Evaluation of Rehabilitation Interventions for Fine Motor Skill Acquisition among Patients with Parkinson’s Disease: A Systematic Review with Meta-Analysis

Hriday Shah; Shivani Gollamudi; Chaitali Shah; Sanjukta Sardesai

doi:10.15621/ijphy/2026/v13i2/2186

Authors

Hriday Shah Ph.D. Scholar, Faculty of Physiotherapy, Parul University, Gujarat, India.
Shivani Gollamudi Asian TransCare Rehabilitation Centre, Telangana, India.
Chaitali Shah Professor, Faculty of Physiotherapy, Parul Institute of Physiotherapy, Gujarat, India. Email: shah.hriday80@gmail.com
Sanjukta Sardesai All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India.

Abstract

Background: Fine motor impairments in Parkinson’s disease (PD) often make everyday tasks difficult. While pharmacologic treatment helps reduce general motor symptoms, targeted rehabilitation strategies are essential for improving upper-limb dexterity and functional independence.
Objective: This systematic review and meta-analysis aim to evaluate the effectiveness of rehabilitation interventions designed to enhance fine motor skills in people with PD (PwPD), addressing gaps in the literature by focusing exclusively on upper-limb outcomes.
Methods: Following PRISMA 2020 guidelines, a comprehensive search across five databases identified 55 eligible studies, including randomized controlled trials (RCTs) and non-randomized studies. Data extraction followed the PICOS framework. Risk of bias was assessed using RoB 2.0 and ROBINS-I tools, and the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses were conducted using a random-effects model, and heterogeneity was explored through subgroup analysis.
Results: Interventions included aerobic training, dexterity-based exercises, virtual reality, telerehabilitation, and LSVTBIG. While individual studies showed positive trends, pooled meta-analyses of aerobic exercise, telerehabilitation, and dexterity training revealed non-significant effects due to substantial heterogeneity (I² > 75%). Studies lacked long-term follow-up, and variability in protocols and outcome measures limited the ability to draw definitive conclusions.
Conclusion: Rehabilitation approaches hold potential to enhance fine motor skills in PwPD, particularly through taskspecific training and technology-assisted methods. However, the current evidence base is hindered by methodological inconsistencies and limited statistical significance. High-quality, longitudinal trials with standardized outcome measures are needed. The promising but underexplored use of weighted gloves for tremor control warrants future investigation.