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  • Writer's pictureEngage PT, OT, SLP Therapy and Wellness

Give Yourself a Hand - Improving Manual Dexterity

The ability to use our hands skillfully, or manual dexterity, impacts practically every activity in daily life. Hands perform work for us like buttoning a shirt, washing dishes, or opening the mail. Hands also help us to express ourselves — from writing well wishes on a birthday card, to arranging flowers, to typing an email to a friend.

Manual dexterity has been shown to be an important factor in predicting performance in basic activities of daily living among people with Parkinson’s (PWP). Improving manual dexterity can have direct benefits for PWP to maintain independence and quality of life.

So, it is essential to keep those hands moving!

What does the research say about improving manual dexterity in PD?

Some recent studies have shown that both intensive, task specific home-based programs and occupational therapy as part of a multidisciplinary rehabilitation approach improve hand functionality and dexterity in PWP. There is also well established evidence that exercise focusing on making big movements with high repetitions effectively trains improved quality of motor performance in a variety of daily tasks.

Handwriting can also be a challenge for PWP. Micrographia — defined by abnormally small handwriting or handwriting that becomes progressively smaller and harder to read — may occur in 50% of PWP and can be an early sign of the disease. Recent studies find that intensive training focusing on high amplitude writing is effective in improving writing size. Handwriting training with visual cues and feedback have also been shown to improve writing speed and motor function of the hands. 

Improving manual dexterity in your daily routine


Try our video with Liz Yates-Horton DPT showing exercises that will help your hands get moving in daily tasks

How to Make Handwriting Easier

  • Use a pen grip. You may find a pen grip assist helpful or using a larger/thicker pen to help keep your hand relaxed.

  • If you have a tremor, a weighted pen can be helpful

  • Take your time and think about moving BIG. Rushing when writing can be a cause of micrographia.

  • Use lined paper that provides a visual target to help keep your writing big.

  • Try printing instead of cursive, which allows for a natural pause between letters.

  • If your hand is feeling tight give your hand a rest and try to do some flicks.

  • Check in on your posture. Your hands are more easily going to write big if you are sitting upright and tall.

  • Practice in a quiet area with few distractions.

  • If you have "on" times, focus on writing during this time.


Use these free downloadable worksheets that can help you with handwriting

Download PDF • 520KB

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