Paper, pen and ink: An innovative system and software framework to assist writing rehabilitation

Handwriting analysis and rehabilitation is an actively explored area in the diagnosis and treatment of Parkinson´s disease, which is usually performed in an ambulatory setting under direct supervision of a clinician. Technology can play an important role to reduce the need of therapist assistance and to enhance diagnostic precision through the computation of non-subjective handwriting quality metrics. This paper introduces an innovative handwriting rehabilitation system for PD patients, which ensures a natural writing experience as it is based on pen, ink and paper (as opposed to tablet and stylus). The system is designed for human-in-the loop operation and it can analyze handwriting in real-time and provide vocal feedback to guide the patient during the execution of exercises. We present a detailed comparative characterization of the key components of the system, namely wireless digital pens; in addition, in-field test assessed the system usability regarding its ease of use, calibration precision and vocal feedback effectiveness.