• Narayanasarma V Singam, Alok Dwivedi, and Alberto J Espay.
• Department of Neurology, UC Neuroscience Institute, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati Cincinnati, OH, USA.
• Front Neurol. 2013 Jan 1;4:2.

BackgroundOral therapies and chemodenervation procedures are often unrewarding in the treatment of focal, task-specific hand disorders such as writer's cramp or primary writing tremor (PWT).MethodsA portable writing orthotic device (WOD) was evaluated on 15 consecutively recruited writer's cramp and PWT subjects. We measured overall impairment at baseline and after 2 weeks of at-home use with the Writer's Cramp Rating Scale (range = 0-8, higher is worse) and writing quality and comfort with a visual analog scale (range = 0-10).ResultsCompared to regular pen, the WOD improved the Writer's Cramp Rating Scale scores at first-test (p = 0.001) and re-test (p = 0.005) as well as writing quality and device comfort in writer's cramp subjects. Benefits were sustained at 2 weeks. PWT subjects demonstrated no improvements.ConclusionWODs exploiting a muscle-substitution strategy may yield immediate benefits in patients with writer's cramp.

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