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

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

Interventions

PROCEDURE

Task-specific drawing exercises

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

PROCEDURE

Fine motor training

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

Sponsors & Collaborators

• Foundation University Islamabad

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

40 Years

Max Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-02-11

Primary Completion

2027-01-22

Completion

2027-02-22

Countries

• Pakistan

Study Locations