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

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

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

Conditions
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Graphomotor Impairment

Participation Criteria
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Eligibility Criteria
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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.

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 6 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| study<br>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<br>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?
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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 |