Differences in Muscle Activity Patterns and Graphical Product Quality in Children With Graphomotor Impairment

Differences in Muscle Activity Patterns and Graphical Product Quality in Children With Graphomotor Impairment Copying and Tracing Activities on Horizontal or Vertical Surfaces

Drawing on a vertical surface, rather than horizontal (such as blackboard) is often used by occupational therapists as a way of developing fine motor control and visual motor integration in children. In healthy children no difference in graphical quality was shown between drawing on vertical or horizontal surfaces. However, this was not investigated in children with graphomotor impairments.

The goal of this study is to determine whether movements produced on a vertical surface differ in their performance level and muscle activation patterns compared to movements produced on a horizontal surface. The investigators predict that there would be a difference in the level of performance between the two surfaces.

Study Overview

• Status: Completed
• Conditions: Graphomotor Impairment

Detailed Description

Drawing on a vertical surface, such as a blackboard (rather than a horizontal surface) is often used by occupational therapists as a way of developing fine motor control and visual motor integration in children. While there is anecdotal evidence to support this intervention, preliminary results in healthy children showed no differences in graphical quality while drawing on vertical or horizontal surfaces. This however was not investigated in children with graphomotor impairments.

The goal of this study is to determine whether movements produced on a vertical surface differ in their performance level and muscle activation patterns compared to movements produced on a horizontal surface.

The investigators predict that the level of performance on the vertical surface will exceed the level of performance on the horizontal surface. Additionally, the investigators hypothesize that the proximal muscles will be more activated and fatigued (in longer tasks) while drawing on the vertical surface, while the distal muscle will be more activated and fatigued while drawing on the horizontal surface.

• Study Type: Observational
• Enrollment (Actual): 48

Contacts and Locations

Study Locations

• Israel
  • Ra'anana, Israel
    • Loewenstein Rehabilitation Center
  • Raanana, Israel
    • Loewenstein Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 4 years to 6 years (Child)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

A total of Forty five 4-6 years old children, referred to occupational therapy

Description

Study group Inclusion criteria:

• Up to 50 percentile in the long form Beery-Buktenica Developmental Test of Visual-Motor Integration (Beery VMI).

Exclusion Criteria:

• children in special education,
• any orthopedic or neurologic impairment,
• visual impairment that could not be corrected with glasses, or
• ability to understand and follow simple instructions, reported by the parents.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
study; After the parents sign an informed consent form, they will fill out a demographic questionnaire. Than if the Beery VMI test was not yet administered, it would be performed, as well as the Developmental Coordination Disorder Questionnaire (DCD-Q). Surface electromyography electrodes will be placed on the Upper Trapezius, Extensor Carpi Radialis, and Biceps brachii of the child's dominant hand. The subject will perform 4 copying tasks and 2 tracing tasks on a tablet placed once on a horizontal surface (while sitting) and once on a vertical surface (while standing).
control; After the parents sign an informed consent form, they will fill out a demographic questionnaire. Than if the Beery VMI test was not yet administered, it would be performed, as well as the Developmental Coordination Disorder Questionnaire (DCD-Q). Surface electromyography electrodes will be placed on the Upper Trapezius, Extensor Carpi Radialis, and Biceps brachii of the child's dominant hand. The subject will perform 4 copying tasks and 2 tracing tasks on a tablet placed once on a horizontal surface (while sitting) and once on a vertical surface (while standing).

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Normilized Muscle Activity	The maximal voluntary contraction (MVC) value for each muscle will be computed as the average of three peaks of the surface electromyography (sEMG) data, which differed by no more than 10% from one another. The mean root mean square (RMS) values of the sEMG data will be normalized by the MVC value for each muscle so that the value is presented by percentage.	day1

Collaborators and Investigators

• Sponsor: Loewenstein Hospital
• Investigators: Principal Investigator: Aviva Mimouni-Bloch, M.D, Clalit Health Services

Publications and helpful links

General Publications

• McHale K, Cermak SA. Fine motor activities in elementary school: preliminary findings and provisional implications for children with fine motor problems. Am J Occup Ther. 1992 Oct;46(10):898-903. doi: 10.5014/ajot.46.10.898.
• Schwellnus H, Carnahan H, Kushki A, Polatajko H, Missiuna C, Chau T. Effect of pencil grasp on the speed and legibility of handwriting after a 10-minute copy task in Grade 4 children. Aust Occup Ther J. 2012 Jun;59(3):180-7. doi: 10.1111/j.1440-1630.2012.01014.x.
• Ratzon NZ, Efraim D, Bart O. A short-term graphomotor program for improving writing readiness skills of first-grade students. Am J Occup Ther. 2007 Jul-Aug;61(4):399-405. doi: 10.5014/ajot.61.4.399.
• Yakimishyn JE, Magill-Evans J. Comparisons among tools, surface orientation, and pencil grasp for children 23 months of age. Am J Occup Ther. 2002 Sep-Oct;56(5):564-72. doi: 10.5014/ajot.56.5.564.
• Wilson BN, Kaplan BJ, Crawford SG, Campbell A, Dewey D. Reliability and validity of a parent questionnaire on childhood motor skills. Am J Occup Ther. 2000 Sep-Oct;54(5):484-93. doi: 10.5014/ajot.54.5.484.

Study record dates

Study Major Dates

• Study Start: June 1, 2015
• Primary Completion (Actual): October 1, 2016
• Study Completion (Actual): October 1, 2016

Study Registration Dates

• First Submitted: July 8, 2015
• First Submitted That Met QC Criteria: July 15, 2015
• First Posted (Estimate): July 17, 2015

Study Record Updates

• Last Update Posted (Actual): April 30, 2019
• Last Update Submitted That Met QC Criteria: April 21, 2019
• Last Verified: April 1, 2019

More Information

Terms related to this study

• Other Study ID Numbers: 22-14-LOE