{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T22:01:57Z","timestamp":1784844117141,"version":"3.55.0"},"reference-count":36,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Internet Res"],"abstract":"\n Background<\/jats:title>\n Children with inattentive attention-deficit\/hyperactivity disorder (ADHD) often present with impairments in executive functions and fine motor skills in addition to core inattentive symptoms. However, evidence remains limited regarding structured telerehabilitation-based fine motor training for these outcomes.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to examine the effects of a 12-week telerehabilitation-based fine motor training program on inattention symptoms, executive functions, and fine motor skills in children with inattentive ADHD.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This randomized controlled trial included 66 children aged 6 to 10 years with inattentive ADHD. Participants were randomly assigned to a telerehabilitation-based fine motor training group (n=33) or a waitlist control group (n=33). The intervention was delivered live online 3 times per week, 60 minutes per session, for 12 weeks. Assessments were conducted at baseline, immediately after the intervention, and at the 3-month follow-up. Outcomes included parent-reported inattention symptoms, executive functions, and fine motor skills. Linear mixed-effects models were used for the primary analysis, and an exploratory mediation analysis was conducted using postintervention values at 12 weeks.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Compared with the waitlist control group, the intervention group showed greater reductions in parent-reported inattention symptoms at 12 weeks (mean difference [MD]=\u22123.85, 95% CI \u22125.01 to \u22122.68; Hedges g=\u22121.13; P<.001) and 24 weeks (MD=\u22122.00, 95% CI \u22123.17 to \u22120.83; Hedges g=\u22120.59; P<.001). For executive functions, between-group differences favored the intervention group for inhibitory control at 12 weeks (MD=\u221211.62, 95% CI \u221219.78 to \u22123.46; Hedges g=\u22120.83; P=.006) and 24 weeks (MD=\u22128.88, 95% CI \u221217.04 to \u22120.72; Hedges g=\u22120.63; P=.03), immediate memory at both time points, and cognitive flexibility at both time points. Delayed memory showed a significant between-group difference only at 12 weeks (MD=3.03, 95% CI 0.57 to 5.49; Hedges g=0.65; P=.02). For fine motor skills, between-group differences favored the intervention group for manual dexterity at 12 weeks (MD=2.97, 95% CI 1.12 to 4.73; Hedges g=1.17; P=.001) and 24 weeks (MD=2.94, 95% CI 1.18 to 4.70; Hedges g=1.16; P=.001), and for hand-eye coordination at 12 weeks (MD=2.48, 95% CI 0.68 to 4.29; Hedges g=1.06; P=.007) and 24 weeks (MD=2.09, 95% CI 0.28 to 3.90; Hedges g=0.89; P=.02). Writing skills improved at 12 weeks but not at follow-up. An exploratory mediation analysis using week-12 postintervention values suggested a statistical indirect association through inhibitory control (\u03b2=\u22120.85, 95% CI \u22121.85 to \u22120.08; P=.05). However, post hoc lagged exploratory mediation analyses did not support longitudinal indirect effects through inhibitory control or other executive function outcomes.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A 12-week telerehabilitation-based fine motor training program may be a feasible and potentially beneficial adjunctive intervention for children with inattentive ADHD. The findings suggest potential benefits for parent-reported inattention symptoms, selected executive function outcomes, and fine motor skills but should be interpreted cautiously given the waitlist control design, parent-reported symptom outcome, and exploratory mediation analysis.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n Chinese Clinical Trial Registry ChiCTR2200065413; https:\/\/www.chictr.org.cn\/showproj.html?proj=182412<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/97365","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T18:05:05Z","timestamp":1781805905000},"page":"e97365","source":"Crossref","is-referenced-by-count":0,"title":["A Telerehabilitation-Based Fine Motor Training Program for Children With Inattentive Attention-Deficit\/Hyperactivity Disorder: Randomized Controlled 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