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Baseline Features Influencing the Effectiveness of Retraining Therapy for Writer's Cramp
Author(s) -
Bleton JeanPierre,
Touzé Emmanuel,
SoulezlaRivière Laure,
BaizabalCarvallo José Fidel,
Guignier Françoise,
Cambriel Claire,
Sangla Sophie,
Grabli David,
Roze Emmanuel,
Mesure Serge,
Vidailhet Marie
Publication year - 2015
Publication title -
movement disorders clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.754
H-Index - 18
ISSN - 2330-1619
DOI - 10.1002/mdc3.12153
Subject(s) - retraining , physical medicine and rehabilitation , baseline (sea) , medicine , psychology , physical therapy , political science , law
Background: The effectiveness of retraining therapy ( RT ) for writer's cramp is difficult to predict and its determinants are unknown. Methods: We examined factors potentially predicting improved legibility after RT in patients with writer's cramp ( WC ). We reviewed the files of 693 WC patients treated with RT from 1995 to 2009. Standardized assessments were made both at baseline and after 2 months of RT in 305 patients. The effect of RT on legibility was evaluated by using the handwriting subscore of the Burke‐Fahn‐Marsden ( BFM ) disability scale. Initial and final handwriting samples were blindly scored in random order. Associations between WC patterns and changes in legibility were identified by uni‐ and multivariable analyses. Results: Legibility improved by ≥1 point in the BFM handwriting subscore in 93 patients (31%). WC patients who improved were more likely to have synergic dystonic patterns involving the wrist and forearm (60% vs. 40%; P = 0.03) and less likely to have flexion of fingers F3 to F5 (19% vs. 81%; P = 0.017). Outcome was not related to gender, age, or dystonia duration. Our results confirm that retraining therapy could improve legibility in patients with writer's cramp. Conclusions: The pattern of writer's cramp can help to identify patients who are most likely to benefit from retraining therapy, regardless of age, gender, and disease duration.