A Study On The Efficacy Of Chinese Calligraphy Practice On The Intervention Of Upper Limb Motor Function Rehabilitation In Subacute Stroke Patients

Background:Chinese calligraphy handwriting(CCH)exercises have comprehensive requirements for coordination and flexibility of the upper limbs and stability of motor performance in stroke patients.The aim of this study is to investigate a CCH-based rehabilitation therapy based on writing characters and compare it with the current selfadministered upper extremity intervention exercise approach(The Graded Repetitive Arm Supplementary Program(GRASP))to provide an evidence reference and theoretical support for the use of CCH therapy in the treatment of upper extremity motor dysfunction in patients with subacute stroke.Methods:Thirty patients with subacute stroke in the Shanghai Second Rehabilitation Hospital were randomly assigned to the calligraphy group(CCH group)and the GRASP group(15 patients in each of the two groups),and both groups received conventional rehabilitation therapy,including manual therapy(30 minutes),exercise therapy(20 minutes)and physical factor therapy(20 minutes).The CCH group received an additional 30 minutes/day,5 days/week for 3 weeks in addition to the regular rehabilitation training,while the GRASP group received an additional 30minutes/day,5 days/week for 3 weeks in addition to the regular rehabilitation training.Fugl-Meyer assessment of the upper extremity(FMA-UE),the Purdue pegboard test(PPT),the Disabilities of arm,shoulder,and hand(DASH),modified Barthel index(MBI)and grip strength were used to assess the upper extremity motor function and activities of daily living of the subjects.In this study,SPSS statistical software was used to statistically analyze the experimental data,and the count data were described using the composition ratio and statistically analyzed using the chi-square test,and the measurement data were compared using the SW normal distribution test,which conformed to the normal distribution and were expressed using the mean ± standard deviation,and the data that did not conform to the normal distribution were expressed using the quartiles,using the Mann-Whitney U test.The difference was considered statistically significant when the test level was set at P<0.05.Results:Within-group pre-and post-intervention analyses showed that the CCH group showed statistically significant differences in FMA-UE(P=0.001),PPT affected hand(P=0.001),PPT both hands(P=0.001),PPT assembly hands(P=0.011),DASH(P=0.024)and MBI(P=0.003)scores compared to pre-intervention;the GRASP group showed statistically significant differences in FMA-UE(P=0.001),PPT healthy side hand(P=0.012),PPT both hands(P=0.007),PPT assembly hands P=0.017),DASH(P=0.015)and MBI(P=0.048)scores appeared statistically different than pre-intervention.Analysis of post-intervention outcome indicators between groups showed statistical differences(P < 0.05)in PPT affected hand(P=0.016)and assembly hands(P=0.041)as well as grip strength(P=0.012)scores between the two groups.no statistical differences(P > 0.05)were observed in FMA-UE,PPT healthy side hand & assembly hands,BMI and DASH scores.Conclusion:(1)After 3 weeks of CCH treatment,the patients’ upper limb motor function condition,fine item manipulation ability and daily living level were improved.(2)After 3 weeks of treatment,patients in the CCH group showed more significant improvements in fine object manipulation ability and grip strength compared with the GRASP group.(3)CCH has great potential to become a self-administered upper extremity rehabilitation intervention to promote the recovery of upper extremity motor function after stroke.