Correlation Between Pinch Grip and Handwriting in School-Age Children

Background: Good handwriting is an important daily skill for school-aged children, helping them to learn and communicate effectively. While experts believe that fine motor skills of the hand, like the strength of a child's pinch grip, might be important for handwriting, we don't yet fully understand the connection between the two.

Purpose: The purpose of this study is to measure the possible relationship between pinch grip strength and handwriting quality in school-aged children.

Study Details: This study will enroll approximately 100 children between 9 and 11 years old from physical therapy clinics in Egypt. Participating children will be asked to complete two simple tasks. First, they will be asked to write 10 lines of text. Their handwriting will then be scored using a standardized scale (the Handwriting Legibility Scale). Second, their pinch grip strength will be measured using a specialized mechanical device called a pinch gauge. The investigators will then analyze the data to see if a relationship exists between pinch grip strength and handwriting performance.

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Key information

Conditions

Healthy Participants

Age range

9 year–10 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Faculty of Physical Therapy, October 6 University

Giza, Giza Governorate, 123, Egypt

About this study

This is an observational, cross-sectional study. The purpose of this study is to evaluate the correlation between palmar pinch grip strength and handwriting legibility in children aged 9-10 years. Approximately 100 participants from both sexes will be recruited from different schools.

Upon enrollment, participants will undergo a single assessment session. Outcome measures will be collected in the following order:

Handwriting Assessment: Each participant will be asked to write 10 lines on A4 paper within a six-minute time limit. The written content will then be assessed using the Handwriting Legibility Scale (HLS). The HLS provides an overall assessment to identify difficulties in producing legible and/or sufficiently fast handwriting. Total scores are interpreted as Good Handwriting (5-10), Legible Handwriting (11-15), or Poor Handwriting (16-25).

Pinch Grip Assessment: Palmar pinch grip strength will be measured using a Baseline mechanical pinch gauge in kilograms. The testing position will be standardized according to the guidelines from the American Journal of Occupational Therapy. The subject will be seated with the shoulder adducted and neutrally rotated, elbow flexed at 90°, forearm in a neutral position, and wrist between 0-15° extension and 0-15° ulnar deviation. For the hand used for writing, three successive trials will be performed, and the scores will be recorded.

For the primary analysis, Pearson's correlation coefficient will be used to assess the relationship between the total HLS score and the mean pinch grip strength score, with statistical significance set at p < 0.05. The null hypothesis is that there is no correlation between pinch grip strength and handwriting quality.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Age between 9 and 10 years old
Both genders (male and female)
Able to understand and follow simple instructions (IQ level not less than 50)
No visual or auditory problems
Not taking special medications affecting mental functions

Exclusion criteria

Children with Attention Deficit Hyperactivity Disorder (ADHD)
Dysgraphia
Cognitive developmental disorder

Treatment and study plan

Primary outcomes

Handwriting Legibility Scale (HLS) Score

Time frame: Baseline (single assessment visit)

The Handwriting Legibility Scale (HLS) is a standardized tool that assesses the overall legibility of handwriting. It contains five components, each rated on a 5-point scale (1-5), with higher scores indicating poorer performance. Total scores range from 5 to 25, interpreted as good handwriting (5-10), legible handwriting (11-15), or poor handwriting (16-25).

Secondary outcomes

Palmar Pinch Grip Strength

Time frame: Baseline (single assessment visit)

Maximum palmar pinch grip strength measured using a Baseline mechanical pinch gauge. Participants are seated with standardized positioning (shoulder adducted, elbow at 90°, forearm neutral, wrist 0-15° extension and 0-15° ulnar deviation). Three successive trials are performed for the writing hand, and the scores are recorded.

Sponsors and collaborators

Lead sponsor

October 6 University

Other

Registry information

Important dates

Study start: 2023
Primary completion: 2026
Study completion: 2026
First posted: May 7, 2026
Registry last updated: Jul 13, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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