Kinematička analiza rukopisa u neurološkim i psihijatrijskim oboljenjima i neurorazvojnim poremećajima dečjeg i adolescentnog doba

Abstract

Uvod: Rukopis je složena veština koja može biti narušena u mnogim neurološkim i psihijatrijskim oboljenjima. Kinematička analiza rukopisa i motorna pravila su objektivan metod u proceni rukopisa. Cilj: Cilj ovog istraživanja bila je analiza rukopisa u deficitu pažnje sa hiperaktivnošću (ADHD), multiploj sklerozi kod dece i adolescenata (PedMS), depresiji major kod dece i adolescenata (PedMDD) i poređenje sa zdravim kontrolama u cilju procene narušenja fine motorike i uticaja farmakoterapije. Procenjivan je i uticaj dominantne ruke na rukopis kod zdravih. Metode istraživanja: Korišćena je digitalna tabla za pisanje koja registruje kinematičke parametre rukopisa i analizirane su i upoređivane eksperimentalne grupe ispitanika sa ADHD, PedMS i PedMDD sa zdravim kontrolama. Takođe su upoređivani levoruki i desnoruki zdravi ispitanici. Rezultati: Pokazano je kinematičko narušenje rukopisa u eksperimentalnim grupama koje je posledica: narušenja fine motorike, pažnje i anticipacije greške u ADHD, subkliničkog neurološkog i kognitivnog oštećenja u PedMS, psihomotornog usporenja u PedMDD. Farmakoterapija ima uticaja na kinematiku rukopisa u navedenim grupama. Dominantna ruka utiče zanemarljivo na kinematiku rukopisa i to pre svega usled biomehaničkih razlika. Nije pokazano odstupanje od motornih pravila u ispitivanim grupama. Zaključak: Kinematička analiza rukopisa može biti objektivan i senzitivan metod u kliničkim studijama u dečjoj populaciji. Ovom metodom moguće je detektovati subkliničke neurološke i kognitivne poteškoće u ADHD, PedMS i PedMDD kao i uticaj farmakoterapije na iste. Ruka kojom se piše nije od velikog uticaja na kinematiku rukopisa.

psychiatric disorders. Kinematic analysis of handwriting and motor rules are an objective method in the evaluation of handwriting. Aim: The aim of this study was to analyze handwriting in attention deficit/hyperactivity disorder (ADHD), multiple sclerosis in childhood and adolescence (PedMS), major depression in childhood and adolescence (PedMDD) and to compare it with healthy controls to assess fine motor impairment and the effects of pharmacotherapy. The influence of the dominant hand on the handwriting in healthy people was also assessed. Method: A digital writing board which register kinematic parameters of handwriting was used and experimental groups of subjects with ADHD, PedMS and PedMDD with healthy controls were analyzed and compared. Left-handed and right-handed healthy subjects were also compared. Results: Kinematic impairment of handwriting in experimental groups has been shown as a consequence of: impaired fine motor skills, attention and anticipation of error in ADHD, subclinical neurological and cognitive impairment in PedMS, psychomotor retardation in PedMDD. Pharmacotherapy has an impact on the kinematics of handwriting in these groups. The dominant hand has a negligible effect on the kinematics of the handwriting, primarily due to biomechanical differences. No deviation from motor rules was shown in the examined groups. Conclusion: Kinematic analysis of handwriting could be an objective and sensitive method in clinical studies in the pediatric population. With this method, it is possible to detect subclinical neurological and cognitive difficulties in ADHD, PedMS and PedMDD, as well as the influence of pharmacotherapy on them. The dominant hand has a minor influence on the kinematics of the handwriting.