2]. “Dysgraphia” is a term that includes all the possible handwriting alterations and the “micrographia”, that defines an impairment of a fine motor skill manifesting mainly as a progressive or stable reduction in amplitude during a writing task, is only one of the characteristics of parkinsonian handwriting [3]. Few studies investigated the effects of a rehabilitative training on handwriting or used measures of handwriting as an outcome in people with PD.
We aim to conduct a scoping review to answer the following question: “What are the effects of a rehabilitative program on handwriting in people with PD?”
METHODS
We will conduct a scoping review according to the five-stage methodological framework for scoping studies proposed by Arksey and O’Malley [4] and the relative additional recommendations by Levac and colleagues [5].
Inclusion Criteria
We will consider any published paper reporting the results of a trial in which people with idiopathic PD received a structured rehabilitation program (i.e., more than a single session) of handwriting. We will exclude case reports.
Information sources and search strategy
We will search MEDLINE (PubMed), Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Physiotherapy Evidence Database (PEDro) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) since their inception. The search strategy for PubMed database is in the Appendix.
Study records management, selection and data collection
We will use EndNote X7 software [6] to manage citation records retrieved through the electronic searches. Two independent reviewers will determine studies eligible for the inclusion; any discrepancies will be resolved by discussion or with the consultation of a third reviewer.
The same two reviewers will extract general characteristics (publication date, study design, description of the intervention and comparator, sample size) and specific information (training characteristics, outcome measures and study results) of included studies on a standardized extraction form.
Risk of bias assessment
Two reviewers will independently assess the risk of bias of included studies. For randomized and non-randomized trials, we will respectively use the version two of the Cochrane Collaboration’s tool for assessing risk of bias (RoB-2) [7] and the Risk of bias for non-randomized studies (ROBINS-I) tool [8]. Discrepancies will be resolved by discussion or with the consultation of a third reviewer.
Data synthesis
We will present findings in a narrative summary. We will describe the characteristics of proposed trainings, the outcomes assessed and the efficacy of trainings in included trials.
References
1. Thomas M, Lenka A, Kumar Pal P. Handwriting Analysis in Parkinson's Disease: Current Status and Future Directions. Movement disorders clinical practice. 2017;4:806-18.
2. Tucha O, Mecklinger L, Thome J, Reiter A, Alders GL, Sartor H, et al. Kinematic analysis of dopaminergic effects on skilled handwriting movements in Parkinson's disease. Journal of neural transmission. 2006;113:609-23.
3. Letanneux A, Danna J, Velay JL, Viallet F, Pinto S. From micrographia to Parkinson's disease dysgraphia. Movement disorders : official journal of the Movement Disorder Society. 2014;29:1467-75.
4. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. International Journal of Social Research Methodology. 2005;8:19-32.
5. Levac D, Colquhoun H, O'Brien KK. Scoping studies: advancing the methodology. Implement Sci. 2010;5:69.
6. https://endnote.com/ (last access: April 2022)
7. Sterne JAC, Savovic J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. Bmj. 2019;366:l4898.
8. Sterne JAC, Hernan MA, McAleenan A, Reeves BC, Higgins JPT. Assessing risk of bias in a non-randomized study. 2020;Cochrane Handbook for Systematic Reviews of Interventions.
Appendix
Search strategy for PubMed database:
(((("upper extremity"[MeSH Terms] OR ("upper"[All Fields] AND "extremity"[All Fields])) OR "upper extremity"[All Fields]) AND (("dexterities"[All Fields] OR "dexterity"[All Fields]) OR "dexterous"[All Fields])) OR ("hand writing"[All Fields] OR ((("handwriters"[All Fields] OR "handwriting"[MeSH Terms]) OR "handwriting"[All Fields]) OR "handwritings"[All Fields]))) AND (("parkinson*"[Text Word] OR "Parkinson disease"[MeSH Terms]) OR "paralysis agitans"[Text Word])
Troubleshooting
Search strategy
1w
The search strategy was runned in April 2022
Study records management, selection and data collection
1w
Risk of bias assessment
Requested time will depend on how many studies will be included
Data synthesis
Requested time will depend on how many studies will be included