Hand

This study aims to evaluate the effectiveness of a VR intervention on teaching handwashing skills which are promoted by the Centre for Health Protection, Department of Health, HKSAR. A 7-step handwashing approach will be taught through a customized VR game in secondary schools in Hong Kong. Participant's handwashing skills and prolonged effects on handwashing habits and hygiene level will be assessed. The main questions it aims to answer are: * Does an intervention of our VR handwashing game enhance handwashing skills amongst junior secondary students? * What are the factors hinder or enhance students' learning of handwashing skills in the intervention? Participating students will be assigned into 3 groups. Each group will receive two sessions of educational training with different kinds of intervention throughout one school year (9 months). The first intervention group will participate in two VR-game sessions on handwashing skill; the second intervention group will participate in one VR-game session and one video session about handwashing; the baseline group will participate in two sessions of other VR activities unrelated to hand hygiene and view a handwashing skill poster. The research will compare the handwashing performance between the three groups. Participants will: * participate into a VR handwashing game intervention, or a video-based intervention, or placebo VR activities as stated hereinafter; * perform handwashing in the VR game, and their hand-motion data will be captured; * participate a UV lighting test after handwashing away fluorescent lotion; and, * fill up questionnaires

This is a cross-sectional survey study investigating how medical team staff in elite Swedish ice hockey perceive hand and wrist injuries in male and female players. Hand and wrist injuries are common in ice hockey and can affect both performance and participation. While injury registries describe how often these injuries occur, less is known about how they are managed and prioritised in daily clinical practice, or whether there are differences in perception between medical teams working in male and female elite leagues. In this study, physiotherapists and team physicians working in Swedish elite ice hockey (including SHL, HockeyAllsvenskan, and SDHL) will complete a structured questionnaire. The survey examines perceptions of injury frequency, underreporting, functional impact, clinical management strategies, and return-to-play decision-making related to hand and wrist injuries. The aim is to better understand how medical teams experience and manage these injuries in real-world elite sport settings, and to identify potential gaps between epidemiological data and clinical practice. The study may help inform future injury prevention strategies, improve clinical decision-making, and support the development of more standardized management approaches in elite ice hockey. No interventions or treatments are performed in this study.

Ice hockey places high physical demands on the hands and wrists due to frequent shooting, passing, and physical contact. This study aims to understand how common hand and wrist pain or symptoms are among ice hockey players in Sweden, and how these symptoms affect training, participation, and performance. Players from different competitive levels (elite, junior, and amateur) and both sexes will complete a structured questionnaire based on the validated Oslo Sports Trauma Research Centre (OSTRC) tool, along with questions about pain intensity, symptom characteristics, and functional impact. The goal is to describe the prevalence and severity of hand and wrist symptoms across different groups of players and to identify potential differences between sex, playing level, and position. No treatment or intervention is involved.

This study investigates the neurophysiological mechanisms underlying the combined use of transcranial direct current stimulation (tDCS) and action observation therapy (AOT) for hand motor recovery in individuals with stroke. Background: While both tDCS and AOT have shown promise individually for stroke rehabilitation, the neural mechanisms of their combined effects remain unclear. Understanding these mechanisms could optimise rehabilitation protocols and improve functional outcomes. Intervention: Participants will receive 10 sessions of anodal tDCS over the ipsilesional motor cortex combined with AOT over two weeks in a clinical setting, followed by 8 weeks of home-based AOT practice. Control groups will receive tDCS alone or AOT alone. Neurophysiological changes will be assessed using motor evoked potentials (MEPs) to evaluate corticospinal excitability. Clinical hand function will be assessed using standardised outcome measures. Measurements: Assessments will be conducted at baseline, during intervention (week 2), and after the home practice phase (week 10) to evaluate neuroplastic changes. Significance: This study will provide mechanistic insights into how neuromodulation and observational learning interact to promote motor recovery, informing evidence-based rehabilitation strategies for stroke survivors in Malaysia and globally. Study Design: Randomised controlled trial with three parallel arms, recruiting 60 participants with chronic stroke from Sabah, Malaysia.

This study investigates whether early changes observed during the first weeks of hand and upper extremity rehabilitation can predict patient outcomes months later. In rehabilitation practice, clinicians make numerous decisions each session regarding exercise type, frequency, duration, and treatment approach. Most of these decisions are currently made without systematic longitudinal data. This study addresses three fundamental questions using data collected during routine clinical care: (1) Can the rate of improvement in the first weeks of treatment predict functional status months later, across both session-based and milestone-based time points? (2) Are there meaningfully different recovery profiles among hand rehabilitation patients? (3) Is there measurable variation in clinical decision-making among patients with similar profiles, and does this variation relate to outcomes? A digital patient monitoring platform developed by the principal investigator, a physiotherapist and academic researcher specializing in hand rehabilitation serves as the data collection infrastructure. The platform records standard clinical assessment measures in a structured format and has been in active clinical use at Hacettepe University prior to this study. For research purposes, the system has been expanded to include structured capture of patient-reported outcomes, patient global impression of change, treatment protocol coding, home exercise adherence, and automated calculation of early response metrics. This is a 12-month prospective observational cohort study enrolling a minimum of 60 patients. Data are stored securely on the university's institutional network. Patients are anonymized using identification codes. The study is subject to Hacettepe University Ethics Committee approval and participant informed consent. Findings are expected to generate evidence supporting data-driven clinical decision-making in rehabilitation and to provide a feasibility foundation for a larger multi-center study.

Introduction: Motor Imagery (MI) and Action Observation (AO) are well-established cognitive training techniques that activate neural networks similar to those involved in actual motor execution. MI involves the mental rehearsal of a movement without physically performing it, while AO relies on observing an action performed by others to stimulate motor-related brain areas. Recent studies suggest that when these methods are combined, they may enhance motor learning, cortical plasticity, and strength gains more effectively than when applied alone. The non-dominant hand, often less trained and weaker in performance compared to the dominant hand, provides an ideal model to examine the effects of these interventions. Strengthening the non-dominant upper limb has implications not only for improving functional balance between the limbs in healthy individuals but also for potential clinical applications in rehabilitation. Aim: The primary aim of this randomized controlled study is to investigate the combined effect of MI and AO on muscular strength and functional performance of the non-dominant hand in healthy university students. Specifically, the study seeks to compare the outcomes of three groups: (1) AO combined with MI, (2) MI only, and (3) a control group with no intervention. It is hypothesized that participants in the AO+MI group will demonstrate greater improvements in grip strength and functional outcomes compared to the other groups. Evaluation: To comprehensively measure the effects of the intervention, several standardized assessment tools will be employed. Motor imagery ability will be evaluated using the Motor Imagery Questionnaire-3 (MIQ-3). Hand dominance will be determined by the Edinburgh Handedness Inventory. Grip strength will be objectively measured using a Hand Grip Dynamometer. The Recognise App will be used to assess laterality recognition and sensorimotor integration, while overall upper limb function will be measured through the Short Musculoskeletal Function Assessment (SMMT). These evaluations will be conducted both before and after the 4-week intervention period to track changes. Treatment: The intervention will span four weeks, with participants attending 2-3 sessions per week. Training protocols will include both cognitive and physical components. In the MI group, participants will engage in guided motor imagery sessions focused on visualizing non-dominant hand exercises. The AO+MI group will observe video demonstrations of the same hand movements, followed by simultaneous motor imagery practice, thereby combining visual and cognitive engagement. Physical strengthening exercises will include dumbbell wrist flexion and handball squeeze, targeting key muscles of the non-dominant hand and forearm. The control group will not undergo any intervention during this period. By integrating AO and MI with specific strengthening exercises, the study aims to determine whether this combined approach enhances neural activation and muscular strength more effectively than MI alone.

This pilot study for stroke patients with chronic upper limb hemiplegia will examine the effects of non-invasive brain stimulation and neuromuscular electrical stimulation on hand motor control and corticospinal excitability. Specifically, this study will investigate the effects of timing and delivery of tDCS in conjunction with contralaterally controlled functional electrical stimulation.