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.