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NCT Number: NCT07615062

Cross-education of Skill and Strength in Healthy People Subjected to an Upper-limb Disuse Model

This randomized controlled trial aims to compare manual dexterity and strength between a group undergoing a contralateral manual dexterity training program and a no-intervention control group in healthy, physically inactive individuals subjected to an induced upper-limb disuse model.

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Key information

Conditions

Disuse Atrophy Immobilization Muscular Diseases Muscular Disorders, Atrophic Musculoskeletal Diseases Nervous System Diseases Neuromuscular Diseases

Age range

18 year–35 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

About this study

Cross-education of skill offers promising opportunities for the rehabilitation of upper-limb musculoskeletal injuries. An approach based on contralateral manual dexterity training could accelerate functional recovery, reduce motor skill loss during periods of immobilization, and optimize conventional rehabilitation protocols. However, controlled studies are needed to analyze the efficacy of specific unilateral training protocols designed to maximize cross-education before clinical translation. To date, no experimental studies have been published on healthy individuals subjected to upper-limb disuse models alongside contralateral skill training involving functional tasks. This cross-education effect could potentially prevent the loss of manual dexterity and strength that occurs during immobilization. For this research, a contralateral manual dexterity training protocol was developed based on the functional limitations commonly experienced by individuals with forearm and hand musculoskeletal injuries (e.g., distal radius fractures, wrist sprains, carpal tunnel syndrome, and tendinopathies). Additionally, the protocol incorporates characteristics from training programs that have demonstrated the greatest cross-education effect.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Individuals will be eligible for inclusion if they are right-handed adults aged 18 to 35 years with a body mass index (BMI) between 18.5 and 30 kg/m².
  • Individuals must be classified as physically inactive, defined as not meeting the World Health Organization criteria of at least 150 minutes of moderate-intensity physical activity or 75 minutes of vigorous-intensity physical activity per week.

Exclusion criteria

  • Individuals who have engaged in physical training (e.g., any form of strength or aerobic exercise) or specific manual dexterity training within the past 6 months. - Individuals who regularly participate in artistic, occupational, or sporting activities requiring high levels of manual dexterity (e.g., musicians, gamers, craftspeople).
  • Individuals with a history of orthopedic or traumatic injuries affecting either upper extremity. Individuals with pathologies or conditions that preclude safe training (e.g., uncontrolled hypertension, or visual, auditory, or cognitive impairments [for example, dyscalculia]).
  • Individuals currently using nutritional supplements or medications that interfere with the regulation of skeletal muscle mass and strength (e.g., whey protein, creatine) or the central nervous system (e.g., antidepressants, anxiolytics, hypnotics).

Treatment and study plan

Contralateral Manual Dexterity Training

Other

The subjects in the experimental group will perform contralateral manual dexterity training focused on moving cylinders of 0.5, 1 or 1.5 kilos with grips and movements in different planes on a gridded board. Participants will have to develop different grips and place the cylinders in the quadrants indicated on a smartphone screen.

Primary outcomes

  1. Fine Manual Dexterity

    Time frame: Baseline and day 7

    Fine manual dexterity will be assessed using the Functional Dexterity test (FDT). Using a stopwatch, the evaluator records the total time in seconds that the participant takes to complete the task.

  2. Force control

    Time frame: Baseline and day 7

    In a seated position with the elbow flexed, participants will perform isometric contractions to reach a target torque guided by real-time visual feedback. The accuracy of maintaining these contractions in the wrist flexor and extensor muscles will be assessed using a Humac Norm isokinetic dynamometer (Computer Sports Medicine, Inc., Stoughton, MA, USA). Participants will perform a continuous 60-second isometric contraction exercise. During this period, participants will adjust their force level to between 10% and 30% of their maximum voluntary contraction (MVC) at 10-second intervals. Three attempts will be performed per limb. The Root Mean Square Error (RMSE) will be recorded.

  3. Gross Manual Dexterity

    Time frame: Baseline and day 7

    This gross manual dexterity will be assessed using the same task performed during the experimental group's contralateral manual dexterity training. Specifically, participants will complete 15 trials, moving cylinders of varying weights across a gridded board following a sequence displayed on a smartphone. The time required to complete these 15 trials will be recorded.

Secondary outcomes

  1. Handgrip strength

    Time frame: Baseline and day 7

    Maximum lumbrical and cylindrical grip strength will be assessed using a Jamar Plus+ digital hand dynamometer. The highest value from three attempts will be recorded for each assessment

  2. Joint Position Sense Test

    Time frame: Baseline and day 7

    Proprioception: Wrist flexion-extension joint position sense will be assessed using the Joint Position Sense Test (JPST). All measurements will be conducted with a Humac Norm isokinetic dynamometer (Computer Sports Medicine, Inc., Stoughton, MA, USA). Three attempts will be made per limb. The absolute error (difference in degrees between 30° and the angle achieved during the test) will be recorded.

  3. Left/right judgment

    Time frame: Baseline and day 7

    Left/right judgment will be assessed using the Recognise™ application (Noigroup, Adelaide, Australia). Performance on the laterality judgment task was quantified using the Inverse Efficiency Score (IES), calculated as the average reaction time of correct responses divided by the proportion of correct responses (IES = RT / PC). 3 blocks of 20 images (60 images total). Maximum exposure time: 5 seconds per image.

Other outcomes

  1. Physical activity level

    Time frame: Baseline and day 7

    Weekly metabolic equivalents (MET-min/week) will be calculated using the validated Spanish version of the Global physical activity questionnaire (GPAQ).

  2. Psychological Distress

    Time frame: Baseline

    Psychological Distress, including symptoms of depression, anxiety, and stress, will be assessed using the 21-item Depression, Anxiety and Stress Scale (DASS-21). This self-report instrument will be used to quantify the severity of emotional distress across these three domains. This scale has a minimum score of 0 and a maximum of 126 points (total score calculated by doubling the sum of the 21 items). Higher scores in DASS-21 indicate greater psychological distress.

  3. Sleep Quality:

    Time frame: Baseline

    Sleep disturbances and overall sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI). This scale has a minimum score of 0 and a maximum of 21 points (higher scores indicate worse sleep quality)

  4. Daily steps

    Time frame: During 7 days of immobilization

    Physical activity will be monitored using a Xiaomi Band 9 smartwatch (number of daily steps), which participants will wear throughout the seven-day mobilization period.

  5. Sleep time

    Time frame: During 7 days of immobilization

    Sleep time will be measured using a Xiaomi Band 9 smartwatch (hours), which participants will wear throughout the seven-day immobilization period.

Study contacts

Contact information is provided by the study sponsor or research team.

Iván A. Cuyul-Vásquez, PhD(c)

CONTACT

[email protected]

+56452205205

Sponsors and collaborators

Lead sponsor

Universidad Catolica de Temuco

Other

Collaborators

  • Universidad de La Frontera
  • University of Valencia

Registry information

Official study title

Cross-education of Skill and Strength Through Contralateral Manual Dexterity Training in Healthy Young Adults Subjected to an Upper-limb Disuse Model: A Randomized Controlled Trial.

Acronym: IMMO-CROSS

Important dates

Study start
2026
Primary completion
2026
Study completion
2027
First posted
May 29, 2026
Registry last updated
May 29, 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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