A comprehensive understanding of the underlying biomechanical processes during handwriting is needed to accurately guide clinical interventions. To date, quantitative measurement of such biomechanical processes has largely excluded measurements of the forces exerted radially on the barrel of the writing utensil (grip forces) and how they vary over time during a handwriting task. An instrumented writing utensil was deployed for a direct measurement of kinematic and temporal information during a writing task, as well as forces exerted on the writing surface and on the barrel of the pen. The writing utensil was used by a cohort of 35 students (19 males), 16 in first grade and 19 in second grade, as they performed the Minnesota Handwriting Assessment (MHA) test. Quantitative grip force variability measures were computed and tested as correlates of handwriting legibility, form, and strokes. Grip force variability was shown to correlate strongly with handwriting quality, in particular for students classified by the MHA as nonproficient writers. More specifically, static grip force patterns were shown to result in poor handwriting quality and in greater variation in handwriting stroke durations. Grip force variability throughout the writing task was shown to be significantly lower for nonproficient writers (t-test, p<0.01) while the number of strokes and per-stroke durations were shown to be higher (p<0.03). The results suggest that grip force dynamics play a key role in determining handwriting quality and stroke characteristics. In particular, students with writing difficulties exhibited more static grip force patterns, lower legibility and form scores, as well as increased variation in stroke durations. These findings shed light on the underlying processes of handwriting and grip force modulation and may help to improve intervention planning.

1.
Feder
,
K.
, and
Majnemer
,
A.
, 2007, “
Handwriting Development, Competency, and Intervention
,”
Dev. Med. Child Neurol.
0012-1622,
49
(
4
), pp.
312
317
.
2.
Latash
,
M.
,
Danion
,
F.
,
Scholz
,
J.
,
Zatsiorsky
,
V.
, and
Schöner
,
G.
, 2003, “
Approaches to Analysis of Handwriting as a Task of Coordinating a Redundant Motor System
,”
Hum. Mov. Sci.
0167-9457,
22
(
2
), pp.
153
171
.
3.
Athenes
,
S.
,
Sallagoity
,
I.
,
Zanone
,
P.
, and
Albaret
,
J.
, 2004, “
Evaluating the Coordination Dynamics of Handwriting
,”
Hum. Mov. Sci.
0167-9457,
23
, pp.
621
641
.
4.
Simner
,
M.
, 1982, “
Printing Errors in Kindergarten and the Prediction of Academic Performance
,”
J. Learn Disabil
0022-2194,
15
(
3
), pp.
155
159
.
5.
Burton
,
A.
, and
Dancisak
,
M.
, 2000, “
Grip Form and Graphomotor Control in Preschool Children
,”
Am. J. Occup. Ther.
0272-9490,
54
(
1
), pp.
9
17
.
6.
Cornhill
,
H.
, and
Case-Smith
,
J.
, 1996, “
Factors that Relate to Good and Poor Handwriting
,”
Am. J. Occup. Ther.
0272-9490,
50
, pp.
732
739
.
7.
Hamstra-Bletz
,
L.
, and
Blöte
,
A.
, 1993, “
A Longitudinal Study on Dysgraphic Handwriting in Primary School
,”
J. Learn Disabil
0022-2194,
26
(
10
), pp.
689
699
.
8.
Benbow
,
M.
, 1995, “
Principles and Practices of Teaching Handwriting
,”
Hand Function in the Child: Foundations for Remediation
,
Mosby
,
St. Louis, MO
, pp.
255
281
.
9.
Rosenblum
,
S.
,
Goldstand
,
S.
, and
Parush
,
S.
, 2006, “
Relationships Among Biomechanical Ergonomic Factors, Handwriting Product Quality, Handwriting Efficiency, and Computerized Handwriting Process Measures in Children With and Without Handwriting Difficulties
,”
Am. J. Occup. Ther.
0272-9490,
60
(
1
), pp.
28
39
.
10.
Graham
,
S.
, and
Harris
,
K. R.
, 2000, “
The Role of Self-Regulation and Transcription Skills in Writing and Writing Development
,”
Educ. Psychol.
0046-1520,
35
(
1
), pp.
3
12
.
11.
Klein
,
J.
, and
Taub
,
D.
, 2005, “
The Effect of Variations in Handwriting and Print on Evaluation of Student Essays
,”
Assess. Writ.
,
10
(
2
), pp.
134
148
.
12.
Schneck
,
C.
, 1991, “
Comparison of Pencil-Grip Patterns in First Graders With Good and Poor Writing Skills
,”
Am. J. Occup. Ther.
0272-9490,
45
(
8
), pp.
701
706
.
13.
Ziviani
,
J.
, and
Elkins
,
J.
, 1986, “
Effect of Pencil Grip on Handwriting Speed and Legibility
,”
Educ. Rev.
,
38
(
3
), pp.
247
257
.
14.
Dennis
,
J.
, and
Swinth
,
Y.
, 2001, “
Pencil Grasp and Children’s Handwriting Legibility During Different-Length Writing Tasks
,”
Am. J. Occup. Ther.
0272-9490,
55
(
2
), pp.
175
183
.
15.
Koziatek
,
S.
, and
Powell
,
N.
, 2003, “
Pencil Grips, Legibility, and Speed of Fourth-Graders’ Writing in Cursive
,”
Am. J. Occup. Ther.
0272-9490,
57
(
3
), pp.
284
288
.
16.
Summers
,
J.
, and
Catarro
,
F.
, 2003, “
Assessment of Handwriting Speed and Factors Influencing Written Output of University Students in Examinations
,”
Aust. Occup. Ther. J.
,
50
(
3
), pp.
148
157
.
17.
Rosenblum
,
S.
,
Parush
,
S.
, and
Weiss
,
P.
, 2003, “
Computerized Temporal Handwriting Characteristics of Proficient and Poor Handwriters
,”
Am. J. Occup. Ther.
0272-9490,
96
, pp.
933
954
.
18.
Chau
,
T.
,
Ji
,
J.
,
Tam
,
C.
, and
Schwellnus
,
H.
, 2006, “
A Novel Instrument for Quantifying Grip Activity During Handwriting
,”
Arch. Phys. Med. Rehabil.
0003-9993,
87
(
11
), pp.
1542
1547
.
19.
Hooke
,
A.
,
Park
,
J.
, and
Shim
,
J.
, 2008, “
The Forces Behind the Words: Development of the Kinetic Pen
,”
J. Biomech.
0021-9290,
41
(
9
), pp.
2060
2064
.
20.
Fernandes
,
D.
, and
Chau
,
T.
, 2008, “
Fractal Dimension of Pacing and Grip Force in Handwriting Stroke Production
,”
J. Biomech.
0021-9290,
41
, pp.
40
46
.
21.
Blote
,
A.
,
Zielstra
,
E.
, and
Zoerewey
,
M.
, 1987, “
Writing Posture and Writing Movement of Children in Kindergarten
,”
J. Hum. Mov. Stud.
,
13
, pp.
323
341
.
22.
Reisman
,
J.
, 1993, “
Development and Reliability of the Research Version of the Minnesota Handwriting Test
,”
Phys. Occup. Ther. Pediatr.
,
13
(
2
), pp.
41
55
.
23.
Reisman
,
J.
, 1999,
Minnesota Handwriting Assessment
,
The Psychological Corporation
, London, UK.
24.
Fisher
,
R.
, 1921, “
On the Probable Error of a Coefficient of Correlation Deduced From a Small Sample
,”
Metron
0026-1424,
1
(
4
), pp.
3
32
.
25.
Volman
,
M.
,
Van Schendel
,
B.
, and
Jongmans
,
M.
, 2006, “
Handwriting Difficulties in Primary School Children: A Search for Underlying Mechanisms
,”
Am. J. Occup. Ther.
0272-9490,
60
(
4
), pp.
451
460
.
26.
Schneider
,
A.
,
Baur
,
B.
,
Fürholzer
,
W.
,
Marquardt
,
C.
, and
Hermsdörfer
,
J.
, 2009, “
Analysis of Pen Grip Force in Writer’s Cramp
,”
Clin. Neurophysiol.
1388-2457,
120
(
1
), p.
e65
.
27.
Graham
,
S.
,
Struck
,
M.
,
Santoro
,
J.
, and
Berninger
,
V.
, 2006, “
Dimensions of Good and Poor Handwriting Legibility in First and Second Graders: Motor Programs, Visual–Spatial Arrangement, and Letter Formation Parameter Setting
,”
Dev. Neuropsychol.
,
29
(
1
), pp.
43
60
.
28.
Tseng
,
M.
, and
Chow
,
S.
, 2000, “
Perceptual-Motor Function of School-Age Children With Slow Handwriting Speed
,”
Am. J. Occup. Ther.
0272-9490,
54
(
1
), pp.
83
88
.
29.
Djioua
,
M.
, and
Plamondon
,
R.
, 2009, “
Studying the Variability of Handwriting Patterns Using the Kinematic Theory
,”
Hum. Mov. Sci.
0167-9457,
28
, pp.
588
601
.
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