A comparison of the oxygen cost and physiological responses to running in children with and without Developmental Coordination Disorder

Physical Fitness in Children With Developmental Coordination Disorder: A Systematic Review

OBJECTIVE

To synthesize evidence about physical fitness levels in children with developmental coordination disorder (DCD) compared with typically developing (TD) children.

METHODS

We searched four databases (PubMed, Scopus, Web of Science, and PsycINFO) for cross-sectional, case-control, and cohort studies comparing physical fitness between children with and without DCD. We assessed the methodological quality of the studies with the Newcastle-Ottawa Scale (NOS). We calculated Cohen's d effect sizes to provide clinical evidence of group differences in aerobic capacity, anaerobic capacity, muscle strength, body composition and flexibility.

RESULTS

We included 32 studies for qualitative synthesis after applying eligibility criteria. All selected studies ranged from moderate to high research quality. Effect sizes in favor of typically developing children over children with DCD were large for aerobic capacity (d = 1.15), anaerobic capacity (d = 0.90), and muscle strength (d = 0.79), and small for body composition (d = 0.43) and flexibility (d = 0.21) outcomes.

CONCLUSION

Children with DCD presented significantly lower physical fitness than their typically developing peers, particularly in aerobic and anaerobic capacity and in muscle strength.

Investigating the mediating role of internalizing and externalizing problems on physical fitness in children at risk for Developmental Coordination Disorder

Children with Developmental Coordination Disorder (DCD) have poorer fitness and greater internalizing/externalizing problems compared with typically developing (TD) children. The purpose of this study was to examine the potential mediating role of internalizing/externalizing problems on the relationship between children at risk for DCD (DCDr) and physical fitness. Participants (N = 589) included 288 children with DCDr (M_age = 4.9, 67% male) and 301 TD children (M_age = 5.0, 48% male). Motor skills were assessed using the Movement Assessment Battery for Children-2^nd edition (DCDr: at or below the 16th percentile, TD: >16th percentile). Parent-reported internalizing/externalizing problems were measured using the Child Behaviour Checklist. Physical fitness was measured using the Bruce protocol maximal treadmill test and a 30-second Wingate test. Tests for indirect (mediation) effects were assessed using the PROCESS v3.5 software macro. Children with DCDr had higher internalizing and externalizing problems (p < 0.001, d = 0.35-0.46) and poorer fitness levels (p < 0.001, ηp² = 0.05-0.09). Internalizing problems mediated fitness performance on both the treadmill and Wingate test; however, externalizing problems showed no mediating effects. Thus, interventions targeting internalizing problems may contribute to improving performance on fitness-based tasks among children with DCDr. Novelty: Children at risk for DCD have poorer fitness when compared with TD children. Children at risk for DCD experience greater internalizing/externalizing problems. Internalizing problems were found to mediate the DCD-physical fitness relationship.

Differences in walking and running gait in children with and without developmental coordination disorder: A systematic review and meta-analysis

BACKGROUND

Developmental coordination disorder (DCD) is a common motor skills disorder in children. Although gait changes are often reported clinically, affecting children's participation in play and sport, there has been no synthesis of research evidence comparing gait of children with and without DCD. Thus, the aim of this research was to determine differences in gait between children with and without DCD METHODS: A search of electronic databases (AMED, CINAHL, Cochrane Library, Embase, Medline, SPORTDiscus, & Web of Science) was conducted from inception to August 2019 for studies comparing walking and/or running gait of children with and without DCD. The McMaster Critical Appraisal Form for Quantitative Studies was used to assess risk of bias amongst included studies. Meta-analysis was completed on measures with four or more homogenous outcomes.

RESULTS

20 studies fulfilled the inclusion criteria and were eligible for review - three of which were pre-post designs, and 17 were cross-sectional designs. Data was extracted in five domains: kinetics, kinematics, physical function, electromyography, and temporospatial parameters. Meta-analysis was performed on one outcome measure - the 6 min Walk Test (6MWT), finding that children with DCD walked significantly shorter distances, indicating reduced endurance in walking gait. Other statistically significant results all favoured typically developing children, however there is little consistency between studies.

CONCLUSION

Although a clear gait pattern for children with DCD is not evident, functional deficits appear to be present in endurance and cardiorespiratory fitness. The current evidence base for gait changes in DCD is currently low-level, and further high quality research is warranted.

PROSPERO REGISTRATION NUMBER

CRD42018106791.

Children's Repetitive and Intermittent Sprinting Performance (CRISP) Test: A new field-based test for assessing anaerobic power and repeated sprint performance in children with developmental coordination disorder

BACKGROUND

Evidence on anaerobic power and sprinting performance of children with Developmental Coordination Disorder (DCD) is limited.

AIMS

The primary aim of this study was to investigate if the Children's Repetitive and Intermittent Sprinting Performance (CRISP) test could induce fatigue among participants. Secondly, the study examined the construct validity of the test in children with probable DCD (p-DCD) and typically developing (TD) peers.

METHODS AND PROCEDURES

The study was carried out in two phases. In phase 1, we compared performance of 25 children (7-12 years) on the CRISP test to their performance on the Muscle Power Sprint test (MPST). For phase 2, forty-six (n = 46) participants with p-DCD were matched with TD children (n = 46) on age, weight and sex. Anaerobic performance of participants was assessed using the CRISP test, 10 × 5 m sprints straight and slalom tests, side jumps, stepping on platform task and the ladder agility test.

OUTCOMES AND RESULTS

Phase 1: The increase in running time on the CRISP test was greater than on the MPST, indicating that the CRISP test was more fatiguing than the MPST. Phase 2: Children with p-DCD had poorer anaerobic capacity (muscle power, muscle endurance) compared to their TD peers. However, fatigue was comparable between the two groups. The differences in performance between p-DCD and TD children were found to be greater for tests with more agility elements.

CONCLUSIONS AND IMPLICATIONS

The findings showed that CRISP test could induce fatigue in children. The CRISP test was also found to have positive construct (i.e. known-group) validity. The differences in muscle power and endurance between children with p-DCD and TD peers tend to widen when assessments are performed with tests having high agility components.

Physiological characteristics, self-perceptions, and parental support of physical activity in children with, or at risk of, developmental coordination disorder

Children with low movement proficiency have been identified as having poorer physiological and psychosocial outcomes; however, the varied measurement approaches used to assess these outcomes have varied resulting in conflicting evidence regarding the presence and magnitude of differences compared to Typically Developing (TD) children. Additionally, there has been limited research into the role of parental support for physical activity (PA) in this group. We compared children with varying levels of movement proficiency on physiological characteristics and self-perceptions regarding PA. In addition, these children's parents were compared on physiological characteristics and support of their children's PA. Children (N = 117) aged 6 to 12 years, along with their parent/guardian, participated in this study. Children were classified according to the Movement Assessment Battery for Children-2 test (Typically Developing (TD) = 60; At Risk = 19; Developmental Coordination Disorder (DCD) = 38). Children's PA, muscle strength, cardio-respiratory fitness (CRF), body composition, and self-perceptions regarding PA were assessed, with parents assessed on CRF, body composition, and PA support. Compared to TD children, children with DCD had lower PA (p = 0.036), predilection (p ≤0.001) and adequacy (p ≤0.001) regarding PA, higher body fat percentage (p = 0.019), and received less logistic support (i.e., transportation) from their parents (p = 0.012). TD children had increased muscle strength compared to the DCD (p ≤ 0.001) and At Risk (p ≤ 0.001) groups. Results indicated that, relative to TD children, children with DCD have multiple physiological deficits, receive less parental logistic support for PA involvement, and report lower scores on psychological constructs that are predictive of PA involvement.

Cognitive and neuroimaging findings in developmental coordination disorder: new insights from a systematic review of recent research

AIM

To better understand the neural and performance factors that may underlie developmental coordination disorder (DCD), and implications for a multi-component account.

METHOD

A systematic review of the experimental literature published between June 2011 and September 2016 was conducted using a modified PICOS (population, intervention, comparison, outcomes, and study type) framework. A total of 106 studies were included.

RESULTS

Behavioural data from 91 studies showed a broad cluster of deficits in the anticipatory control of movement, basic processes of motor learning, and cognitive control. Importantly, however, performance issues in DCD were often shown to be moderated by task type and difficulty. As well, we saw new evidence of compensatory processes and strategies in several studies. Neuroimaging data (15 studies, including electroencephalography) showed reduced cortical thickness in the right medial orbitofrontal cortex and altered brain activation patterns across functional networks involving prefrontal, parietal, and cerebellar regions in children with DCD than those in comparison groups. Data from diffusion-weighted magnetic resonance imaging suggested reduced white matter organization involving sensorimotor structures and altered structural connectivity across the whole brain network.

INTERPRETATION

Taken together, results support the hypothesis that children with DCD show differences in brain structure and function compared with typically developing children. Behaviourally, these differences may affect anticipatory planning and reduce automatization of movement skill, prompting greater reliance on slower feedback-based control and compensatory strategies. Implications for future research, theory development, and clinical practice are discussed.

Physical and Mental Health of Children with Developmental Coordination Disorder

Developmental coordination disorder (DCD) is a neurodevelopmental condition characterized by poor motor proficiency that interferes with an individual’s activities of daily living. These problems in motor coordination are prevalent despite children’s intelligence levels. Common symptoms include marked delays in achieving motor milestones and clumsiness, typically associated with poor balance, coordination, and especially handwriting skills. Currently, DCD is said to impact about 2–7% of school-age children. More importantly, DCD is considered to be one of the major health problems among school-aged children worldwide, with unique consequences to physical and mental health. Because these children and adolescents often experience difficulties participating in typical childhood activities (e.g., riding a bike), they tend to be more sedentary, more overweight/obese, at a higher risk for coronary vascular disease, and have lower cardiorespiratory and physical fitness than their typically developing peers. From another perspective, the motor difficulties have also been linked to an increased risk for mental health issues, such as higher anxiety and depression. The understanding of the health consequences associated with DCD offers practical applications for the understanding of the mechanisms and intervention protocols that can improve the consequences of this condition. In this review, I will explore such consequences and provide evidence for the implementation of interventions that focus on improving physical and mental health in this population.

Investigation of treadmill and overground running: implications for the measurement of oxygen cost in children with developmental coordination disorder

Differences in the kinematics and kinetics of overground running have been reported between boys with and without developmental coordination disorder (DCD). This study compared the kinematics of overground and treadmill running in children with and without DCD to determine whether any differences in technique are maintained, as this may influence the outcome of laboratory treadmill studies of running economy in this population. Nine boys with DCD (10.3 ± 1.1 year) and 10 typically developing (TD) controls (9.7 ± 1 year) ran on a treadmill and overground at a matched velocity (8.8 ± 0.9 km/h). Kinematic data of the trunk and lower limb were obtained for both conditions using a 12-camera Vicon MX system. Both groups displayed an increase in stance time (p < 0.001), shorter stride length (p < 0.001), higher cadence (p < 0.001) and reduced ankle plantar flexion immediately after toe-off (p < 0.05) when running on the treadmill compared with overground. The DCD group had longer stance time (p < 0.009) and decreased knee flexion at mid-swing (p = 0.04) while running overground compared to their peers, but these differences were maintained when running on the treadmill. Treadmill running improved ankle joint symmetry in the DCD group compared with running overground (p = 0.019). Overall, these findings suggest that there are limited differences in joint kinematics and lower limb symmetry between overground and treadmill running in this population. Accordingly, laboratory studies of treadmill running in children with DCD are likely representative of the energy demands of running.

Physical fitness in children with developmental coordination disorder: measurement matters

Children with Developmental Coordination Disorder (DCD) experience considerable difficulties coordinating and controlling their body movements during functional motor tasks. Thus, it is not surprising that children with DCD do not perform well on tests of physical fitness. The aim of this study was to determine whether deficits in motor coordination influence the ability of children with DCD to perform adequately on physical fitness tests. A case-control study design was used to compare the performance of children with DCD (n=70, 36 boys, mean age=8 y 1 mo) and Typically Developing (TD) children (n=70, 35 boys, mean age=7 y 9 mo) on measures of isometric strength (hand-held dynamometry), functional strength, i.e. explosive power and muscular endurance (Functional Strength Measurement), aerobic capacity (20 m Shuttle Run Test) and anaerobic muscle capacity, i.e. muscle power (Muscle Power Sprint Test). Results show that children with DCD were able to generate similar isometric forces compared to TD children in isometric break tests, but were significantly weaker in three-point grip strength. Performance on functional strength items requiring more isolated explosive movement of the upper extremities, showed no significant difference between groups while items requiring muscle endurance (repetitions in 30s) and items requiring whole body explosive movement were all significantly different. Aerobic capacity was lower for children with DCD whereas anaerobic performance during the sprint test was not. Our findings suggest that poor physical fitness performance in children with DCD may be partly due to poor timing and coordination of repetitive movements.