Home-Based Calligraphic Handwriting Exercises in Parkinson's Disease

February 6, 2026 updated by: Sara Llamas Velasco

A Randomized Controlled Trial of Home-Based Calligraphic Handwriting Exercises in Patients With Parkinson's Disease

Parkinson's disease is a progressive neurodegenerative disorder with no curative treatment currently available. Its symptoms lead to increasing limitations in daily activities, with impairments in manual dexterity being particularly relevant. Handwriting difficulties are common in patients with Parkinson's disease; however, it remains unclear whether a rehabilitation program based on handwriting exercises can improve overall manual dexterity and daily functioning.

This randomized, single-blind controlled trial aims to evaluate the effects of a 12-week home-based calligraphic handwriting exercise program on manual dexterity in patients with Parkinson's disease. Participants will be recruited from the Movement Disorders Clinic of Hospital 12 de Octubre (Madrid, Spain) and randomly assigned to either an intervention group or a control group.

Manual dexterity will be primarily assessed using the Purdue Pegboard Test across scheduled study visits. Secondary outcomes will include measures of dexterity related to activities of daily living, quality of life, and motor function.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

53

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Spain
    • Madrid
      • Madrid, Madrid, Spain
        • Hospital Universitario 12 de Octubre

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

INCLUSION CRITERIA:

  • Patients aged 40 to 80 years
  • Clinical diagnosis of Parkinson's disease according to the UK Brain Bank criteria.
  • Hoehn and Yahr stage 1 to 4
  • Assessed in the ON-medication state (approximately 90 minutes after levodopa intake)
  • Stable antiparkinsonian treatment for at least 4 weeks prior to study entry and maintained throughout the study period

EXCLUSION CRITERIA:

  • Parkinson's disease-related dementia, defined as a Montreal Cognitive Assessment (MoCA) score < 21
  • Upper limb comorbidities unrelated to Parkinson's disease that could interfere ith exercise performance (e.g., arthritis, recent fractures, stroke sequelae, or peripheral neuropathy)

  • Severe tremor or severe dyskinesias affecting the dominant hand, defined as:

    • a score ≥ 3 on UPDRS-III items 20 or 22, or
    • score ≥ 2 on UPDRS-IV item 33

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Calligraphic Handwriting Exercise Program
Participants assigned to this group will perform a structured home-based calligraphic handwriting exercise program designed to improve fine motor control and manual dexterity over a 12-week period.
Behavioral: Calligraphic Handwriting Exercise Program
A structured home-based calligraphic handwriting exercise program designed to train fine motor control and manual dexterity. Participants perform predefined handwriting exercises regularly over a 12-week period using provided written materials.
No Intervention: Usual Care
Participants assigned to this group will receive usual clinical care and will not participate in the calligraphic handwriting exercise program during the study period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Manual Dexterity
Time Frame: Baseline and up to 12 weeks
Manual dexterity will be assessed using the Purdue Pegboard Test. The primary outcome will be the change in Purdue Pegboard Test score from baseline across scheduled study visits.
Baseline and up to 12 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sara Llamas Velasco

Collaborators

Carlos III Health Institute

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 5, 2022

Primary Completion (Actual)

September 8, 2025

Study Completion (Actual)

September 8, 2025

Study Registration Dates

First Submitted

January 21, 2026

First Submitted That Met QC Criteria

February 6, 2026

First Posted (Actual)

February 10, 2026

Study Record Updates

Last Update Posted (Actual)

February 10, 2026

Last Update Submitted That Met QC Criteria

February 6, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PI21-01622

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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