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Master Thesis

Are tilted writing and drawing after stroke related to a biased perception of the vertical?

Abstract : Spatial dysgraphia showed after a right hemispheric stroke (RHS) is partially explained by spatial neglect. This study aimed to test the hypothesis that the counterclockwise tilt of the handwriting and drawing is due to a counterclockwise tilt in representing the vertical, transposed on the sheet of paper. It also aimed to propose valid and reliable criteria with cut off values to routinely diagnose a counterclockwise tilt of the writing or the drawing in victims of a RHS. This is an observational study on 61 right-handed patients tested 30 days after a RHS and 44 aged and sex matched healthy subjects. All were asked to write and draw by hand standardized material. We measured the inclination of margin and lines (writing) and of the trees and base lines (drawing). Spatial neglect, Postural (PV) and visual (VV) vertical were assessed in patients. Statistics were non-parametric and normality defined as the 95th percentile of normal data. Negative signs indicated counterclockwise tilts. The cut off to diagnose a tilted material was -6.9° (left margin), -4.9° (lines written); -5.5° (trees). Healthy subjects had a significant counterclockwise writing and drawing tilt. At least one criteria presented a counterclockwise tilt in 23 patients (38%). Compared to others, these patients showed greater lateropulsion (p=0.001), bias in PV (p=0.018) and VV (p=0.001), non body neglect and more hemianopia. This study gives valid and reliable criteria to diagnose a counterclockwise tilt of the writing or drawing, showed by 38% of the patients, who showed a greater bias in perception of verticality. Healthy subjects wrote and drew with a counterclockwise tilt.
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Master Thesis
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Contributor : Jean-Hugues Morneau <>
Submitted on : Tuesday, June 30, 2020 - 11:50:14 AM
Last modification on : Tuesday, May 11, 2021 - 11:36:24 AM


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  • HAL Id : dumas-02884957, version 1


Flora Diaine. Are tilted writing and drawing after stroke related to a biased perception of the vertical?. Human health and pathology. 2019. ⟨dumas-02884957⟩



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