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Chinese calligraphy handwriting (CCH): a case of rehabilitative awakening of a coma patient after stroke

Authors Kao HSR, Lam SPW, Kao TT

Received 30 July 2017

Accepted for publication 11 December 2017

Published 31 January 2018 Volume 2018:14 Pages 407—417

DOI https://doi.org/10.2147/NDT.S147753

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Professor Wai Kwong Tang

Video abstract presented by Henry Kao.

Views: 70

Henry SR Kao,1 Stewart PW Lam,2 Tin Tin Kao3,4

1Calligraphy Therapy Laboratory, Shenzhen Institute of Neuroscience, Shenzhen, China; 2Research and Development Division, Calli-Health Society, 3Department of Geography, 4Department of Psychology, University of Hong Kong, Hong Kong

Introduction: This study investigated the efficacy of Chinese calligraphy handwriting (CCH) for the awakening of patients under a vegetative state after stroke. The theories, the instrument, and the treatment protocols were reported. A single case of a severe stroke patient who was in a coma state for 2 years is presented in this study. The objectives were to apply finger writing as a new method to awaken a stroke patient in a coma state and to test the effect of this method in improving the patient’s vegetative states over time.
Case presentation: A 55-year-old man suffered a severe stroke in 2004 which left him in a coma for 2 years without any systematic rehabilitation. A culture-based finger-writing method of visual-spatial intervention was then applied to improve his condition. The writing tasks involved aided viewing and finger tracing of sets of innovative characters with enriched visual-spatial and movement characteristics. Following regular treatment protocols involving diverse movement and sensory feedback, the patient was awakened after 12 months. As a consequence, the patient showed significant behavioral changes favoring enhanced focusing, alertness, visual scan, visual span, and quickened visual and motor responses. The treatment continued for another 12 months. As the treatment progressed, we gradually observed improvements in his attention span and mental concentration. His eye ball movements – the left eye in particular – were quickened and showed wider visual angularity in his focal vision. Currently, the patient can now watch television, engage in improved visual sighting, and focus on visual-spatial and cognitive-linguistic materials.
Conclusion: This CCH method of training by finger tracking has shown its effectiveness in awakening the patient from his coma state and in producing long-term, clinical outcomes that were similar from those that took place 10 years ago. This finding supports the efficacy of the system for clinical improvement of the patient’s conditions.

Keywords: calligraphy therapy, coma, vegetative state, awakening, functional plasticity, finger writing

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