The effect of the upper extremite motor training on writing of children having disgraphia problem

ivSUMMARYÇinar Özdemir Ö,The Effect Of The Upper Extremite Motor Training onWriting of Children Having Disgraphia Problem, Abant İzzet Baysal UniversityScience Of Health Enstitute Physiotherapy and Rehabilitation Program ,Master Research/Bolu 2006.This study was planned to determine the effect of actuation of the upper extremiteproximal and distal muscles on legibility of writing of children having education innormal schools. 87 inviduals having education in Milli Egemenlik and KültürPrimary schools in Bolu, joined this study. Being randomized, they were divided into5 groups as; 16 of them were selected as distal physiotherapy education group, 17 ofthem as proximal physiotherapy education group, 18 of them as distal-proximalphysiotherapy education group, 17 of them as poor handwriting control group I and19 of them as good handwriting control group II. At the begining of the study thelegibility of writings, the muscle strengths, the fine manual skills and the strength ofgrasps of the inviduals in education and control groups were evaluated. Themeasurements were repeated after 8 weeks. The distal, proximal and distal-proximaleducation groups were taken into the program three 30-45 minuted sessions a weektotally for 8 weeks. The control groups didn?t join any education programs. Duringthe evaluation of the facts after the study, it was seen that the legibility of writings,the muscle strengths, the fine manual skills and the strength of fine and gross grasps?values of distal, proximal and distal-proximal physiotherapy education groupsincreased significantly (p<0,05). The improvement of flexion and extansion of wristsof distal physiotherapy education group and distal-proximal physiotherapy educationgroup increased significantly more than the proximal education group. Theimprovement of strength of shoulder and elbow muscle groups of proximal anddistal-proximal education groups showed more increase than the distal educationgroup. When the scores of the legibility of writing and the fine manual skillmeasures, evaluated before and after the education, were examined, significantimprovements were observed in all three physiotherapy education groups (p<0,05).When all groups were compared among each other, no significant difference wasseen (p>0,05). After the measurements, the significant improvements were observed;vin distal physiotherapy education group mostly in manual skills and hand musclestrength, in proximal education group in proximal muscles, in distal-proximal group,both in proximal and distal muscles and manual skills. As the skill of hand writing isformed of making the manual skills in coordination with the proximal musclestability, it was observed that, to improve skill of writing it is necessary to actuateboth proximal and distal muscles as conclusion.Key words: Handwriting,evaluation, fine motor skills, physiotherapy, disgraphia