Comparative Effects of Task-specific Drawing Exercises and Fine Motor Training on Dexterity and Hand Motor Function After Stroke

NCT07803016 | Recruiting

• 1 other identifier: FUI/FUCP/CTR/Neuro/Sawaira
• Study Type: interventional
• Target: 26
• Locations: 1 country
• Sites: 1

Brief Summary

Stroke is a leading cause of long-term disability worldwide and frequently results in persistent upper limb impairment, particularly affecting hand dexterity and motor function. These impairments significantly restrict the performance of activities of daily living, reduce functional independence, and negatively affect quality of life. Task-oriented rehabilitation has become an important component of stroke management because it promotes motor relearning through repetitive practice of meaningful functional activities. Among these approaches, task-specific drawing exercises and fine motor hand training have demonstrated potential to improve upper limb function; however, evidence directly comparing their effectiveness remains limited. This randomized controlled trial will compare the effects of task-specific drawing exercises and fine motor hand training on hand dexterity and hand motor function in individuals with subacute stroke. Twenty-six participants will be randomly allocated to one of two intervention groups. Both groups will receive conventional wrist and finger range-of-motion exercises before participating in their assigned intervention. Participants in the task-specific drawing exercise group will perform a progressively graded drawing program, whereas participants in the fine motor hand training group will complete a structured program of functional object-manipulation activities. Both interventions will be administered on alternate days for 30-45 minutes over a four-week period. The primary outcome will be hand dexterity, and the secondary outcome will be hand motor function. Outcome assessments will be performed at baseline and following completion of the intervention period using standardized assessment tools. The findings of this study are expected to provide comparative evidence regarding the effectiveness of task-specific drawing exercises and fine motor hand training for improving hand function after stroke. The results may contribute to evidence-based neurological rehabilitation and assist physiotherapists in selecting effective intervention strategies to enhance upper limb recovery, functional independence, and quality of life in individuals with subacute stroke.

Conditions

Stroke

Keywords

Dexterity; Hand motor function; Task specific drawing exercises; Fine motor training; Stroke rehabilitation; Nine hole peg test; Fugl-Meyer Assessment Hand

Outcome Measures

Primary Outcomes (1)

• Dexterity

  Hand dexterity will be assessed using the Nine-Hole Peg Test (NHPT), a standardized performance-based measure of dexterity. The outcome will be recorded as the time in seconds required to complete the task, with a lower completion time indicating better dexterity. For interpretation, the study protocol will classify completion times as \<30 seconds: normal dexterity; 30-60 seconds: mild impairment; 60-120 seconds: moderate impairment; and \>120 seconds or inability to complete the test: severe fine motor impairment

  4 weeks

Secondary Outcomes (1)

• Hand motor Function

  4 weeks

Study Arms (2)

Task-specific Drawing exercises group

EXPERIMENTAL

Procedure: Task-specific drawing exercises

Fine motor training Group

ACTIVE COMPARATOR

Procedure: Fine motor training

Interventions

Task-specific drawing exercises PROCEDURE

Participants allocated to the task-specific drawing exercise group will receive a structured four-week progressive drawing intervention. Both groups will first perform standardized wrist and finger range-of-motion exercises, including wrist circles, wrist flexion and extension, finger abduction and adduction, and thumb opposition. The drawing intervention will be delivered on alternate days for 30-45 minutes, with 15 repetitions of each activity. 7 Week 1 will include geometric drawing and shading activities, including parallel vertical, horizontal, and diagonal lines, curved and semicircular lines, concentric circles and ovals, spirals, repeated curved patterns, cone-like forms, nested squares, rectangles, parallelogram-like forms, and triangles. Week 2 will progress to combined forms such as a house, table, chair, bowl or cup, and bicycle. Week 3 will include irregular natural forms, particularly leaf patterns. Week 4 will progress to freehand drawings, including trees and human eyes

Task-specific Drawing exercises group

Fine motor training PROCEDURE

Participants allocated to the fine motor training group will receive a structured four-week progressive program targeting coordinated finger movements, grasp, release, precision, and object manipulation. Both groups will first perform standardized wrist and finger range-of-motion exercises, including wrist circles, wrist flexion and extension, finger abduction and adduction, and thumb opposition. Fine motor training will be delivered on alternate days for 30-45 minutes, with 15 repetitions of each activity. Week 1 will include rolling paper pieces into wads, transferring large beads into a small jar, and rolling a pencil between the thumb and fingers. Week 2 will include paper folding, stacking medium cubes, card manipulation, opening and closing a jar, pen twirling, and transferring medium beads. Week 3 will include tearing paper, paper-clip placement, stacking small cubes, transferring small beads, and buttoning. Week 4 will include tearing small paper pieces, coin picking, bottle-c

Fine motor training Group

Eligibility Criteria

• Age: 40 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 40-70 years.
• Diagnosed with MCA ischemic or hemorrhagic stroke, confirmed by medical records.
• Sub-acute stroke patients and to perform minimal voluntary finger or wrist movement in the affected hand (\_\>30 pronation supination and wrist flexion)
• Ability to understand and follow simple verbal instructions.
• Able to sit without upper limb support.

You may not qualify if:

• Aphasia, cognitive deficits
• Modified Ashworth Scale \>3 in the wrist or fingers of the affected hand.
• History of Parkinson's disease, multiple sclerosis, traumatic brain injury, or recurrent stroke.
• Fracture, arthritis, tendon injury, or deformity affecting the upper limb or hand.
• visuospatial neglect interfering with drawing tasks.

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University College of Physical Therapy

Islamabad, Pakistan

RECRUITING

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Central Study Contacts

Sawaira Naeem, DPT

CONTACT

+923195547002; sawairanaeem987@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: August 31, 2026
• First Posted: September 3, 2026
• Study Start: February 11, 2026
• Primary Completion (Estimated): January 22, 2027
• Study Completion (Estimated): February 22, 2027
• Last Updated: September 3, 2026

Record last verified: 2026-08

Locations

PA (1)