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Subara-Zukic E, McGuckian TB, Cole MH, Steenbergen B, Wilson PH. Locomotor-cognitive dual-tasking in children with developmental coordination disorder. Front Psychol 2024; 15:1279427. [PMID: 38510308 PMCID: PMC10951910 DOI: 10.3389/fpsyg.2024.1279427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Children with Developmental Coordination Disorder (DCD) demonstrate deficits in predictive motor control and aspects of cognitive control compared with their typically developing (TD) peers. Adjustment to dynamic environments depends on both aspects of control and the deficits for children with DCD may constrain their ability to perform daily actions that involve dual-tasking. Under the assumption that motor-cognitive integration is compromised in children with DCD, we examined proportional dual-task costs using a novel locomotor-cognitive dual-task paradigm that enlisted augmented reality. We expect proportional dual-task performance costs to be greater for children with DCD compared to their TD peers. Methods Participants were 34 children aged 6-12 years (16 TD, 18 DCD) who walked along a straight 12 m path under single- and dual-task conditions, the cognitive task being visual discrimination under simple or complex stimulus conditions presented via augmented reality. Dual-task performance was measured in two ways: first, proportional dual-task costs (pDTC) were computed for cognitive and gait outcomes and, second, within-trial costs (p-WTC) were measured as the difference on gait outcomes between pre- and post-stimulus presentation. Results On measures of pDTC, TD children increased their double-limb support time when walking in response to a dual-task, while the children with DCD increased their locomotor velocity. On p-WTC, both groups increased their gait variability (step length and step width) when walking in response to a dual-task, of which the TD group had a larger proportional change than the DCD group. Greater pDTCs on motor rather than cognitive outcomes were consistent across groups and method of dual-task performance measurement. Discussion Contrary to predictions, our results failed to support dramatic differences in locomotor-cognitive dual-task performance between children with DCD and TD, with both groups tending to priorities the cognitive over the motor task. Inclusion of a within-trial calculation of dual-task interference revealed an expectancy effect for both groups in relation to an impending visual stimulus. It is recommended that dual-task paradigms in the future continue to use augmented reality to present the cognitive task and consider motor tasks of sufficient complexity to probe the limits of performance in children with DCD.
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Affiliation(s)
- Emily Subara-Zukic
- Healthy Brain and Mind Research Center, School of Behavioral and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Thomas B. McGuckian
- Healthy Brain and Mind Research Center, School of Behavioral and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Michael H. Cole
- Healthy Brain and Mind Research Center, School of Behavioral and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Bert Steenbergen
- Behavioral Science Institute, Radboud University, Nijmegen, Netherlands
| | - Peter Henry Wilson
- Healthy Brain and Mind Research Center, School of Behavioral and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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Kuijpers R, Smulders E, Groen BE, Smits-Engelsman BCM, Nijhuis-van der Sanden MWG, Weerdesteyn V. Walking adaptability improves after treadmill training in children with Developmental Coordination Disorder: A proof-of-concept study. Gait Posture 2022; 92:258-263. [PMID: 34890915 DOI: 10.1016/j.gaitpost.2021.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/02/2021] [Accepted: 11/28/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children with Developmental Coordination Disorder (DCD) have motor coordination deficits leading to difficulties in sports and play that require adaptations of the walking pattern. Children with DCD indeed demonstrate poorer walking adaptability (WA) compared to typically developing children, but it remains elusive whether WA can be improved by training. RESEARCH QUESTION Does augmented-reality treadmill training lead to improvements in WA in children with DCD? METHODS Seventeen children with DCD were included in this proof-of-concept intervention study. They received a six-session training on the C-mill, a treadmill on which gait adjustments can be evoked by projected visual context. The effect of the training was evaluated before (M1), directly after training (M2) and after 6 months follow-up (M3) using the WAL-K (single and double run) and WA-tasks on the C-mill (as a single and with concurrent visuo-motor and cognitive task). In addition, parents completed a questionnaire on their perception of the training. Linear Mixed Model analyses were performed to assess the differences in WAL-K scores and success rates on the WA-tasks between M1-M2 and M1-M3. RESULTS Children significantly improved on the WAL-K double run and on all three WA-tasks between M1-M2 and M1-M3. Children did not improve on the WAL-K single run. Parents found the training useful and fun for their child and indicated that their child fell less frequently. SIGNIFICANCE The results show that C-mill training had positive and task-specific effects on WA in children with DCD, which effects generalized to an overground task and were retained at 6 months follow-up. This may help children with DCD to better participate in daily activities. Future research should include a control group to examine the effectiveness of the training program compared to receiving no training and may also examine the effect of the training on participation in daily life.
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Affiliation(s)
- Rosanne Kuijpers
- Sint Maartenskliniek Research, Nijmegen, The Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands.
| | - Ellen Smulders
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands; Avans+, University of Applied Sciences, Master Specialized Physical Therapy, Breda, The Netherlands
| | - Brenda E Groen
- Sint Maartenskliniek Research, Nijmegen, The Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Bouwien C M Smits-Engelsman
- Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Maria W G Nijhuis-van der Sanden
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands; IQ Healthcare, Research Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Vivian Weerdesteyn
- Sint Maartenskliniek Research, Nijmegen, The Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
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Subara-Zukic E, Cole MH, McGuckian TB, Steenbergen B, Green D, Smits-Engelsman BCM, Lust JM, Abdollahipour R, Domellöf E, Deconinck FJA, Blank R, Wilson PH. Behavioral and Neuroimaging Research on Developmental Coordination Disorder (DCD): A Combined Systematic Review and Meta-Analysis of Recent Findings. Front Psychol 2022; 13:809455. [PMID: 35153960 PMCID: PMC8829815 DOI: 10.3389/fpsyg.2022.809455] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/03/2022] [Indexed: 01/16/2023] Open
Abstract
AIM The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD. METHODS The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis. RESULTS The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions. INTERPRETATION Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed. SYSTEMATIC REVIEW REGISTRATION PROSPERO, identifier: CRD42020185444.
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Affiliation(s)
- Emily Subara-Zukic
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Michael H. Cole
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Thomas B. McGuckian
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Bert Steenbergen
- Department of Pedagogical and Educational Sciences, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Dido Green
- Department of Health Sciences, Brunel University London, London, United Kingdom
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Bouwien CM Smits-Engelsman
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Jessica M. Lust
- Department of Pedagogical and Educational Sciences, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Reza Abdollahipour
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Erik Domellöf
- Department of Psychology, Umeå University, Umeå, Sweden
| | | | - Rainer Blank
- Heidelberg University, Heidelberg, Germany
- Klinik für Kinderneurologie und Sozialpädiatrie, Kinderzentrum Maulbronn gGmbH, Maulbronn, Germany
| | - Peter H. Wilson
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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Verbecque E, Johnson C, Rameckers E, Thijs A, van der Veer I, Meyns P, Smits-Engelsman B, Klingels K. Balance control in individuals with developmental coordination disorder: A systematic review and meta-analysis. Gait Posture 2021; 83:268-279. [PMID: 33227605 DOI: 10.1016/j.gaitpost.2020.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/28/2020] [Accepted: 10/11/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although it is recognized that the majority of children with developmental coordination disorder (DCD) have balance deficits, comprehensive insights into which balance domains are affected, are still lacking in literature. RESEARCH QUESTION To what extent is balance control deficient in individuals with DCD compared to controls? METHODS Pubmed, Scopus and Web of Science were systematically searched. Risk of bias was assessed with the Scottish Intercollegiate Guidelines Network checklist for case-control studies. Mean and standard deviations characterizing balance control were extracted to calculate standardized mean differences (SMD) and pooled, if possible, using Review Manager. RESULTS The results of 31 studies (1152 individuals with DCD, 1103 typically developing (TD) peers, mean age 10.4 years old) were extracted of which 17 were used for meta-analysis. The mean SMD for the balance subscale of the Movement Assessment Battery for Children was 1.63 (pooled 95 %CI =[1.30;1.97]), indicating children with DCD to perform significantly poorer than their TD peers. Force plate studies also revealed that children with DCD present with a larger sway path during bipedal stance with eyes closed (pooled mean SMD = 0.55; 95 %CI=[0.32;0.78]). Children with DCD tend to have direction-specific limited stability limits and task-independent delayed onset of anticipatory postural adjustments. INTERPRETATION Children with DCD perform poorer on different domains of balance compared to TD peers. Future research should focus on comprehensive balance assessment in these children, preferably using a longitudinal design.
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Affiliation(s)
- Evi Verbecque
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and Physiotherapy, Hasselt University, Agoralaan Building A, 3590, Diepenbeek, Belgium; Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium.
| | - Charlotte Johnson
- Department of Rehabilitation Sciences and Physiotherapy/Movant, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Eugène Rameckers
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and Physiotherapy, Hasselt University, Agoralaan Building A, 3590, Diepenbeek, Belgium; Department of Rehabilitation Medicine Maastricht University, Maastricht, the Netherlands; Center of Expertise Adelante Rehabilitation, Valkenburg, the Netherlands; AVANSplus, University for Professionals, Breda, the Netherlands
| | - Angelina Thijs
- Center of Development Advancement and Pediatric Neurorehabilitation of the Wildermeth Foundation, Biel/Bienne, Switzerland
| | - Ingrid van der Veer
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and Physiotherapy, Hasselt University, Agoralaan Building A, 3590, Diepenbeek, Belgium; AVANSplus, University for Professionals, Breda, the Netherlands
| | - Pieter Meyns
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and Physiotherapy, Hasselt University, Agoralaan Building A, 3590, Diepenbeek, Belgium
| | - Bouwien Smits-Engelsman
- Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, Division of Physiotherapy, University, Cape Town, South Africa
| | - Katrijn Klingels
- Rehabilitation Research Centre (REVAL), Rehabilitation Sciences and Physiotherapy, Hasselt University, Agoralaan Building A, 3590, Diepenbeek, Belgium
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Kuijpers R, Smulders E, Groen BE, Smits-Engelsman BCM, Nijhuis-Van der Sanden MWG, Weerdesteyn V. Reliability and construct validity of the Walking Adaptability Ladder Test for Kids (WAL-K): a new clinical test for measuring walking adaptability in children. Disabil Rehabil 2020; 44:1489-1497. [PMID: 32776854 DOI: 10.1080/09638288.2020.1802523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Walking adaptability is essential for children to participate in daily life, but no objective measurement tools exist. We determined psychometric properties of the Walking Adaptability Ladder test for Kids (WAL-K) in 6-12 year old children. MATERIALS AND METHODS In total, 122 typically developing (TD) children and 26 children with Developmental Coordination Disorder (DCD) completed the single and double run conditions of the WAL-K. Intra-rater, inter-rater and test-retest reliability were determined by ICCs and Smallest Detectable Change (SDC) in 53 TD children. Construct validity was determined by comparing WAL-K scores between 69 TD and all DCD children and correlating these scores with age and MABC-2 scores. RESULTS ICCs for reliability varied between 0.76 and 0.99. Compared to the first test performance, WAL-K scores were lower (i.e., better) at retest. SDCs for test-retest reliability varied between 20.8 and 26.1% of the mean scores. WAL-K scores were significantly higher (i.e., worse) in DCD children compared to TD children (p < 0.001). Significant negative correlations were found with MABC-2 (-0.52 and -0.60) and age (-0.61 and -0.68). CONCLUSIONS The WAL-K shows to be a valid, reliable and easy-to-use tool for measuring walking adaptability in children. Adding an extra practice trial may reduce the observed learning effect.Implications for rehabilitationWalking adaptability is an essential skill for children to participate in daily life, but no objective measurement tools are available.The Walking Adaptability Ladder test for Kids (WAL-K) is a new measurement tool for evaluating walking adaptability in children.The WAL-K shows to be a reliable and valid measurement tool for evaluating walking adaptability in 6-12 year old children.
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Affiliation(s)
- Rosanne Kuijpers
- Sint Maartenskliniek Research, Nijmegen, The Netherlands.,Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Ellen Smulders
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands.,Master Specialized Physical Therapy, Avans+, Breda, The Netherlands
| | - Brenda E Groen
- Sint Maartenskliniek Research, Nijmegen, The Netherlands.,Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
| | - Bouwien C M Smits-Engelsman
- Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Maria W G Nijhuis-Van der Sanden
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands.,IQ Healthcare, Research Institute for Health Sciences, Radboud university medical center, Nijmegen, The Netherlands
| | - Vivian Weerdesteyn
- Sint Maartenskliniek Research, Nijmegen, The Netherlands.,Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, The Netherlands
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Parr JVV, Foster RJ, Wood G, Hollands MA. Children With Developmental Coordination Disorder Exhibit Greater Stepping Error Despite Similar Gaze Patterns and State Anxiety Levels to Their Typically Developing Peers. Front Hum Neurosci 2020; 14:303. [PMID: 32848677 PMCID: PMC7399056 DOI: 10.3389/fnhum.2020.00303] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/08/2020] [Indexed: 12/21/2022] Open
Abstract
This study examined stepping accuracy, gaze behavior, and state-anxiety in children with (N = 21, age M = 10.81, SD = 1.89) and without (N = 18, age M = 11.39, SD = 2.06) developmental coordination disorder (DCD) during an adaptive locomotion task. Participants walked at a self-selected pace along a pathway, placing their foot into a raised rectangular floor-based target box followed by either no obstacles, one obstacle, or two obstacles. Stepping kinematics and accuracy were determined using three-dimensional motion capture, whilst gaze was determined using mobile eye-tracking equipment. The children with DCD displayed greater foot placement error and variability when placing their foot within the target box and were more likely to make contact with its edges than their typically developing (TD) peers. The DCD group also displayed greater variability in the length and width of their steps in the approach to the target box. No differences were observed between groups in any of the gaze variables measured, in mediolateral velocity of the center of mass during the swing phase into the target box, or in the levels of self-reported state-anxiety experienced prior to facing each task. We therefore provide the first quantifiable evidence that deficits to foot placement accuracy and precision may be partially responsible for the increased incidence of trips and falls in DCD, and that these deficits are likely to occur independently from gaze behavior and state-anxiety.
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Affiliation(s)
- Johnny V V Parr
- Department of Sport and Exercise Sciences, Research Centre for Musculoskeletal Science and Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Richard J Foster
- Research to Improve Stair Climbing Safety, Faculty of Science, School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Greg Wood
- Department of Sport and Exercise Sciences, Research Centre for Musculoskeletal Science and Sports Medicine, Manchester Metropolitan University, Manchester, United Kingdom
| | - Mark A Hollands
- Research to Improve Stair Climbing Safety, Faculty of Science, School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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Li R, Fu H, Zheng Y, Lo WL, Yu JJ, Sit CHP, Chi Z, Song Z, Wen D. Automated Fine Motor Evaluation for Developmental Coordination Disorder. IEEE Trans Neural Syst Rehabil Eng 2019; 27:963-973. [PMID: 30998471 DOI: 10.1109/tnsre.2019.2911303] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Developmental coordination disorder (DCD) is a type of motor learning difficulty that affects five to six percent of school-aged children, which may have a negative impact on the life of the sufferers. Timely and objective diagnosis of DCD are important for the success of the intervention. The present evaluation methods of DCD rely heavily on the observational analysis of occupational therapists and physiotherapists, who score the performance when children conduct some designed tasks. However, these methods are expensive, subjective, and are not easy to expand to a larger population. A fine motor evaluation system (FMES) is proposed with two views of cameras to record children's performance, when they carry out three fine motor tasks. Automated algorithms are developed to perform automated scoring of fine motor skill. The automated algorithms include task localization and individual task evaluation. The purpose of task localization is to detect each task and extract segments belonging to each task from the original video that includes multiple segments of different tasks. A convolutional neural network with temporal filtering is used to do frame-wise classification, and a boundary localization algorithm is proposed to localize each task segment. For individual task evaluation, the extracted video segments of task 1 and task 2 are evaluated based on the proposed feature extraction and time positioning algorithm, and the paper drawings of task 3 are evaluated based on image processing. The proposed methods are validated on a diverse population of children with or without DCD by comparing automated scoring with manual scoring from a professional evaluator. The experimental results suggest that the proposed methods can effectively achieve fine motor evaluation for DCD assessment. Besides, our system is a low-cost solution, and the evaluation methods developed are automated, objective, and can be suited for large population evaluation and analysis.
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Wilmut K, Barnett AL. When an object appears unexpectedly: foot placement during obstacle circumvention in children and adults with Developmental Coordination Disorder. Exp Brain Res 2017; 235:2947-2958. [PMID: 28707062 DOI: 10.1007/s00221-017-5031-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 07/09/2017] [Indexed: 11/25/2022]
Abstract
Adjustments to locomotion to avoid an obstacle require a change to the usual pattern of foot placement, i.e. changes to step length and/or step width. Previous studies have demonstrated a difficulty in individuals with Developmental Coordination Disorder (DCD) in controlling stability while both stepping over and while circumventing an obstacle. In a previous study, we have considered the way in which individuals with DCD prepare for the possibility of an obstacle appearing (Wilmut and Barnett in Exp Brain Res 235:1531-1340, 2017). Using a parallel data set from this same task on the same individuals, the aim of the current study was to investigate the exact nature of changes in foot placement during obstacle avoidance, as this was not clear from previous work. Children and adults aged from 7 to 34 years of age took part in the study. Forty-four met the criteria for a diagnosis of DCD and there were 44 typically developing (TD) age and gender-matched controls. Participants walked at a comfortable pace down an 11 m walkway; on 6 out of 36 trials a 'gate' closed across their pathway which required circumvention. These 6 'gate close' trials were analysed for this study. The number and magnitude of step length and step width adjustments were similar across the DCD and TD groups, however, the younger children (7-11 years) made a greater number of early adjustments compared to the older children and adults (12-34 years of age). In contrast the adults made a greater number of adjustments later in the movement compared to the children. In terms of foot placement adjustments a clear preference was seen across all participants to use adjustments which resulted in reducing step length, stepping away from the obstacle and a combination of these. Apart from subtle differences, the individuals with DCD make step placements to circumvent an obstacle in line with their peers. It is suggested that the choice of foot placement strategy in individuals with DCD, although in line with their peers, may not be optimal for their level of motor ability.
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Affiliation(s)
- K Wilmut
- Perception and Motion Analysis Lab, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, UK.
| | - A L Barnett
- Perception and Motion Analysis Lab, Oxford Brookes University, Gipsy Lane, Oxford, OX3 0BP, UK
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