Finger Individuation Training With a Training Device Versus Conventional Rehabilitation for Writer's Cramp

Study Overview
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Brief Summary
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Writer's cramp (WC) is a focal dystonia characterized by abnormal movements and postures during writing. Limited finger independence during writing manifests as difficulty suppressing unwanted activations of neighbouring non task-relevant fingers. WC patients also have difficulty in fine control of grip force. However, some previous studies indicate positive effects of individual finger movement training in WC although these studies lacked enhanced visual feedback of activations in 'stationary' fingers. The investigators have recently developed the Finger Force Manipulandum which quantifies the forces applied by the fingers in different tasks. This method is sensitive for detection and quantification of small unwanted contractions in non-active ('stationary') fingers. Forces in 'stationary' fingers can be displayed on-line providing enhanced feedback on independence of finger movements. The aim of this study is to test the effectiveness of finger individuation training using the FFM to improve symptoms in WC patients.

Official Title
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Effectiveness Study of Finger Individuation Training by Finger Force Manipulandum (FFM) Compared to Conventional Rehabilitation for Patients With Writer's Cramp

Conditions
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Dystonic Disorders

Intervention / Treatment
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* Device: Finger Force Manipulandum
* Other: Conventional physiotherapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: writer's cramp (diagnostic confirmed by a neurologist specialized in movement disorders handwriting speed < 140 letters per minute simple or complex writer's cramp scholarship in French language absence of treatment by botulinum neurotoxin, or last injection > 3 months age > 18 and < 71 years informed consent medical insurance coverage Exclusion Criteria: writer's cramp with no impact on writing writing tremor other neurological disease with effect on writing pain or traumatism of the limb used for writing, requiring medical or surgical treatment in the last preceding months participation in another research with a potential impact on evaluation criteria pregnant or breast feeding patient patient under judiciary protection

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Finger individuation training<br>Finger Force Manipulandum | Device: Finger Force Manipulandum<br> <br> |
| Active Comparator: control<br>conventional physiotherapy | Other: Conventional physiotherapy<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change in writing speed after rehabilitation | number of letters correctly copied in 60 seconds | Change from baseline writing speed at week 8 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Focal Dystonia, Writer's cramp