Hand GraspNCT07331675
Effect of Marble Play on Handgrip Strength and Handwriting Among School Going Children.
A study testing Marble play game and Free Play in people with Hand Grasp, run by Riphah International University at 1 site in Pakistan.
Trial summary
This study aims to address the effects of a Marble Play on the handgrip strength and handwriting skills of primary school children, providing empirical evidence for a cost-effective and culturally relevant therapeutic tool. This study will be a randomized controlled trial. Read more about this study
- Who is it for?
- Ages 6 to 9 yearsHealthy volunteers can take part
- Conditions the study is for
- Hand Grasp
- What is being tested?
- Marble play game and Free Play
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 46 participants
- Where
- 1 sitePakistan
- Study dates
- 22 Dec 2025to 20 Aug 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 6 to 9 years
- All sexes
- Healthy volunteers accepted
- Child
Who may be able to join
- Children enrolled in Grade 1-3 (typically aged 6-9 years)
- Children with normal cognitive development, as assessed by school records or teacher reports
- Students with average or below average handwriting fluency (based on teacher observation or pre-test).
- Parental or guardian consent obtained for participation.
- Regular school attendance and ability to participate in intervention sessions.
Who cannot join
- Children with significant visual or motor impairments that may affect fine motor coordination.
- Participants with a known history of dust allergy or diagnosed allergic rhinitis triggered by dust exposure will be excluded.
- Individuals with a current or recent (within the last 6 months) fracture of any upper, wrist, or hand) will be excluded.
- Students with a history of behavioral issues that would prevent consistent participation in structured play.
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
Official title: Effects of Marble Play on Hand Grip Strength and Handwriting Skills Among School Going Children
This study aims to address the effects of a Marble Play on the handgrip strength and handwriting skills of primary school children, providing empirical evidence for a cost-effective and culturally relevant therapeutic tool. This study will be a randomized controlled trial. A total of 46 children from Grades 1-3 will be recruited via convenience sampling and randomly assigned to either an experimental group (n=23) or a control group (n=23).The experimental group will participate in one-on-one sessions of Marble Play game with
.The control group will continue with their regular free play activities. The primary assessment tools will be the Evaluation Tool of Children's Handwriting (ETCH) to measure writing legibility and speed, and a hand-held dynamometer to measure hand grip strength.
Read the detailed description
In 2022, Audrey Saile and Mohd Hanafi Mohd Yasin hey conducted a study in Malaysia, to investigate the efficacy of fine motor training for improving handwriting legibility among students with special educational needs. Their study used a quasi-experimental pre-test/post test design but was limited by a very small, purposefully selected sample of only four students.
Despite this limitation, the results indicated a positive outcome: the treatment group showed an average 15-point increase on a modified Handwriting Legibility Scale, improving their performance from "very poor" to "moderate." The authors concluded that fine motor training is a valuable intervention for enhancing the handwriting skills of SEN students.
Current literature reveals a significant gap in research examining marble play as a targeted fine motor intervention. While existing studies have explored the effectiveness of various manipulative activities such as clay modeling, bead threading, and drawing exercises for fine motor development, there is a notable absence of research that specifically isolates and examines the unique benefits of marble play. This represents a critical oversight, given the accessibility and affordability of marbles as intervention tool. The findings of this study will provide much-needed, evidence-based guidance for educators and therapists, particularly those working in resource-limited environments.
- Conditions
- Hand Grasp
- Being tested
- Marble play game, Free Play
- Keywords
- Dynamometer, Hand writing skills, Hand grip strength
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Marble play gameOther
Participants have to be sure to play in playground, as we will used natural ground floor. A small circle will be dig. A straight line will be marked 40 cm away from the edge of the circle. At the beginning of game, the researcher will place 10 target marbles in the circle. The participant will be given a marble.
Free PlayOther
The control group (n=38) will continues regular playing activities except Marble play.
| Study group | Role | What they receive |
|---|---|---|
| Marble play group | Experimental | The experimental group will participate in one-on-one sessions of Marble Play game with progressive difficulty levels, designed to enhance fine motor control, handgrip and handwriting skills. Receives: Other: Marble play game |
| Free play | Other | The control group will continue with their regular free play activities. Receives: Other: Free Play |
What is being measured
The primary outcome is the main question the study is designed to answer.
Hand Grip Strength
Hand grip strength will be measured by dynamometer
Measured: Baseline and after 6 weeks
handwriting skills
handwriting skills will be measured by ECTH. ECTH scoring refers to the Evaluation Tool of Children's Handwriting (ECTH), a criterion-referenced assessment for grades 1-6, scored by occupational therapists and educators to evaluate manuscript/cursive writing speed and legibility (letter/word formation, size, spacing, alignment) through specific tasks like copying, dictation, and sentence composition, yielding scores for each task and overall legibility percentages, with established cutoffs (e.g., Total Letter <90%, Total Word <85%) indicating dysfunction.
Measured: Baseline and after 6 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jan 2026
- Study start22 Dec 2025 (estimated)
- Primary completion1 Aug 2026 (estimated)
- Study completion20 Aug 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 Hand GraspStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- 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
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 46 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Aamna Hassan, MS, Principal investigator, Riphah International University, Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07331675
- Sponsor's protocol ID
- maqsood Bibi
- Status last verified
- Dec 2025
- First submitted
- 29 Dec 2025
- Last updated
- 12 Jan 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Hendrickx S. The adolescent and adult neuro-diversity handbook: Asperger's syndrome, ADHD, dyslexia, dyspraxia, and related conditions: Jessica Kingsley Publishers; 2010.
Davis RD, Braun EM. The Gift of Learning: Proven New Methods for Correcting ADD, Math & Handwriting Problems: Penguin; 2003.
Engel-Yeger B, Nagauker-Yanuv L, Rosenblum S. Handwriting performance, self-reports, and perceived self-efficacy among children with dysgraphia. Am J Occup Ther. 2009 Mar-Apr;63(2):182-92. doi: 10.5014/ajot.63.2.182.
PubMed 19432056
Study at a glance
From the registry record, last updated by the sponsor on 12 Jan 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Marble Play on Hand Grip Strength and Handwriting Skills Among School Going Children
- ClinicalTrials.gov ID
- NCT07331675
- Acronym / sponsor ID
- maqsood Bibi
- Conditions
- Hand Grasp
- Keywords
- Dynamometer, Hand writing skills, Hand grip strength
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 46 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 22 Dec 2025 (estimated)
- Primary completion
- 1 Aug 2026 (estimated)
- Study completion
- 20 Aug 2026 (estimated)
- First posted
- 12 Jan 2026 (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.
This study aims to address the effects of a Marble Play on the handgrip strength and handwriting skills of primary school children, providing empirical evidence for a cost-effective and culturally relevant therapeutic tool. This study will be a randomized controlled trial. A total of 46 children from Grades 1-3 will be recruited via convenience sampling and randomly assigned to either an experimental group (n=23) or a control group (n=23).The experimental group will participate in one-on-one sessions of Marble Play game with
.The control group will continue with their regular free play activities. The primary assessment tools will be the Evaluation Tool of Children's Handwriting (ETCH) to measure writing legibility and speed, and a hand-held dynamometer to measure hand grip strength.
Detailed description
In 2022, Audrey Saile and Mohd Hanafi Mohd Yasin hey conducted a study in Malaysia, to investigate the efficacy of fine motor training for improving handwriting legibility among students with special educational needs. Their study used a quasi-experimental pre-test/post test design but was limited by a very small, purposefully selected sample of only four students.
Despite this limitation, the results indicated a positive outcome: the treatment group showed an average 15-point increase on a modified Handwriting Legibility Scale, improving their performance from "very poor" to "moderate." The authors concluded that fine motor training is a valuable intervention for enhancing the handwriting skills of SEN students.
Current literature reveals a significant gap in research examining marble play as a targeted fine motor intervention. While existing studies have explored the effectiveness of various manipulative activities such as clay modeling, bead threading, and drawing exercises for fine motor development, there is a notable absence of research that specifically isolates and examines the unique benefits of marble play. This represents a critical oversight, given the accessibility and affordability of marbles as intervention tool. The findings of this study will provide much-needed, evidence-based guidance for educators and therapists, particularly those working in resource-limited environments.
Study design
- Primary purpose
- Other
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Marble play group | Experimental | Other: Marble play gameThe experimental group will participate in one-on-one sessions of Marble Play game with progressive difficulty levels, designed to enhance fine motor control, handgrip and handwriting skills. |
| Free play | Other | Other: Free PlayThe control group will continue with their regular free play activities. |
Who may qualify
- Ages
- 6 to 9 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Child
Key inclusion criteria (5 listed)
- Children enrolled in Grade 1-3 (typically aged 6-9 years)
- Children with normal cognitive development, as assessed by school records or teacher reports
- Students with average or below average handwriting fluency (based on teacher observation or pre-test).
- Parental or guardian consent obtained for participation.
- Regular school attendance and ability to participate in intervention sessions.
Key exclusion criteria (4 listed)
- Children with significant visual or motor impairments that may affect fine motor coordination.
- Participants with a known history of dust allergy or diagnosed allergic rhinitis triggered by dust exposure will be excluded.
- Individuals with a current or recent (within the last 6 months) fracture of any upper, wrist, or hand) will be excluded.
- Students with a history of behavioral issues that would prevent consistent participation in structured play.
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 |
|---|---|---|
| Marble play gameParticipants have to be sure to play in playground, as we will used natural ground floor. A small circle will be dig. A straight line will be marked 40 cm away from the edge of the circle. At the beginning of game, the researcher will place 10 target marbles in the circle. The participant will be given a marble. | Other | Marble play group |
| Free PlayThe control group (n=38) will continues regular playing activities except Marble play. | Other | Free play |
Primary outcome
Hand Grip Strength
Time frame: Baseline and after 6 weeks
Hand grip strength will be measured by dynamometer
handwriting skills
Time frame: Baseline and after 6 weeks
handwriting skills will be measured by ECTH. ECTH scoring refers to the Evaluation Tool of Children's Handwriting (ECTH), a criterion-referenced assessment for grades 1-6, scored by occupational therapists and educators to evaluate manuscript/cursive writing speed and legibility (letter/word formation, size, spacing, alignment) through specific tasks like copying, dictation, and sentence composition, yielding scores for each task and overall legibility percentages, with established cutoffs (e.g., Total Letter <90%, Total Word <85%) indicating dysfunction.
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 12 Jan 2026.
- BackgroundHendrickx S. The adolescent and adult neuro-diversity handbook: Asperger's syndrome, ADHD, dyslexia, dyspraxia, and related conditions: Jessica Kingsley Publishers; 2010.
- BackgroundDavis RD, Braun EM. The Gift of Learning: Proven New Methods for Correcting ADD, Math & Handwriting Problems: Penguin; 2003.
- Background: PubMed 19432056Engel-Yeger B, Nagauker-Yanuv L, Rosenblum S. Handwriting performance, self-reports, and perceived self-efficacy among children with dysgraphia. Am J Occup Ther. 2009 Mar-Apr;63(2):182-92. doi: 10.5014/ajot.63.2.182.
- Individual participant dataSharing planned: No
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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.
Aamna Hassan, MS principal investigator
Riphah International University, Lahore
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Marble play game and Free Play in people with Hand Grasp, run by Riphah International University at 1 site in Pakistan.
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 5 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 12 Jan 2026. 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 Pakistan. 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?
Contact Imran Amjad, Phd (03324390125, imran.amjad@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Hand Grip Strength (time frame: Baseline and after 6 weeks). 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 NCT07331675, 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 12 Jan 2026.