Nackaerts Evelien, Heremans Elke, Smits-Engelsman Bouwien C M, Broeder Sanne, Vandenberghe Wim, Bergmans Bruno, Nieuwboer Alice
Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa.
PLoS One. 2017 Mar 2;12(3):e0173157. doi: 10.1371/journal.pone.0173157. eCollection 2017.
Handwriting in Parkinson's disease (PD) features specific abnormalities which are difficult to assess in clinical practice since no specific tool for evaluation of spontaneous movement is currently available.
This study aims to validate the 'Systematic Screening of Handwriting Difficulties' (SOS-test) in patients with PD.
Handwriting performance of 87 patients and 26 healthy age-matched controls was examined using the SOS-test. Sixty-seven patients were tested a second time within a period of one month. Participants were asked to copy as much as possible of a text within 5 minutes with the instruction to write as neatly and quickly as in daily life. Writing speed (letters in 5 minutes), size (mm) and quality of handwriting were compared. Correlation analysis was performed between SOS outcomes and other fine motor skill measurements and disease characteristics. Intrarater, interrater and test-retest reliability were assessed using the intraclass correlation coefficient (ICC) and Spearman correlation coefficient.
Patients with PD had a smaller (p = 0.043) and slower (p<0.001) handwriting and showed worse writing quality (p = 0.031) compared to controls. The outcomes of the SOS-test significantly correlated with fine motor skill performance and disease duration and severity. Furthermore, the test showed excellent intrarater, interrater and test-retest reliability (ICC > 0.769 for both groups).
The SOS-test is a short and effective tool to detect handwriting problems in PD with excellent reliability. It can therefore be recommended as a clinical instrument for standardized screening of handwriting deficits in PD.
帕金森病（PD）患者的笔迹具有特定异常，由于目前尚无评估自发运动的特定工具，因此在临床实践中难以评估。
本研究旨在验证帕金森病患者的“笔迹困难系统筛查”（SOS测试）。
使用SOS测试检查了87例患者和26名年龄匹配的健康对照者的笔迹表现。67例患者在1个月内进行了第二次测试。要求参与者在5分钟内尽可能多地抄写一段文本，并按照在日常生活中一样尽可能整洁、快速地书写。比较了书写速度（5分钟内的字母数）、大小（毫米）和笔迹质量。对SOS测试结果与其他精细运动技能测量结果及疾病特征进行了相关性分析。使用组内相关系数（ICC）和Spearman相关系数评估了评分者内、评分者间和重测信度。
与对照组相比，帕金森病患者的笔迹较小（p = 0.043）、较慢（p<0.001），且书写质量较差（p = 0.031）。SOS测试结果与精细运动技能表现、疾病持续时间和严重程度显著相关。此外，该测试显示出优异的评分者内、评分者间和重测信度（两组的ICC均>0.769）。
SOS测试是一种简短有效的工具，可用于检测帕金森病患者的笔迹问题，可靠性极佳。因此，它可被推荐作为一种临床工具，用于对帕金森病患者的笔迹缺陷进行标准化筛查。
