A review of factors that influence adult handwriting performance

BACKGROUND: Handwriting is an important activity for people of all ages. Handwriting is frequently affected after stroke and other neurological conditions. However, research on the handwriting of healthy adults is difficult to find. This review aims to advance the development of evidence-informed handwriting assessment and retraining. AIM: The aim of this paper was to review factors that influence the handwriting performance of unimpaired adults, some of which are amenable to intervention. METHODS: Searches were conducted of eight electronic databases up to April 2009 and again in November 2010. Reference lists were also used to identify potential studies of interest. No limits were placed on study design. FINDINGS: Age: Younger adults write more legibly and faster than older adults. Gender: Women write faster and more legibly than men. Pengrip: Grips other than the traditional dynamic tripod are functional, producing legible text in an acceptable time. Pen pressure: Pressure varies with different letters, words, text size, speed and across a page of text. Error corrections and a mixed writing style occur in healthy adult handwriting. Research was inconclusive about the association between speed, pressure and upper limb movements on handwriting performance. Other factors able to predict adult handwriting legibility have been largely unexplored. DISCUSSION: A number of knowledge and research gaps about adult handwriting were identified, including the need for more contemporary normative data.