An investigation of two interventions for micrographia in individuals with Parkinson’s disease

Objective: This pilot study was designed to compare a change in micrographia between using grid lines and parallel horizontal lines as visual cues in individuals with Parkinson’s disease. Design: Single group pre- and post-test. Setting: Research lab. Participants: Eleven males with Parkinson’s disease. Interventions: Practice writing words with parallel and grid lines. The sequence of practising was randomized. Main outcome measures: Length of words. Results: The length of the words after practising with parallel lines was longer than in the initial free writing condition (17.83 ± 3.93 cm vs. 23.36 ± 5.82 cm, P =0.008). The length of the words after practising with grid lines was also longer than during free writing (17.83 ± 3.93 cm vs. 22.65 ± 4.04 cm, P =0.003). The length of the words after practising with parallel lines was not different from that after practising with grid lines. Conclusion: Improvements in letter size after practising with horizontal parallel lines and grid lines were not different. The addition of vertical lines to form a grid did not appear to improve the writing more than horizontal lines alone in persons with Parkinson’s disease who experienced micrographia.