Hand-Focused Strength and Proprioceptive Training for Improving Grip Strength and Manual Dexterity in Healthy Adults: A Systematic Review and Meta-Analysis.

Background

Hand function is critical for daily living, occupational performance, and sports. Optimal training approaches for healthy adults remain unclear.

Objective

To evaluate the effects of hand-focused strength and proprioceptive training on grip strength, pinch strength, manual dexterity, maximum voluntary contraction, joint position sense, and force sense in healthy younger and older adults.

Methods

PubMed, Google Scholar, Semantic Scholar, Web of Science, Cochrane CENTRAL and registers were searched until July 2025 for randomized controlled trials (RCTs) involving adults (≥18 years) without upper limb dysfunction. Studies with clinical populations, single-session interventions, or lacking pre-post outcome data were excluded. Risk of bias was assessed using the Cochrane RoB 2 tool. Random-effects meta-analyses (Hedges' g) pooled pre-post change score differences for each outcome; subgroup analyses examined age, training type, and comparator.

Results

Twenty-two RCTs (n = 1017 participants; 19-78 years) met the inclusion criteria. Strength and proprioceptive training produced a small-to-moderate improvement in grip strength (g = 0.44, 95% CI [0.23-0.64], 95%PI [-0.09, 0.96]) and a large improvement in manual dexterity (g = 1.11, 95% CI [0.52-1.71], 95%PI [-0.01, 2.23]). Effects on pinch strength were positive but non-significant (g = 0.63, 95% CI [-0.09-1.35], 95%PI [-1.38, 2.63]) and showed substantial heterogeneity. Moderator analyses indicated greater effects in older adults (g = 0.97) compared to younger adults (g = 0.18). Strength-only protocols showed significant effects, while combined protocols yielded smaller, non-significant effects; however, the difference between them was not statistically significant. Effects were also larger when compared with passive controls than with untrained hands. Limitations: Evidence quality was limited by high risk of bias, measurement variability, and small study numbers for some outcomes.

Conclusions

Strength-focused hand training, particularly in older adults, yields meaningful improvements in grip strength and dexterity. Further high-quality RCTs are needed for under-studied outcomes.