Journal of Clinical and Diagnostic Research. 2023 Jan, Vol-17(1): YC15-YC18 1515
DOI: 10.7860/JCDR/2023/59208.17430 Original Article
Gender Difference in Hand-eye Coordination
in Young Adults-A Cross-sectional Study
Hand-eye coordination is one of the human abilities that is required
and can inﬂuence various parts of daily life, such as school, daily
activities, and social interactions . Eye movements have a role
in skilled motor activity that is distinct from the action itself but is
intricately linked to it . Hand-eye coordination is the visual system’s
ability to synchronise the information received from the eyes to
control, guide, and steer the hands in completing a task .
The typical hand-eye coordination involves the synergistic function
of numerous sensorimotor systems, including the visual system,
vestibular system, and proprioception, as well as the head, eye,
and arm control systems, in addition as some components of
cognition, such as memory and attention . All three systems
are constrained by the fourth system, the schema system, which
deﬁnes the prevailing tasks and projects the overall chain of
Fixing gaze at task-relevant points in an integrated pattern which
allows the brain to appraise the geometric relationships between
the exterior world and the interior world through vision and
proprioception over lengths of time . Various investigations have
been conducted on the meaning of visual-motor synchronisation in
human behaviour. Before initiating the hand movement they showed
that their gaze was ﬁxed on an aimed object implying that the eyes
convey information about the distance to the arms . The ability to
coordinate is one of the component of physical ﬁtness that is related
to one’s skills, both hand and eye coordination .
The beginning of performance in motor skill learning activities
allegedly reﬂects on regulated procedures such as trial and error
and adaptation of performance solutions, which progress with
age . Desired muscle contractions are transformed due to the
visual information that falls on the retina which is uniﬁed with other
sensory information related to gaze direction, hand location, and
head orientation .
Generally, males outperform females in spatial tasks, working
memory, mathematical and numerical abilities, while females have
more precedence in verbal ﬂuency, perceptual speed, accuracy,
and ﬁne motor skills [11,12]. Previous research has shown that the
female advantage is distinct when it comes to generating items in
a sequence, but not when it comes to ordering sequential objects.
Furthermore, females continue to achieve movement sequences in
the action of pursuing complex and compound skilled movements
than the males do .
Since 1910, skill learning studies uses the mirror drawing task.
In this task, students are required to trace a shape commonly,
a polygon, e.g., a star, diamond, square, or a triangle and
stay inside the boundaries of a double borderline, mean while
only looking at the upturned reﬂection of their hand through a
mirror. Mirror learning gives the information about the construction
of new afﬁliations between pivoted vision by 180° and arm
Earlier research indicated that the average male achievements in
spatial tasks is superior to females  recognised by biological
and cultural information as inspected . Physical practices
improved eye-hand coordination in both male and female
participants, according to researchers . Hand-eye coordination
and spatiotemporal skills play a vital role in everyday performance
and learning skills . However, there is inadequate knowledge
about the gender difference in learning hand-eye coordination
and the efﬁciency, speed, accuracy in learning tasks regarding
hand-eye coordination . Hence, the current study was aimed to
investigate which gender is better and efﬁcient in learning hand-eye
coordination using the mirror drawing task. The objectives of the
B SWATHI1, SAUMYA SRIVASTAVA2, KM KRISHNAPRASAD3
Keywords: Efﬁciency index, Mirror drawing task, Mirror-tracing, Sex difference, Visuomotor coordination
Introduction: The ability of the visual system to coordinate the
information acquired from the eyes to control, and guide the
hands in completing a task is known as hand-eye coordination.
The typical hand-eye coordination involves the synergistic
function of numerous sensorimotor systems, including the
visual system, vestibular system, and proprioception, as well as
the head, eye, and arm control systems.
Aim: To investigate which gender is superior and efﬁcient in
learning hand-eye coordination using the mirror drawing task.
Materials and Methods: A cross-sectional study was conducted
at a tertiary care hospital, Mangalore, Karnataka, India from
April 2020 to April 2021 involving a total of 90 young adults
divided into two groups of 45 males (group A) and 45 females
(group B). A mirror drawing task was given to each student with
four trials and two minutes rest in between the trials. Subjects
were expected to trace a shape, most typically a polygon while
only seeing the upturned reﬂection of their hand in a mirror and
staying within the conﬁnes of a double boundary using a mirror
drawing test. The number of errors, time taken to complete
the task, and efﬁciency index of each student was calculated
manually using the efﬁciency index formula and compared
between the two groups.
Results: Total 90 participants were included with a mean age
of 21.2 and 21.8 years for group A and group B, respectively.
Group A (males) showed a greater efﬁciency index (5.52±2.29)
when compared to group B (females) (4.61±1.77) (p-value-
0.039). The Spearman’s ratio of mean error and mean time was
0.575 in males and 0.483 in females.
Conclusion: The males outperformed in efﬁciency index when
compared to females in hand-eye coordination with repeated
practice. The study concluded that males were having greater
efﬁciency index and less number of errors and less time taken
compared to females.
B Swathi et al., Difference in Gender with Hand-eye Coordination in Young Adults www.jcdr.net
Journal of Clinical and Diagnostic Research. 2023 Jan, Vol-17(1): YC15-YC18
study were to assess the correlation between mean error, mean
time and efﬁciency index in hand-eye coordination.
MATERIALS AND METHODS
The cross-sectional study was conducted on college students of
the Institute of Physiotherapy situated in Mangalore, Karnataka,
India between April 2020-April 2021. The study protocol was approved
by the Institutional Ethical Committee (NIPT/IEC/Min/23/2019-20)
of a deemed to be University, Mangalore, Karnataka, India. The
study was registered in clinical trial registry, India with registration
number CTRI/2020/06/025905. Eligible students were given
information about the procedure, after which students were given
an informed consent form to be signed.
Inclusion criteria: Participants aged between 19-26 years and
who were willing to participate in the study with written informed
Exclusion criteria: Participants with any diagnosed neurological
disorders, any congenital deformity of the hand, participants with
established visual impairments, cognitive limitations that interfere
with the test, recent fracture, or any trauma to the dominant hand
were excluded from the study.
Sample size calculation: It was calculated based on a 5% level of
signiﬁcance, 80% power, effect size of 0.6 and the required samples
in each group were 45 that is a total of 90. This was calculated
using G* power software. A total of 100 students were screened out
of which 90 students who met the inclusion criteria were recruited
into the study. Following the completion of screening by convenient
sampling, students were allocated into two groups, 45 in group A
(males) and 45 in group B (females).
The students were made to sit comfortably on an adjustable chair
(swivel or revolving chair) in front of the occluder where the mirror
drawing apparatus was placed on the table. The mirror of dimension
15×15 inches was placed at one edge of the table. A wooden
board was kept behind the mirror to support the mirror to stand
independently. An occluder made of cardboard, with a dimension
of 20×15 inches was placed at the other edge of the table upon the
task sheet. A slot was cut along the bottom of the cardboard so that
the participant could insert his/her hand to draw. The occluder was
kept in such a way that the participant could see only the task sheet
in the mirror. The distance between the mirror and the occluder was
maintained at 10 inches.
The participants were instructed to trace the star between the
two bordered lines from the point marked as a start and not to
cross the borders of the star and try to complete the star within
the time given. They were also instructed not to lift the pen from
the tracing sheet until the student completed the star. Four trials
were given and a time limit of three minutes 30 seconds was given
to complete each trial. Efﬁciency of index was calculated after the
student completes four trials. The procedure of performing the task
is shown in [Table/Fig-1].
The mirror drawing task aimed to check the time and error components
of each participant. After instructing the participant, the tracing sheet
was placed between the mirror and the occluder. The participant was
asked to place the tip of the pencil on the start point of the tracing
sheet. Four trials were given each participant with a session break of
two minutes in between the trials.
Time taken to complete each trial was noted using a stopwatch
and the number of errors which included touching the borders of
the star, lifting the pen during the task and crossing the borders
was manually calculated. The individual with more of errors in the
respective group was considered to be the maximum error of that
group. The efﬁciency index is calculated using the formula 10
[Table/Fig-1]: Performing the mirror drawing task.
(maximum number of errors minus the number of errors of each
person) divided by time spent to complete the task .
Data analysis was performed by Statistical Package for Social
Sciences (SPSS) (version 26) for windows, where the Independent
sample t-test was used to compare age and efﬁciency index
according to gender. The Spearman’s Ratio was used to ﬁnd the
relationship between mean error, meantime and efﬁciency index.
The Mann-Whitney U test was used to compare the mean error and
mean time according to gender.
The mean and standard deviation for age, mean error, mean time,
and efﬁciency index is shown in [Table/Fig-2]. The Independent
t-test was used to compare age according to gender (p-value
>0.05) and hence the distribution of age was homogeneous
according to gender. Efﬁciency index showed a statistically
signiﬁcant difference when compared on the basis of gender
Variables Mean SD
Age (years) 21.50 2.17
Mean error (n) 22.30 17.11
Mean time (sec) 148.49 40.01
Efﬁciency index (%) 5.06 2.09
[Table/Fig-2]: Mean and Standard Deviation of age mean error, mean time,
*n: number of subjects; †SD: Standard Deviation
Variables Groups Mean SD t p-value
Male 21.2 2.074
Female 21.8 2.242
Efﬁciency index (%)
Male 5.52 2.29
Female 4.61 1.77
[Table/Fig-3]: Comparison of age and efﬁciency index according to gender.
*n: number of subjects; †SD: Standard Deviation; ǂp-value>0.05 denotes no signiﬁcant difference,
*p-value<0.05 denotes signiﬁcant difference
The independent t-test was used to compare age according to gender.
The independent sample t-test was used to compare the “efﬁciency index” according to gender
The Spearman’s ratio was used to ﬁnd the relationship between
mean error, mean time and efﬁciency index. There was a positive
correlation (p<0.05) between mean error and mean time among
the males as well as females. The Spearman’s ratios were negative
for mean error and efﬁciency index; mean time and efﬁciency
index. The same type of correlation was found between the mean
error, mean time and efﬁciency index irrespective of gender as
shown in [Table/Fig-4-6]. The Mann-Whitney U test was used to
www.jcdr.net B Swathi et al., Difference in Gender with Hand-eye Coordination in Young Adults
Journal of Clinical and Diagnostic Research. 2023 Jan, Vol-17(1): YC15-YC18 1717
Males Females Irrespective of gender
Spearman’s ratio p-value Spearman’s ratio p-value Spearman’s ratio p-value
Mean error (n) & mean time (sec) 0.575 <0.001* 0.483 0.001* 0.523 <0.001*
Mean error (n) & efﬁciency index (%) -0.752 <0.001* -0.792 <0.001* -0.757 <0.001*
Mean time (sec) & efﬁciency index (%) -0.945 <0.001* -0.82 <0.001* -0.898 <0.001*
[Table/Fig-4]: Relationship between mean error, mean time and efﬁciency index.
n=number of subjects; †p-value <0.05 denotes signiﬁcant difference.
The Spearman's Ratio was used to ﬁnd the relationship between “mean error”, “mean time” & “efﬁciency index”.
[Table/Fig-5]: Relationship between mean time and efﬁciency index (Males).
[Table/Fig-6]: Relationship between mean error and efﬁciency index (Females).
compare the mean error according to gender (p-value>0.05) and
hence there was no difference in the mean error between males
and females. The Mann-Whitney U test was used to compare the
mean time according to gender (p-value>0.05) and hence there
was no difference in the mean time between males and females as
shown in [Table/Fig-7].
Variables Groups Median IQR “Z” p-value
Mean error (n)
Male 17 9.88 to 30.75
Female 20.5 8.38 to 35.5
Mean time (sec)
Male 145.7 114.75 to 171.5
Female 150 128 to 183.25
[Table/Fig-7]: Comparison of the mean error and mean time according to gender.
n: number of subjects; †IQR=Inter Quartile Range; ǂZ=Standard score, Ꞩp-value >0.05 denotes
no signiﬁcant difference. The Mann-Whitney U test was used to compare the “mean error” and
“mean time” according to gender
Hand-eye coordination is the regulated and synchronised movement
of the hand and eye to perform a purpose. In other words, eye-hand
coordination refers to the ability to complete a task. It involves
everything from cooking our daily meals to moving heavy things, as
well as other sports performances and games .
In the current study, 100 students were screened and 90 students
were recruited after they met with the inclusion criteria after which
we divided them into two groups according to the gender group
A was male and group B was female with 45 students each in the
In our study, we found out a positive correlation between mean
error and mean time in both males and females, which suggests
that as error increased for the task there was an increase in time
, the result also showed that there was a negative correlation
between mean error and mean time with efﬁciency index in both
the genders which means as a mean error decreased there was
an increase in efﬁciency index and as mean time decreased there
was increased in efﬁciency index . The mean error and time
taken to complete the task were also in females compared to male
young adults although there was no signiﬁcant difference between
them. Also, the study proved there was a statistically signiﬁcant
difference (p-value <0.05) found in the efﬁciency index between
males and females, where it has reﬂected male population is more
efﬁcient in mirror drawing task than females. The cerebellum, a brain
structure that helps regulate consciousness, and the pons, a brain
structure linked to the cerebellum that helps drive consciousness,
are both larger in men than in women . Since the presence of
anatomical difference also could be the reason for males to achieve
more advantage in hand-eye coordination. Hence, it answers the
research question and proves that there is a gender difference in
hand-eye coordination in young adults.
Sex differences in visuomotor tracking were investigated by Mathew
J et al., . They looked at sex differences in a visual-occulo-manual
motor task that involves tracking a moving target with the hand.
They also looked into whether men and women had different hand
kinematics and gaze strategies. They claim that men have a distinct
advantage in hand tracking accuracy and hand kinematics. So this
adds to the evidence in our study that males had better hand-eye
A study on gender differences in motor coordination on a visual test
was undertaken by Chraif M and Aniţei M. They used the Vienna
testing system to administer two hand coordination tests. The
ﬁndings revealed that young male students are statistically more
precise in completing the task, but young female students can
calibrate, ﬁx errors, and learn from them. Hence, this study also
correlates with the present study .
The goal of Valtr L et al., study was to see if there were any gender
differences in the performance of motor tasks using Movement
Assessment Battery for Children-2 (MABC-2) test in adolescents aged
15-16 years. The results showed that the boys performed much better
than the girls in the aiming and catching tests. In dynamic balancing
tasks, there was no signiﬁcant difference between the genders. As a
result, this research backs up the present study ﬁndings .
The study done by Bressel E et al., to assess the speed and
accuracy of acquiring a motor skill on land versus in chest-deep
water concluded that with practicing, both groups’ time and errors
decreased dramatically; nevertheless, drawing time was longer
in water than on land. Hence, this article supports the present
study ﬁndings . More right hemisphere activation was linked
to improved spatial problem-solving in males with superior spatial
aptitude, according to Ray WJ et al., . Visual-spatial talents,
such as aiming at stationary or moving targets, as well as throwing
and intercepting projectiles, have always been dominated by men.
Males have also excelled at mental rotation, numeric problem
solving, and tasks requiring the maintenance and manipulation
of a visual image in working memory, all of which are underlying
cognitive processes .
B Swathi et al., Difference in Gender with Hand-eye Coordination in Young Adults www.jcdr.net
Journal of Clinical and Diagnostic Research. 2023 Jan, Vol-17(1): YC15-YC18
PARTICULARS OF CONTRIBUTORS:
1. Student, Department of Physiotherapy, Nitte Institute of Physiotherapy, NITTE (Deemed to be) University, Mangalore, Karnataka, India.
2. Associate Professor, Department of Physiotherapy, Nitte Institute of Physiotherapy, NITTE (Deemed to be) University, Mangalore, Karnataka, India.
3. Assistant Professor, Department of Physiotherapy, Nitte Institute of Physiotherapy, NITTE (Deemed to be) University, Mangalore, Karnataka, India.
PLAGIARISM CHECKING METHODS: [Jain H et al.]
• Plagiarism X-checker: Jul 27, 2022
• Manual Googling: Nov 10, 2022
• iThenticate Software: Nov 16, 2022 (13%)
ETYMOLOGY: Author Origin
NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR:
Associate Professor, Department of Physiotherapy, Nitte Institute of Physiotherapy,
NITTE (Deemed to be) University, Deralakatte, Mangalore, Karnataka, India.
Date of Submission: Jul 25, 2022
Date of Peer Review: Sep 10, 2022
Date of Acceptance: Nov 18, 2022
Date of Publishing: Jan 01, 2023
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. Yes
Adult brain volume sexual dimorphisms were more obvious in the
cortex, with women having greater volumes to cerebrum size,
particularly in the frontal and medial paralimbic cortices. Men had
larger volumes in the frontomedial cortex, hypothalamus, and
amygdala in accordance with their cerebrum size. The cerebellum,
a brain structure that helps regulate consciousness, and the
pons, a brain structure linked to the cerebellum that helps drive
consciousness, are both larger in men than in women . Since
there is anatomical difference could also be the reason for males to
achieve more advantage in hand-eye coordination.
Hence, it can be concluded that the mirror drawing task improves
hand-eye coordination through procedural memory. With repeated
practice, the number of errors and time taken to complete the
task will be reduced. Also, it clearly shows there is a greater male
advantage in the efﬁciency of hand-eye coordination in young
The study has not measured the long-term beneﬁts of the test.
Selection of small age range 19-26 years may not reveal the
Hand-eye coordination is a complex procedure and any simplifying
rule that might help us understand its neural underpinnings are
potentially useful. The present study results demonstrate that the
mirror drawing task improves hand-eye coordination. Moreover, it
clearly shows a greater male advantage in the efﬁciency of hand-eye
coordination compared to females. It is important to focus visually
on a task to master it early and perform accurately therefore it is
advisable to the participant especially females, to focus on the task
in which they are engaged to accomplish it faster. There is a need
for longitudinal studies on long time scale to establish if capacity of
motor planning or anticipatory control determines the ﬁnal level of
acquisition of the skill.
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