The control group did not receive any additional treatments during the study period, allowing for a clear comparison between the experimental group and the baseline conditions.

In the Combined Sensorimotor Group (CSMG), sensory and motor exercises were applied according to the protocols used in the Sensory Exercise Group (SEG) and Motor Exercise Group (MEG). However, each exercise was performed as a single set, with the remaining session time allocated to superficial massage and sensory stimulation. The sensory and motor components were administered sequentially, with each phase lasting approximately 7-8 minutes to maintain temporal balance within the session.

Hand function was evaluated using the Moberg Pick-up Test (MPUT), a standardized method for assessing functional hand use and fine-motor skills, specifically measuring the ability to grasp and manipulate small objects. During the test, participants were instructed to pick up various small objects (e.g., coins and small blocks) and place them in a container as quickly as possible. During the test, the participants were instructed to pick up various small objects and place them in a container as quickly as possible. The assessment was conducted with the dominant hand, first with eyes open and then with eyes closed, to test sensory function. For each condition, the test was repeated three times, and the best performance time, recorded in seconds, was used for analysis. The objects used in the test were of similar size and required coordinated hand movements for successful completion, ensuring consistency in task difficulty

Light Trainer® system, which consists of a wireless lighting system with LED pods and a central controller. The participants were seated with their hands on the table, 40 cm apart, palms down, and elbows at 90°. The Light Trainer was positioned centrally 20 cm away from each hand. When the pod was illuminated, the participants were instructed to turn off the light as quickly as possible by touching it. Light activation was randomized to avoid predictability, requiring participants to respond based on light cues each time. In the first task, the participants used their dominant hand to turn off the light as quickly as possible. In the second task, they responded to a light signal by deactivating a predetermined light from two different colors using their dominant hand. Scale Range: No minimum or maximum value in milliseconds (lower time is better). Interpretation: Lower reaction times signify better outcomes, as they reflect faster muscle response to visual stimuli.

Hand performance was assessed based on grip strength using a Takei Handheld Dynamometer (Takei Scientific Instruments Co., Tokyo, Japan). Participants were seated with elbows flexed at 90 degrees and forearms in a neutral position, and were instructed to squeeze the dynamometer with maximum force for 3-5 seconds, with the palm facing upwards. Each hand was tested three times with a 20-second rest between trials, and the highest value was recorded. This protocol ensures standardized and consistent results, with measurements documented in kilograms (kg) to provide reliable grip strength assessment. Scale Range: The dynamometer measures from 0 to 90 kg. Interpretation: Higher scores reflect stronger grip strength, which is indicative of better hand function.