The effects of pencil grip posture and different desk designs on handwriting performance in children with hemiplegic cerebral palsy.

OBJECTIVE The aim of this study was to investigate the effect of different ergonomic desk designs and pencil grip patterns on handwriting performance in children with hemiplegic cerebral palsy and healthy children. METHODS Twenty-six children with left hemiplegic cerebral palsy and 32 typically developing children were included. The Minnesota Handwriting Assessment was used to evaluate handwriting abilities. Pencil grip posture was assessed with a 5-point rating system. Specifically designed adjustable desks and chairs were used. Four different desk types were used in this study: 1) regular desk; 2) regular desk with a 20 degrees inclination; 3) cutout desk; and 4) cutout desk with a 20 degrees inclination. RESULTS Statistically significant differences were found between both groups in terms of handwriting ability (p < 0.001). There was no significant difference regarding grip scores between children with cerebral palsy and healthy children (p > 0.05). We found that children with cerebral palsy had better performance using cutout desks in relation to rate and spacing parameters of handwriting (p < 0.05). CONCLUSION The results of our study demonstrated that the pencil grip patterns have no effect on the handwriting parameters in both children with cerebral palsy and healthy children. It is recommended that a cutout table be used to provide more upper extremity support in handwriting activities for students with cerebral palsy.