HandNCT07235449
Investigation of the Effect of Combined Motor Imagery and Activity Observation Therapy on Strengthening the Non-Dominant Hand in Healthy Individuals
A study testing Conservative treatment + Motor imagery program, Conservative treatment + Motor imagery and action observation program and Conservative treatment via strengthening exercises in people with Hand, run by Bahçeşehir University at 1 site in Turkey (Türkiye).
Trial summary
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. Read more about this study
- Who is it for?
- Ages 18 to 65 yearsHealthy volunteers can take part
- Conditions the study is for
- Hand
- What is being tested?
- Conservative treatment + Motor imagery program, Conservative treatment + Motor imagery and action observation program and Conservative treatment via strengthening exercises
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 60 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 20 Nov 2025to 16 Jan 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Age between 18 and 65 years old
- They agreed to participate
- Having no pathology in hearing and vision
- Having no history of upper limb injury or musculoskeletal
- Having no neurologic disorders
- All subjects had no prior experience with motor imagery
- Having a Standardized Mini-Mental State Test (SMMT) score of more than 24 points
Who cannot join
- A score of the Movement Imagery Questionnaire (MIQ-3) was less than ≥5
- Severe cognitive deficits
- Neurological problems
- Left-handedness that was measured using the Edinburgh Handedness Inventory
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this 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.
Read more
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.
- Conditions
- Hand
- Being tested
- Conservative treatment + Motor imagery program, Conservative treatment + Motor imagery and action observation program, Conservative treatment via strengthening exercises
- Keywords
- Motor imagery, Action observation, Non-dominant hand, Strengthening exercises
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Conservative treatment + Motor imagery programOther
Participants will perform guided motor imagery of non-dominant hand strengthening exercises (dumbbell wrist flexion and handball squeeze) without video observation, 5 sessions per week for 4 weeks.
Conservative treatment + Motor imagery and action observation programOther
Participants will observe videos of non-dominant hand strengthening exercises (dumbbell wrist flexion and handball squeeze) and simultaneously perform guided motor imagery of the same movements, 5 sessions per week for 4 weeks.
Conservative treatment via strengthening exercisesOther
Participants will perform only the physical strengthening exercises (dumbbell wrist flexion and handball squeeze) for the non-dominant hand, 5 sessions per week for 4 weeks, without any motor imagery or action observation.
| Study group | Role | What they receive |
|---|---|---|
| Experimental: Motor Imager | Experimental | Conservative Treatment + Motor imagery Program Receives: Other: Conservative treatment + Motor imagery program |
| Experimental: Motor imager + Action Observation | Experimental | Conservative Treatment + Motor imagery and Action observation Program Receives: Other: Conservative treatment + Motor imagery and action observation program |
| Experimental: Conservative | Active comparator | Conservative Treatment Program Receives: Other: Conservative treatment via strengthening exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
Handedness was measured using the Edinburgh Handedness Inventory
Handedness was measured using the Edinburgh Handedness Inventory, a standardized tool that assesses hand preference in 10 everyday activities (e.g., writing, brushing teeth, using scissors). The Laterality Quotient (LQ) is calculated to determine whether a participant is right-handed, left-handed, or ambidextrous. This measure will be used to identify each participant's dominant and non-dominant hand for the study.
Measured: 3 minutes
Standardized Mini-Mental State Test
The Standardized Mini-Mental State Test (SMMT) is a 30-point cognitive screening tool assessing orientation, memory, attention, language, and visuospatial skills. Scores below 24 indicate cognitive impairment, while scores of 24-30 are considered normal. In this study, the SMMT was used to evaluate cognitive status, and only participants scoring 24 or higher were included.
Measured: 5 minutes
Secondary outcomes (3)
Movement Imagery Questionnaire (MIQ-3)
The Movement Imagery Questionnaire-3 (MIQ-3) is a 12-item tool used to assess an individual's ability to imagine movements through kinesthetic, internal visual, and external visual imagery. Participants physically perform and then imagine specific movements, rating the ease of imagery on a 7-point Likert scale. In this study, the MIQ-3 was used to evaluate motor imagery ability.
Measured: 10 minutes
Grip Strength Using a hand grip Dynamometer
Grip strength, an indicator of upper limb strength and functional capacity, will be measured using a hand grip dynamometer. Participants will sit with the elbow at 90° and wrist in neutral, then squeeze the device maximally for 3-5 seconds. The highest value from 2-3 trials will be recorded as the grip strength score.
Measured: 8 minutes
Recognize lateralization app
The Recognise Hand App (Noigroup) is used to assess left-right hand discrimination and implicit motor imagery ability. Participants view images of hands in different orientations and identify them as left or right, with response time and accuracy recorded. In this study, the app was used to evaluate laterality recognition of the non-dominant hand.
Measured: 10 minutes
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted19 Nov 2025
- Study start20 Nov 2025 (estimated)
- Primary completion16 Jan 2026 (estimated)
- Study completion16 Jan 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for HandStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Bahçeşehir University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Ammar Mahmoud Ahmed, Bahçeşehir University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07235449
- Sponsor's protocol ID
- 61351342/020-1391
- Status last verified
- Oct 2025
- First submitted
- 2 Oct 2025
- Last updated
- 19 Nov 2025
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Publications
Tsukazaki I, Uehara K, Morishita T, Ninomiya M, Funase K. Effect of observation combined with motor imagery of a skilled hand-motor task on motor cortical excitability: difference between novice and expert. Neurosci Lett. 2012 Jun 19;518(2):96-100. doi: 10.1016/j.neulet.2012.04.061. Epub 2012 May 2.
PubMed 22580208Aoyama T, Kaneko F, Kohno Y. Motor imagery combined with action observation training optimized for individual motor skills further improves motor skills close to a plateau. Hum Mov Sci. 2020 Oct;73:102683. doi: 10.1016/j.humov.2020.102683. Epub 2020 Sep 16.
PubMed 32949991Marshall B, Wright DJ, Holmes PS, Wood G. Combining Action Observation and Motor Imagery Improves Eye-Hand Coordination during Novel Visuomotor Task Performance. J Mot Behav. 2020;52(3):333-341. doi: 10.1080/00222895.2019.1626337. Epub 2019 Jun 11.
PubMed 31185831
Study at a glance
From the registry record, last updated by the sponsor on 19 Nov 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Investigation of the Effect of Combined Motor Imagery and Activity Observation Therapy on Strengthening the Non-Dominant Hand in Healthy Individuals
- ClinicalTrials.gov ID
- NCT07235449
- Acronym / sponsor ID
- 61351342/020-1391
- Conditions
- Hand
- Keywords
- Motor imagery, Action observation, Non-dominant hand, Strengthening exercises
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- Bahçeşehir UniversityUniversity, hospital or other
- Study start
- 20 Nov 2025 (estimated)
- Primary completion
- 16 Jan 2026 (estimated)
- Study completion
- 16 Jan 2026 (estimated)
- First posted
- 19 Nov 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Experimental: Motor Imager | Experimental | Other: Conservative treatment + Motor imagery programConservative Treatment + Motor imagery Program |
| Experimental: Motor imager + Action Observation | Experimental | Other: Conservative treatment + Motor imagery and action observation programConservative Treatment + Motor imagery and Action observation Program |
| Experimental: Conservative | Active comparator | Other: Conservative treatment via strengthening exercisesConservative Treatment Program |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Age between 18 and 65 years old
- They agreed to participate
- Having no pathology in hearing and vision
- Having no history of upper limb injury or musculoskeletal
- Having no neurologic disorders
Key exclusion criteria (4 listed)
- A score of the Movement Imagery Questionnaire (MIQ-3) was less than ≥5
- Severe cognitive deficits
- Neurological problems
- Left-handedness that was measured using the Edinburgh Handedness Inventory
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Conservative treatment + Motor imagery programParticipants will perform guided motor imagery of non-dominant hand strengthening exercises (dumbbell wrist flexion and handball squeeze) without video observation, 5 sessions per week for 4 weeks. | Other | Experimental: Motor Imager |
| Conservative treatment + Motor imagery and action observation programParticipants will observe videos of non-dominant hand strengthening exercises (dumbbell wrist flexion and handball squeeze) and simultaneously perform guided motor imagery of the same movements, 5 sessions per week for 4 weeks. | Other | Experimental: Motor imager + Action Observation |
| Conservative treatment via strengthening exercisesParticipants will perform only the physical strengthening exercises (dumbbell wrist flexion and handball squeeze) for the non-dominant hand, 5 sessions per week for 4 weeks, without any motor imagery or action observation. | Other | Experimental: Conservative |
Primary outcome
Handedness was measured using the Edinburgh Handedness Inventory
Time frame: 3 minutes
Handedness was measured using the Edinburgh Handedness Inventory, a standardized tool that assesses hand preference in 10 everyday activities (e.g., writing, brushing teeth, using scissors). The Laterality Quotient (LQ) is calculated to determine whether a participant is right-handed, left-handed, or ambidextrous. This measure will be used to identify each participant's dominant and non-dominant hand for the study.
Standardized Mini-Mental State Test
Time frame: 5 minutes
The Standardized Mini-Mental State Test (SMMT) is a 30-point cognitive screening tool assessing orientation, memory, attention, language, and visuospatial skills. Scores below 24 indicate cognitive impairment, while scores of 24-30 are considered normal. In this study, the SMMT was used to evaluate cognitive status, and only participants scoring 24 or higher were included.
3 secondary outcomes
Movement Imagery Questionnaire (MIQ-3)
Time frame: 10 minutes
Grip Strength Using a hand grip Dynamometer
Time frame: 8 minutes
Recognize lateralization app
Time frame: 10 minutes
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 19 Nov 2025.
- Results publication: PubMed 22580208Tsukazaki I, Uehara K, Morishita T, Ninomiya M, Funase K. Effect of observation combined with motor imagery of a skilled hand-motor task on motor cortical excitability: difference between novice and expert. Neurosci Lett. 2012 Jun 19;518(2):96-100. doi: 10.1016/j.neulet.2012.04.061. Epub 2012 May 2.
- Results publication: PubMed 32949991Aoyama T, Kaneko F, Kohno Y. Motor imagery combined with action observation training optimized for individual motor skills further improves motor skills close to a plateau. Hum Mov Sci. 2020 Oct;73:102683. doi: 10.1016/j.humov.2020.102683. Epub 2020 Sep 16.
- Results publication: PubMed 31185831Marshall B, Wright DJ, Holmes PS, Wood G. Combining Action Observation and Motor Imagery Improves Eye-Hand Coordination during Novel Visuomotor Task Performance. J Mot Behav. 2020;52(3):333-341. doi: 10.1080/00222895.2019.1626337. Epub 2019 Jun 11.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Conservative treatment + Motor imagery program, Conservative treatment + Motor imagery and action observation program and Conservative treatment via strengthening exercises in people with Hand, run by Bahçeşehir University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: opening soon, as of the sponsor's last update on 19 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Handedness was measured using the Edinburgh Handedness Inventory (time frame: 3 minutes). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07235449, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Nov 2025.