Hand-Focused Strength and Proprioceptive Training for Improving Grip Strength and Manual Dexterity in Healthy Adults:...

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.