Writing Orthotic Device for the Management of Writer’s Cramp

Background: Oral therapies and chemodenervation procedures are often unrewarding in the treatment of focal, task-specific hand disorders such as writer’s cramp or primary writing tremor (PWT). Methods: A portable writing orthotic device (WOD) was evaluated on 15 consecutively recruited writer’s cramp and PWT subjects. We measured overall impairment at baseline and after 2 weeks of at-home use with the Writer’s Cramp Rating Scale (range = 0–8, higher is worse) and writing quality and comfort with a visual analog scale (range = 0–10). Results: Compared to regular pen, the WOD improved the Writer’s Cramp Rating Scale scores at first-test (p = 0.001) and re-test (p = 0.005) as well as writing quality and device comfort in writer’s cramp subjects. Benefits were sustained at 2 weeks. PWT subjects demonstrated no improvements. Conclusion: WODs exploiting a muscle-substitution strategy may yield immediate benefits in patients with writer’s cramp.