Parkinson's Disease and Handwriting - Occupational Therapy Can Get You Back on the Right Page 

By Emilee Kucheruk, COTA/L 

Over time, handwriting can change, especially with age, tremors, and changes in vision, and strength. With Parkinson’s Disease (PD), handwriting can be impacted by tremors, slowed movement, and rigidity. Seventy-five percent of people with PD have micrographia, which is small, cramped handwriting. It is a result of the same brain processes that affect the amplitude of other movements in the body. 

The good news? There are ways to manage the symptoms of PD that affect handwriting. The most important is to PRACTICE writing every day! The saying “If you don’t use it, you lose it” applies here. To prevent handwriting from worsening, practice, practice, practice! Using lined paper helps provide visual feedback for letter spacing and sizing, and practicing when medication is working best is also helpful. Be certain to take adequate rest breaks as needed to avoid onset of fatigue and hand cramping. Another important consideration is you might need to update your legal signature as your handwriting changes, this is especially important for legal and financial documents. A lawyer and notary can assist with these changes. 

Maintaining your hand strength will also assist with continued independence and legibility in handwriting and keyboarding. Exercise tools, such as resistive putty, resistive hand exercise balls, and grip strengtheners can be beneficial for overall hand strength, too. If your handwriting feels tight and is getting smaller and smaller try 10 big finger flicks like you are trying to flick water off the ends of your fingers. This simple big motion can improve dexterity and amplitude of the hands and fingers. 

Utilizing different writing utensils and tools can assist with making writing easier. If writing becomes too difficult it may be time to switch to typing. There are many different tools available. Below is a list of writing utensils/tools and keyboarding tools that could assist with independence and participation. 

Writing Utensils/Tools: 

Keyboarding Tools: 

If you have concerns about your handwriting, keyboarding, or hand strength and dexterity, schedule an appointment with our occupational therapy team. They will perform an evaluation and get you back on the right page.