Home calligraphic exercises as manual dexterity training in patients with Parkinson’s disease: a pilot feasibility study

Abstract

Purpose

To assess the feasibility and effects on manual dexterity and the quality of life (QoL) of a 12-week home calligraphic training program in patients with Parkinson’s disease (PD).

Methods

A pilot study with participants recruited from the Movement Disorders consultation at the Hospital 12 de Octubre (Madrid). The main outcome, manual dexterity, was assessed using the Purdue Pegboard Test (PPT). Secondary outcomes included clinical rating scales that contemplate aspects related to manual dexterity (DextQ-24, UPDRSII, UPDRSIII), and QoL (PDQ-39 and EuroQoL-5D).

Results

Thirty PD patients (57% males) with a mean age of 66.11 (9.76) years and 93% adherence rate. The PPT scores improved significantly (p < 0.0001) from T0 (start of the study) to T1 (after 24 weeks). No statistically significant change was found in DextQ-24, UPDRS-II and UPDRS-III, but a clear improvement was observed in the QoL measurement: EuroQoL-5D (p < 0.0001), PDQ-39 (p < 0.0001) and modified PDQ-39 (p = 0.022).

Conclusions

This is the first study to demonstrate the feasibility and improvement in hand dexterity assessed by the PPT for patients diagnosed with PD after a 12-week home calligraphic training program. A significant improvement was noted in the QoL measurements, such as the PDQ-39, modified PDQ-39, and EuroQoL-5D.

Implications for Rehabilitation

1. Most patients with Parkinson’s disease suffer from impaired manual dexterity, making it difficult to perform activities of daily living such as eating, buttoning, or shaving.

2. A 12-week home calligraphic training program could improve hand dexterity in these patients.

3. The advantage of this home calligraphic trainingis is that it is an easy-to-perform, low-cost and no side effects.

4. This training also improves their quality of life.

Keywords:

• Parkinson’s disease
• calligraphic exercises
• manual dexterity
• quality of life
• disability

Acknowledgments

The authors thank all the subjects for participating in the study and their families for the support provided.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

Sara Llamas is supported by the Instituto de Salud Carlos III (ISCIII; Spanish Biomedical Research Institute) through a ‘Juan Rodés’ contract (JR 18/00046). Fundación Atlético de Madrid and Montblanc were our sponsors. These companies paid for the printing costs of the notebooks and office consumables.