{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T21:16:39Z","timestamp":1769462199066,"version":"3.49.0"},"reference-count":62,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Manual dexterity (MD) impairment is a frequent and disabling feature in patients with Parkinson\u2019s disease (PD) and paranoid schizophrenia (PS), significantly affecting functional independence and activities of daily living. However, rehabilitation strategies specifically targeting fine motor control remain insufficiently integrated into routine physiotherapy (PT). Objective: This study investigated the effects of a structured, progressive PT program incorporating targeted MD training on upper limb function in patients with PD and PS. Methods: A prospective, exploratory, interventional study was conducted in 30 patients, allocated to either an experimental group (EG, n = 20) or a control group (CG, n = 10). Participants had PD (Hoehn and Yahr stages II\u2013III) or chronic, clinically stable PS. MD was assessed using the Purdue Pegboard Test, Coin Rotation Task, and Kapandji opposition score. The EG completed a four-phase, 40-week dexterity-oriented rehabilitation program, while the CG received standard disease-specific PT. Between-group differences in change scores were analyzed using one-way ANOVA. Results: The EG showed significantly greater improvements than the CG in thumb opposition, psychomotor processing speed, and unilateral and bilateral fine motor performance (p &lt; 0.001 for all), with large to very large effect sizes (\u03b72 = 0.45\u20130.76). No significant between-group differences were observed for complex sequential assembly tasks. Conclusions: Integrating targeted MD training into structured PT programs significantly improves fine motor performance in patients with PD and PS, supporting its inclusion in rehabilitation protocols for residential and outpatient care settings.<\/jats:p>","DOI":"10.3390\/life16020196","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T10:24:36Z","timestamp":1769423076000},"page":"196","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Manual Dexterity Rehabilitation in Parkinson\u2019s Disease and Paranoid Schizophrenia: A Controlled Study"],"prefix":"10.3390","volume":"16","author":[{"given":"Tatiana","family":"Balint","sequence":"first","affiliation":[{"name":"Faculty of Movement, Sports, and Health Sciences, \u201cVasile Alecsandri\u201d University of Bac\u0103u, 600115 Bacau, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2928-2844","authenticated-orcid":false,"given":"Alina-Mihaela","family":"Cristuta","sequence":"additional","affiliation":[{"name":"Faculty of Movement, Sports, and Health Sciences, \u201cVasile Alecsandri\u201d University of Bac\u0103u, 600115 Bacau, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9884-7466","authenticated-orcid":false,"given":"Adina Camelia","family":"Slicaru","sequence":"additional","affiliation":[{"name":"Faculty of Movement, Sports, and Health Sciences, \u201cVasile Alecsandri\u201d University of Bac\u0103u, 600115 Bacau, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1003-0719","authenticated-orcid":false,"given":"Ilie","family":"Onu","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700454 Iasi, Romania"},{"name":"Department of Physical Therapy, Elipetro Med Clinic, 610119 Piatra Neamt, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6422-2030","authenticated-orcid":false,"given":"Daniel Andrei","family":"Iordan","sequence":"additional","affiliation":[{"name":"Center of Physical Therapy, Rehabilitation and Wellness, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"},{"name":"Department of Individual Sports and Kinetotherapy, Faculty of Physical Education and Sport, \u201cDun\u0103rea de Jos\u201d University of Galati, 800008 Galati, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2051-4728","authenticated-orcid":false,"given":"Ana","family":"Onu","sequence":"additional","affiliation":[{"name":"Doctoral School, Grigore T. Popa University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Kreutzer, J.S., DeLuca, J., and Caplan, B. (2011). Manual Dexterity. Encyclopedia of Clinical Neuropsychology, Springer.","DOI":"10.1007\/978-0-387-79948-3"},{"key":"ref_2","first-page":"683","article-title":"Neural bases of hand synergies","volume":"17","author":"Santello","year":"2016","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"459","DOI":"10.2147\/CIA.S510670","article-title":"Understanding Cognitive Decline in Aging: Mechanisms and Mitigation Strategies\u2014A Narrative Review","volume":"20","author":"Jost","year":"2025","journal-title":"Clin. Interv. 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