Schenk Thomas, Bauer Barbara, Steidle Birgit, Marquardt Christian
Cognitive Neuroscience Research Unit, Wolfson Institute, University Durham, Stockton-on-Tees, United Kingdom.
J Hand Ther. 2004 Jul-Sep;17(3):349-63. doi: 10.1197/j.jht.2004.04.005.
Patients with writer's cramp (WC) show uncontrollable muscle co-contractions of agonists and antagonists and unusual postures of the upper limb during writing; their handwriting is inefficient and exhausting. Currently the treatment of choice is to inject botulinum toxin in selective hand muscles. However, this treatment has two drawbacks: it is short-lasting and may be associated with adverse side effects. An alternative behavioral treatment, namely, the handwriting training developed by Mai and coworkers, was carried out and evaluated in 50 patients with WC. A digitizing tablet was used to record the handwriting movements before and after training, and then again after a follow-up period. The results indicate the efficacy of the handwriting training. Speed and smoothness of the handwriting increased during the training with effects observed after an extended follow-up period. Handwriting training leads to significant improvements, but does not bring handwriting performance to normal levels. This training should be considered as an alternative or supplement to the traditional treatment with botulinum toxin or other programs based on neuroplasticity.
书写痉挛（WC）患者在书写过程中表现出主动肌和拮抗肌无法控制的肌肉共同收缩以及上肢的异常姿势；他们的书写效率低下且费力。目前的首选治疗方法是在手部特定肌肉中注射肉毒杆菌毒素。然而，这种治疗方法有两个缺点：效果持续时间短，且可能伴有不良副作用。一种替代性的行为治疗方法，即Mai及其同事开发的书写训练，在50例书写痉挛患者中进行了实施和评估。使用数位板记录训练前后以及随访期后的书写动作。结果表明了书写训练的有效性。在训练期间，书写的速度和平滑度有所提高，且在延长的随访期后仍能观察到效果。书写训练带来了显著改善，但并未使书写表现恢复到正常水平。这种训练应被视为肉毒杆菌毒素传统治疗或其他基于神经可塑性的方案的替代方法或补充。
