fine motor coordination activities for neuro

10 Fine Motor Coordination Activities for Neuro Patients

As an occupational therapist, OT student or COTA working in adult rehab settings, you will see your fair share of patients with a neurological disorder that affects their fine motor coordination.

This can include a stroke, spinal cord injury, brain injury, Parkinson’s, multiple sclerosis, or any other illness that affects the patient’s nervous system. These conditions can cause decreased fine motor coordination that directly affects their independence completing self-care tasks.

This article specifically addresses functional, occupation-based ways to address decreased fine motor coordination.

So if you’re bored with pegs and putty and are looking for more meaningful activities for fine motor coordination, this article is for you!

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1. Dressing

There are so many fine motor components in dressing that can present a problem. Whether it’s tying shoelaces, buttoning a shirt or pants, zipping a jacket, or fastening a bra, focusing on what’s difficult for your patient and targeting that in the intervention is a great way to address fine motor coordination in the most functional way.


2. Medication Management

Creating a simulated medication management kit is a great way to target more difficult fine motor coordination skills. Opening/closing medication containers as well as picking up small “pills” both add a fine motor coordination component.

This activity also incorporates a high level cognitive element by verifying if the patient has added the correct “medications” that you have given them.

For how to make your own medication management kit, check out this example from the University of Utah’s College of Health.


3. Grooming

If you’re in a setting (such as acute care) that doesn’t have full kits for fine motor coordination, grooming is a great way to incorporate fine motor coordination. This can be done by having your patient open small toothpaste or soap containers, as well as applying toothpaste to the toothbrush if they can.

4. Self-feeding

Self-feeding or even simulated self feeding tasks like cutting and piercing “food” (like Theraputty) or scooping dried beans can be a good fine motor challenge for patients who demonstrate difficulty with managing self-feeding.

Starting off with finger foods during mealtime (if appropriate for the patient’s diet) is also a good fine motor challenge if utensils are too much of a challenge to start with.

5. Managing Grocery Containers

This activity requires a little extra prep work beforehand but can be used over and over. It’s often called a “Groceries Galore” kit which is one of my favorite interventions. This was also one of my in-service projects during my Level II, so I’m partial to it 🙂

The kit includes clean grocery containers of all varieties with added small items inside, such as pennies, Scrabble pieces, or other small items that the patient can open and dump out the small items in the container.

Adding the small items makes the task more of a graded-up challenge than simply opening and closing the containers.

6. Money Management

If your patient still uses change and cash regularly, this is a great way to really challenge their fine motor skills. Picking up small coins and bills and placing them in a small piggy bank while adding some money math skills can add in some bonus cognitive retraining.

7. Using a Lock Board

I’ve seen and used a lock board in several settings and have found it’s a great task to work the patient’s affected hand, since we all have locks at home! If your facility doesn’t have a lock board, they can be ordered online or one could be made for a great in-service project by a crafty fieldwork student.


8. Keyboarding/Typing

If your patient was using a computer, iPad, or iPhone frequently and has been having difficulty, this is also a great fine motor coordination activity that many of my patients have been glad to address. Not only are these important work skills but also are commonly used in virtual social interaction.

Want to learn more about functional interventions?

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9. Handwriting

In addition to keyboarding, handwriting can also be a new challenge if the patient’s dominant hand has been affected. If handwriting starts off as too challenging, you can modify by incorporating coloring in adult coloring books if it is something the patient enjoys. This is not only great for fine motor skills but as also been shown to be helpful in stress reduction.

10. Meal Preparation

Simple meal preparation has so many components that address fine motor coordination, from opening packages, containers, scooping, and cutting the food. I also love doing meal preparation activities to address standing tolerance, balance, functional reaching, and safety awareness.


Many of these fine motor coordination activities may initially be challenging for your patients, so you can certainly adapt each task as needed.

For example, you may incorporate larger buttons, zippers or “medications” if you find the task to be too difficult. You can then progress to the more challenging, smaller items as your patients master the easier task.

And for even more fine motor coordination activities, Seniors Flourish’s blog also has 27 occupational therapists’ fine motor intervention ideas to add to your repertoire. 

I hope this article helps you add some functional fine motor coordination treatment ideas to your personal toolbox. I’d also love to hear some of your favorite go-to fine motor coordination interventions in the comments below!

This post was originally published on Jan. 24, 2017 and updated on Fed. 15, 2021.

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  • Jackie January 26, 2017   Reply →

    Love this. This is very helpful for me as a level 2 student in snf. My classmates and I always complain about not knowing treatment ideas in our setting that is more functional based. Can you do another post about therapeutic activities and neuro re-education?

    • Sarah Stromsdorfer, OTR/L January 27, 2017   Reply →

      Thanks Jackie! I struggled a lot with coming up with occupation-based intervention ideas in FW as well, so I definitely plan on writing a lot more intervention posts this year.

  • Jennifer September 4, 2017   Reply →

    I just found your blog and am loving it! I am a COTA student, and just started FW. I, too, am struggling with treatment ideas in the afternoon. Patients are encouraged to be in the therapy gym after lunch. I find it repetitive and boring, with too many prepatory activities being done. Unfortunately, the facility isn’t equipped with a whole lot, and I’m unable to bring in food and ingredients for patients to cook, as that would get pricey. I do hope that you continue your blog and post about intervention ideas.

  • Ruthie April 25, 2018   Reply →

    I love this site and have found the information provided to be very helpful. Thank you for all your time and effort. For one of my Level IIs, I incorporated the rehab department’s goal of creating “functional toolboxes”, such as the medication management activity kit listed in this article. I created a kit based on the mail. The kit included: various sizes and types of: paper, cards, envelopes, pens, markers, stamps (USPS) and decorative, letter openers, staplers, scissors, tape etc., a mail bag, a mailbox (could be placed on table/counter or moved to simulate at home-outside if possible) and of course assorted mail in the box to be removed, placed in bag, brought to table, sorted, and opened. This tool kit provided many options for grading these related functional activities with opportunities to employ fine and gross motor skills.

    • Sarah Stromsdorfer, OTR/L April 25, 2018   Reply →

      Creating a mail occupation-based toolkit is an awesome idea! I’m sure your fieldwork site was really grateful to have that; I think every rehab unit could benefit from this. Thank you for sharing!

  • Amanda Miller May 14, 2018   Reply →

    I am a entry level COTA, and just landed my first job
    YAY me! But the stress of having functional intervention ideas are hard. Especially when all OT collection of notes and books are packed… yes I’m moving for my job. Pinterest is great, but this blog really helps me! I currently have a few people that would def gain from these intervention ideas! THANK YOU!! 🙂

    • Sarah Stromsdorfer, OTR/L May 14, 2018   Reply →

      Hi Amanda, huge congrats on your first job! Moving and finding treatment notes definitely sounds tough (moving in general is hard enough!) so I’m really glad the blog is helpful for you!

  • Marci November 26, 2018   Reply →

    Oh I love these! I was curious about your Groceries Galore kit and how do you grade it down?

    • Sarah Stromsdorfer, OTR/L November 27, 2018   Reply →

      I’m so glad to hear that! To grade Groceries Galore down for fine motor coordination in particular, you could utilize just the large-lid, easy-open containers without the picking up small items part if that’s too hard. In addition, you could do this in sitting versus standing to make it easier as well.

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