Can balance trampoline training promote motor coordination and balance performance in children with developmental coordination disorder?

A systematic review and meta-analysis of outcome measures to assess coordination among children

BACKGROUND

Coordination can be tested through different outcomes, which provide a platform for clinical and research purposes. The psychometric properties of the outcomes aid clinicians/researchers in appropriately selecting the measure.

OBJECTIVE

To investigate the coordination outcomes measures for children aged 4-17.

METHODOLOGY

A literature search was made using PubMed/Medline, Scopus, Cochrane, Ovid-SP, and PEDro from inception to August 2021. Experimental studies involving children, written in English with coordination as one of the variables, were included. An adapted version of the COSMIN checklist was used for psychometric properties. Quality assessment of included articles was evaluated through the risk of bias, Level of Evidence, Grades, and PEDro.

RESULT

1082 articles were screened, of which 12 trials were included. Gross motor coordination has been observed as a part of the coordination tests. Meta-analysis of Korperkoordinationtests fur Kinder (KTK) showed high heterogeneity (I2 = 93%) among intervention effects. 93% of outcome measures are reliable, but only 46% have criterion validity, while responsiveness is found in 73%.

CONCLUSION

The KTK showed excellent methodological quality, while other outcome measures had limitations in their psychometric properties. Therefore, there is a need to refine and develop coordination scales with excellent psychometric properties that could be useful for children aged 4-17 years.

The Effect of Task-Oriented Basketball Training on Motor Skill-Related Fitness in Children with Developmental Coordination Disorder

Developmental Coordination Disorder (DCD) is one of the most prevalent neurodevelopmental disorders in childhood. DCD is classified as a motor learning deficit because it interferes with the ability to learn and automate movement skills. There is a lack of information on how these children acquire complex motor skills relevant to their daily recreational or sports activities. Evidence to guide physical trainers, educators, and health professionals to select an effective type of training to improve physical fitness for children with poor motor coordination is scarce. The purpose of this study was to analyze the effect of an 8-week task-oriented basketball training program on motor coordination and motor skill-related fitness for DCD children in the school context. Motor performance and motor skill-related fitness were evaluated before and after the intervention using the Movement Assessment Battery for Children-2 (MABC-2) and Performance and Fitness Test Battery (PERF-FIT). A total of 52 children with DCD aged 8 to 9 were invited to join the intervention. Parents of 18 children accepted for their child to participate in the training program. In the remaining children, 20 identified as the most similar based on the diagnostic criteria for DCD (DSM-5) and anthropometric features (age, BMI) and were asked to participate as the usual care group. The difference in improvement on the MABC-2 and the PERF-FIT between the two groups on the two test occasions was compared using Mann-Whitney U tests. Within-group pre-post comparison on these test items was performed using the Wilcoxon signed rank test. Significant differences in all performance scores were found in favor of the training group. Post-hoc analysis revealed that the DCD training group improved significantly on MABC-2 total and subscores (p < 0.001) and on all PERF-FIT items (p < 0.001). No significant changes were found on any of the test items in the DCD usual care group. Group-based training in a more natural environment (playing games with peers in school) might help children with DCD as an adjunct to or before individual therapy. Based on our findings, we believe it is possible to work in large groups (n = 18), led by trained physical education teachers and special educators, to lessen the impact of motor coordination and physical fitness problems in children with neurodevelopmental disorders so that they can participate more easily in active games. Results of the usual care group showed that extra instruction and practice are needed for children with DCD.

A Longitudinal, Observational, and Descriptive Study About Benefits of Craniosacral Therapy in Child Neurodevelopment

INTRODUCTION

Coordination and balance are progressive motor skills that guide physical therapists in recognizing abnormal patterns during childish neurodevelopment. We aim to compare the efficacy of craniosacral therapy (CST) together with balance and coordination therapy (BCT) vs traditional BCT during neurodevelopment.

METHODS

Longitudinal, observational, and descriptive study with 111 apparently healthy children divided into 4 groups: craniosacral-balance and coordination therapy placebo (CS-BCTp), craniosacral-balance and coordination therapy (CS-BCT), balance and coordination therapy placebo (BCTp), and balance and coordination therapy (BCT).

RESULTS

Significant changes have been observed with the CS-BCT from the fourth session. Balance and coordination therapy is less effective. There are differences in the Battelle Scale at the beginning and after the 7 therapy sessions in the CS-BCT group.

CONCLUSIONS

The study shows that CST together with balance and coordination exercises can be a more effective and faster treatment to improve these motor skills, correcting and improving alterations during child neurodevelopment.

The effect of planned active play on the fundamental movement skills of preschool children

BACKGROUND

At present, Chinese children aged 3-6 years old are facing challenges such as insufficient physical activity, declining physical health, and obesity, and China has yet to issue curriculum standards or physical activity guidelines for this age group. At the same time, the present kindergarten physical activity curriculum is insufficient. To address this issue, this study focused on designing and executing a planned active play intervention program for the kindergarten setting to analyze its efficacy in enhancing children's fundamental movement skills (FMS). This study aims to provide a reference for the theoretical and practical exploration of children's acquisition of fundamental movement skills in the Chinese context.

METHODS

Fifty-two preschoolers participated in this study and were either part of an intervention group (n = 30) or a control group (n = 24). Children's FMS were assessed before and after the intervention using the Test of Gross Motor Development-3 (TGMD-3) and the balance ability of the The Movement Assessment Battery for Children-2 (MABC-2). Physical activity (PA) during the planned active play intervention and the routine physical activity curriculum were assessed using the SOFIT throughout the intervention.

RESULTS

All the children significantly improved their locomotor skills, ball skills, and TGMD from baseline to the late assessment (p < 0.05). Children in the planned active play intervention group demonstrated greater rates of change (p < 0.001) and scored higher on ball skills and TGMD in the late assessment than those in the control group (p < 0.001). The children in the intervention group, but not those in the control group, significantly improved their balance over time (p < 0.05), and the former had greater rates of change (p < 0.001). Similarly, planned active play was found to provide children with more physical activity than the routine physical activity curriculum.

CONCLUSIONS

The eight-week planned active play intervention was effective in improving FMS in preschool children, with higher rates of FMS change in children who completed the intervention than children in the control group.

Effects of a highly intensive balance therapy camp in children with developmental coordination disorder - An intervention protocol

BACKGROUND

Children with Developmental Coordination Disorder (DCD) often (<87 %) experience postural control problems, impacting all levels of the International Classification of Functioning, Disability and Health (ICF) including their daily participation, self-esteem and mental health. Due to the multisystemic nature of postural control, comprehensive therapy should target all systems which is currently not the case. Highly intensive therapy is effective and commonly used in pediatric populations, but has not been explored yet to train postural control in children with DCD.

AIMS

To investigate the effects of a highly intensive functional balance therapy camp at all ICF levels in children with DCD.

METHODS AND PROCEDURES

The effects on postural control, muscle activity, brain alterations, self-perceived competence, self-identified goals, gross motor activities and participation are evaluated. Participants are assessed pre- and post-intervention, including a 3 months follow-up. Forty-eight children with DCD, aged 6-12 years old, receive 40 h of comprehensive balance training. This intervention is fun, individually tailored, targets all postural control systems, implements different motor learning strategies and includes both individual and group activities.

CONCLUSION

Novel insights into the effects of a highly intensive comprehensive balance therapy camp designed for children with DCD will be gained at all levels of the ICF.

A Clinical Practice Guide to Enhance Physical Activity Participation for Children with Developmental Coordination Disorder in Canada

Purpose

This clinical practice guide (CPG) aims to provide evidence-based recommendations for promoting and enhancing the participation and integration of children with developmental coordination disorder (DCD) into physical activities that take place in the home, school, community, or rehabilitation clinic contexts.

Methods

A panel of key stakeholders relevant to these contexts (parents, instructors, rehabilitation professionals) developed evidence-based recommendations using a consensus methodology after reviewing results from a recent systematic review of relevant literature. The quality of the evidence on which the recommendations were based was evaluated (2011 Oxford Centre for Evidence-Based Medicine Levels of Evidence scale) as was the strength of the final CPG recommendations (American Society of Plastic Surgeons Grade Recommendation Scale).

Results

Recommendations (n = 50; 36% supported by robust, empirically derived evidence) for the different stakeholder groups fell into three categories: 1) Choose an appropriate activity for your child, 2) Harmonize the activity with the child's interests and abilities, and 3) Help the child learn new movements prior to the activity.

Conclusions

This comprehensive CPG provides concrete recommendations, based on the currently available evidence, that can be used by stakeholders to address the physical activity participation and integration needs of children with DCD in a variety of contexts.

The Effect of a Short-Term Occupational Therapy Intervention on the Participation and Personal Factors of Preschoolers with Developmental Disabilities

BACKGROUND

Preschoolers with developmental disabilities are referred to occupational therapy due to their decreased participation in daily life occupations. The purpose of this study was to evaluate the improvement in preschoolers' participation and sensory-motor abilities following an occupational therapy intervention.

MATERIALS AND METHODS

A prospective cohort study of 38 preschoolers and their parents was conducted using an interrupted time-series design, including assessments at three time points: base line (upon referral to an occupational therapy assessment), pre-intervention, and post-intervention after 9-12 sessions of occupational therapy interventions. Children were evaluated with the Developmental Test of Visual-Motor Integration, as well as the balance and fine motor precision sub tests of the Bruininks-Oseretsky Test of Motor Proficiency. Parents completed the Children's Participation Questionnaire and the Child Performance Skills Questionnaire. Each intervention session was documented by the therapists using the Documentation of Occupational Therapy Session Intervention form.

RESULTS

Significant improvement in children's sensory-motor abilities were found in balance, visual integration, and fine motor precision post-intervention. There were also improvements in the measures of diversity, children's independence, and parental satisfaction.

CONCLUSIONS

A short-term occupational therapy intervention applied to preschoolers with developmental disabilities is effective in improving their sensory-motor abilities, as well as in promoting their participation in daily activities.

The Effects of Physical Activity in Children and Adolescents with Developmental Coordination Disorder

The purpose of this literature review was to detect and study the effectiveness of therapeutic intervention programs, such as physical activities and sports, on children and adolescents with Developmental Motor Coordination Disorder (DCD) to improve their motor skills. The sample for this study consisted of 48 (100%) papers, specifically, 40 (83.5%) articles, 3 (6.2%) doctoral theses, 2 (4.1%) master's theses and 3 (6.2%) papers from conference proceedings from the year 2014 to 2022. To search the sample, the following terms were used: DCD or dyspraxia, physical activity programs, intervention, physical intervention, physical education, etc. The results for the existence of statistically significant results and internal validity of intervention programs using physical activities and sports in children and adolescents with DCD showed that a large number of intervention programs improved the children's motor skills as well as their daily functionality. In contrast, other interventions failed to improve dynamic and static balance. The negative result could be due either to the short duration of the interventions or to the improper suboptimal design-organization of the methodology of these programs-such as the heterogeneous intervention samples and the use of inappropriate and reliable assessment tools.

Motor, Physical, and Psychosocial Parameters of Children with and without Developmental Coordination Disorder: A Comparative and Associative Study

(1) Background: Developmental coordination disorder (DCD) is a chronic impairment that affects several domains that mark the developmental trajectory from childhood to adulthood. Aim: This study examined the differences in physical and psychosocial factors for children with DCD and typical development (TD) and the associations between these factors with gross motor coordination. (2) Methods: Children with DCD (n = 166; age: M = 8.74, SD = 2.0) and TD (n = 243; Age: M = 8.94; SD = 2.0) attending private and public schools were screened using the MABC-2. Children were then assessed using the Körperkoordination test für Kinder (gross coordination), the Perceived Efficacy and Goal Setting System (self-efficacy), horizontal jump (lower limb strength), and dynamometer (handgrip strength). A semi-structured interview was carried out to examine the oriented physical activity practice in the daily routine, the time spent in the activities, and the use of public spaces to practice non-oriented physical activities. (3) Results: Children with TD showed scores significantly higher than children with DCD in almost all factors with small to very large effect sizes; the exceptions were self-care and daily physical activity. The structural equation model showed that for children with DCD, the BMI explained negatively and significantly the motor coordination (b = -0.19, p = 0.019), whereas physical activity (b = 0.25, p < 0.001), lower limb strength (b = 0.38, p < 0.001), and perceived self-efficacy (b = 0.19, p = 0.004) explained it positively. For children with TD, the BMI explained negatively and significantly the motor coordination (b = -0.23, p = 0.002), whereas physical activity (b = 0.25, p < 0.001) and lower limb strength (b = 0.32, p < 0.001) explained it positively. (4) Conclusions: The authors extended previous research by providing evidence that factors affecting motor coordination vary across childhood for children with DCD and TD. Self-efficacy was relevant only in explaining motor coordination for children with DCD.

Table Tennis, as a Method of Sensorimotor Training, Induces Haptic and Motor Gains in Children With a Probable Developmental Coordination Disorder

This study examined whether table tennis as a method of sensorimotor training improves haptic and motor function and to what extent haptic function gain correlates with changes in motor ability in children with probable developmental coordination disorder (pDCD). Children with pDCD were randomly assigned to the table tennis and nontraining control groups. The children in the table tennis group received 36 sessions of table tennis training, including ball balancing, hitting the ball against the wall, strokes, and serving. Haptic sensitivity, acuity, and motor function domains were measured. The results showed a 41.5% improvement in haptic sensitivity in children exposed to table tennis training compared with 2.8% in those without training. This improved haptic sensitivity significantly correlated with motor function gain, suggesting that somatosensory gains occur simultaneously with changes in motor function in children with pDCD. This novel upper limb motor training approach may be an interesting method of sensorimotor training in neurological rehabilitation in children with pDCD.

A Public Health Review into Two Decades of Domestic Trampoline Injuries in Children within Queensland, Australia

Trampolining as an activity brings enjoyment and many health benefits, but at the same time it carries an injury risk. Most domestic trampoline users are children who are developing in skill, cognition, risk perception, physical strength and resilience to injury. Several common patterns of child trampoline injuries have been identified and countermeasures outlined in standards have been taken to reduce higher risk injury mechanisms, such as entrapment and falls from the trampoline through design, product and point of sale labelling. In Australia, the first national trampoline standard was published in 2003 which introduced improvements in trampoline design and requirements for labelling and padding. This work investigated the potential impact of these and subsequent changes based on almost two decades of emergency department trampoline injury data collected in Queensland, Australia. These data describe the changing representative proportion and pattern of trampoline injuries in Queensland over time by age, mechanism, gender, severity and nature of injury of injured persons up to the age of 14 years. The interrelationships between different injury characteristics were also analysed to propose the main factors influencing injury occurrence and severity. These findings seem to indicate that safety evolution in the form of enclosure nets, frame impact attenuation and entrapment protection have likely improved domestic trampoline safety. Other factors, such as adult supervision, minimum age and avoidance of multiple users, could further reduce injury but are harder to influence in the domestic setting.

Physical Education on the Beach: An Alternative Way to Improve Primary School Children's Skill- and Health-Related Outcomes during the COVID-19 Pandemic

The COVID-19 restrictions could preclude children from participating in physical education (PE) interventions. This study aimed to evaluate the efficacy of a PE intervention conducted on the beach on children’s skill- and health-related outcomes, as a possible alternative PE intervention that could be also applied during the COVID-19 pandemic. The study involved 106 primary school children, randomly assigned to the traditional indoor (TI) intervention or to the experimental outdoor (EO) intervention. The intervention period lasted 4 months and consisted of two 1-h sessions per week. Intervention was conducted just before the beginning of the COVID-19 pandemic. Children’s anthropometric parameters (height, weight, BMI, body fat percentage, and abdominal circumference), fitness parameter (VO_2peak), health parameters (resting heart rate, and systolic and diastolic blood pressure), gross motor coordination, and physical activity level were assessed before and after intervention. Both groups significantly improved fitness and motor coordination but worsened some anthropometric parameters (weight, abdominal circumference) after the intervention period. The EO group showed a higher increase of gross motor coordination than the TI group. Results of this study demonstrated that children benefited from a well-structured PE intervention conducted in the natural environment of the beach improving physical fitness and gross motor coordination. Therefore, planning outdoor PE interventions could be an alternative and safe way to encourage and implement physical activity at school during the particular period of COVID-19 pandemic.

Sex differences in postural control under unstable conditions in schoolchildren with accelerometric assessment

BACKGROUND

Although the effects of balance training on unstable surfaces have been widely studied, the impact of exposure to an unstable surface in static balance throughout childhood has not been described to date.

RESEARCH QUESTION

How does postural stability vary between sexes in children 6-12 years of age during single leg static support on unstable surface? What are the normative values of centre of mass acceleration in the mentioned age range during such test? Is the postural stability on an unstable surface in the postural control of children aged 6-12 years during static single-leg stance. Secondarily, the normative acceleration values of the gravity centre, recorded during such tests and throughout the mentioned age range, were also provided.

METHODS

Descriptive, transversal study conducted with a total of 316 school children (girls = 158). The analysed variables were the mean and maximum values obtained in each of the three body axes and their root mean square during static single-leg support test on an unstable surface (a mat).

FINDINGS

Accelerations decreased in magnitude with the increasing age of the participants. The highest accelerometric values were recorded in the medio-lateral axis in both sexes and throughout the entire age range studied. Between sexes, the greatest differences were obtained between 8 and 11 year-olds. The regression models revealed significant values about the influence of sex on the accelerometric variables (girls were more likely to obtain less accelerations in postural adjustments with increasing age).

INTERPRETATION

Boys depend more on somatoaesthetic information, whereas girls would use more visual and vestibular information. In the age range of 8-11 years, the postural control system is significantly different between sexes regarding the hierarchy of the efferent information of the available postural control subsystems. Moreover, the reactions of straightening and postural control on single-leg stance are, fundamentally, flexion-extension movements.

Coordination dynamics of hopping on a mini-trampoline in adults and children

BACKGROUND

While mini-trampolines have been used among a variety of groups including children as an intervention tool, the motor behavior children adopt while hopping on this soft, elastic surface is unknown. Identifying coordinative structures and their stability for hopping on a mini-trampoline is imperative for recommending future interventions and determining appropriateness to populations with motor dysfunctions.

RESEARCH QUESTION

Do children demonstrate similar biomechanical and coordination patterns as adults while hopping on a mini-trampoline?

METHODS

Fifteen adults aged 18-35 years and 14 children aged 7-12 years completed bouts of continuous two-legged hopping in-place on a stiff surface for 10 s at a time and on a mini-trampoline for 30 s at a time. 3-D motion capture tracked whole-body movement. We evaluated whole-body vertical stiffness as a ratio of peak vertical force and peak vertical displacement, as well as spatiotemporal parameters of hopping. Coordinative structures were evaluated as continuous relative phase angles of the foot, shank, thigh, and pelvis segments.

RESULTS AND SIGNIFICANCE

Adults did not modify whole-body vertical stiffness on a mini-trampoline, while children increased whole-body vertical stiffness to compensate for the reduced surface stiffness. Both groups conserved the coordinative structure for hopping on a mini-trampoline by modulating hopping cycle timing. Moreover, children hopped with an adult-like coordinative structure, but required greater shank-thigh and thigh-pelvis out-of-phase motion. However, the consistency of their coordination was diminished compared to adults. Children aged 7-12 years old have formed a stable coordinative structure for spring-mass center-of-mass dynamics that is preserved on this soft, elastic surface. However, children might be developing control strategies for preferred whole-body vertical stiffness, particularly when required to dampen peak vertical forces. These results highlight the importance of evaluating the emerging motor behavior to manipulated environmental constraints, particularly when considering the utility and appropriateness of mini-trampoline interventions for children with motor dysfunctions.

Spring-like leg dynamics and neuromuscular strategies for hopping on a mini-trampoline in adults and children

Improved balance control is an often-cited potential benefit for trampoline interventions. However, it is unknown whether the soft, elastic surface of a trampoline elicits different motion and neuromuscular strategies between adults and children. Therefore, the purpose of the study was to evaluate the center-of-mass (COM) dynamics and neuromuscular strategies for hopping on a mini-trampoline in adults and children. Fourteen children aged 7-12 years and 15 adults aged 18-35 years hopped on a stiff surface and a mini-trampoline. We evaluated the vertical displacement of COM and leg length, as well as the horizontal displacements between hops. We also assessed muscle activation from tibialis anterior, lateral gastrocnemius, biceps femoris, and vastus lateralis during time periods surround landing and estimated fatigue across the hopping cycles. Our results indicated both groups used spring-like leg dynamics to regulate the COM movement while hopping on a mini-trampoline. Children increased horizontal displacements between hops on the mini-trampoline, requiring greater muscle activation during time-periods associated with proprioceptive input. Moreover, children might not have developed the adult-like ability to appropriately adjust muscle pre-activation for feedforward control. Hopping on a mini-trampoline might increase proprioceptive information and postural demand compared to a stiff surface while reducing neuromuscular fatigue.

Trampoline Versus Resistance Training in Young Adults: Effects on Knee Muscles Strength and Balance

Purpose: Trampoline parks are becoming popular in many countries, providing recreational facilities for children and adults. This study investigated the effects of trampoline training on knee muscles strength and balance in young adults. Methods: Twenty-six participants (14 males, 12 females) were randomized into trampoline training (TT) and resistance training (RT) groups to undergo a 6-week supervised intervention program (2 × 30 min per week). TT group performed basic trampoline exercises while the RT group performed resistance training targeting lower extremities muscles. Peak knee extension and flexion torque, postural sway characteristics, and Y balance test (YBT) performance were evaluated before and after the intervention. A mixed model analysis of variance (group × time) was applied. Results: After training there were significant improvements in knee extension torque (mean difference_post-pre [95% CI], TT: 0.27 [0.00, 0.54] N∙m/kg, RT: 0.31 [0.09,0.54] N∙m/kg, p = .001), knee flexion torque (TT: 0.25 [0.17,0.33] N∙m/kg, RT: 0.21 [0.08,0.34] N∙m/kg, p < .001), and dynamic balance (YBT composite scores, mean difference_post-pre [95% CI], TT: 4.9 [-0.3, 10.2]%, RT: 5.2 [2.4,8.0]%, p = .001). No difference between groups was found. Conclusion: Trampoline training can be as effective as resistance training for improving knee muscles strength and dynamic balance in young men and women.

Effect of 12-Week Rebound Therapy Exercise on Static Stability of Patients With Spinal Cord Injury

Background: To resolve the impairments associated with spinal cord injury (SCI), such as decreased balance, patients have been recommended to undergo various therapeutic strategies, including the use of different physical exercise methods. The aim of this study was to evaluate the efficiency of using rebound therapy (exercise on a trampoline) on SCI individuals' static stability. Methods: Sixteen people with SCI (American Spinal Cord Association classification: A = 6, B = 6, C = 2, and D = 2) were randomly assigned to an experimental (rebound exercise) group or a control group. The rebound therapy exercise program, lasting 12 weeks, was performed by means of a modified trampoline. During the said period, the experimental group received rebound therapy exercise for 10 to 30 minutes 3 sessions a week. Standing stability parameters (ie, excursion, velocity, and path length of the center of pressure in mediolateral and anteroposterior plane) were assessed before and after the exercise intervention by Kistler force plate (50 × 60 cm). Data were analyzed by repeated measures analysis of variance. Results: Significant interactions were observed for all 6 dependent variables except excursion of the center of pressure in mediolateral and the path length of center of pressure in anteroposterior plane (P < .01). This means that the control group had no progress, whereas the experimental group made a significant improvement in terms of static stability. Conclusion: The results of this study confirmed that rebound therapy could reinforce the static stability of individuals with SCI during motionless standing. It suggests that rebound exercise is a useful sports rehabilitation method for patients with SCI and other wheelchair-bound individuals.

KTK MOTOR TEST: REVIEW OF THE MAIN INFLUENCING VARIABLES

OBJECTIVE

To analyze the scientific literature regarding the effects of external variables on KTK motor test scores and to verify which motor tests are associated with KTK.

DATA SOURCES

Four databases (PubMed, Science Direct, Scientific Electronic Library Online - SciELO - and Latin American and Caribbean Health Sciences Literature - LILACS) were used to search for studies in which the descriptors Körperkoordinationstest für Kinder and KTK were presented in the title, abstract and keywords. Inclusion criteria were: articles published in English or Portuguese from January 2006 to December 2016; free access to the article in full and texts available online; presenting the descriptor terms mentioned above in the title, abstract or keywords; containing sample with children and adolescents aged 4 to 16 years old; being indexed in a journal with a rating of B2 or higher (WebQualis; Qualis 2016) for the area of physical education. The following were excluded: studies in books, chapters of books, theses and dissertations; duplicate scientific articles; conference summaries; articles published in proceedings and abstracts of congresses.

DATA SYNTHESIS

After the three stages of selection (identification, screening and eligibility) and the criteria proposed at the PICOS scale, 29 studies were included in this review.

CONCLUSIONS

Body composition and the regular practice of physical activities were the variables that presented the greatest influence on KTK. It is important that health professionals working with the pediatric public encourage regular physical activity to improve body composition and, thus, to obtain better KTK scores. Additionally, the Movement Assessment Battery for Children (M-ABC) test had the highest positive correlation with the KTK test.

Effects of Adaptive Bungee Trampolining for Children With Cerebral Palsy: A Single-Subject Study

PURPOSE

To assess effects of adaptive bungee trampoline training for children with cerebral palsy.

METHODS

This was a single-subject intervention study, A-B-A, with 4 children aged 6 to 11 years. Measurements included muscle strength, balance, functional muscle strength, functional mobility, selected Gross Motor Function Measure items, heart rate, enjoyment, and for adverse effects-range of motion and spasticity. Goals were measured using the Canadian Occupational Performance Measure.

RESULTS

Lower limb muscle strength improved in 3 children, and balance and functional strength in 2 children. The child who was not walking increased sitting and supported standing times. All participants had clinically significant increases on the Canadian Occupational Performance Measure. Adherence and enjoyment were high, with no adverse effects.

CONCLUSION

Adaptive bungee trampoline training can improve strength, balance, and functional mobility in children with cerebral palsy.

Evaluating the evidence for motor-based interventions in developmental coordination disorder: A systematic review and meta-analysis

BACKGROUND

As part of the process of creating an update of the clinical practice guidelines for developmental coordination disorder (DCD) (Blank, Smits-Engelsman, Polatajko, & Wilson, 2012), a systematic review of intervention studies, published since the last guidelines statement was conducted.

AIM

The aim of this study was to 1) systematically review the evidence published from January 2012 to February 2017 regarding the effectiveness of motor based interventions in individuals with DCD, 2) quantify treatment effects using a meta-analysis, 3) examine the available information on different aspects of delivery including use of group intervention, duration and frequency of therapy, and 4) identify gaps in the literature and make recommendations for future intervention research.

METHOD

An electronic search of 5 databases (PubMed, Embase, Pedro, Scopus and Cochrane) was conducted for studies that evaluated motor-based interventions to improve performance for individuals with DCD.

RESULTS

Thirty studies covering 25 datasets were included, 19 of which provided outcomes on standardized measures of motor performance. The overall effect size (Cohen's d) across intervention studies was large (1.06), but the range was wide: for 11 interventions, the observed effect was large (>0.80), in eight studies moderate (>0.50), and in five it was small or negligible (<0.50). Positive benefits were evident for activity-oriented approaches, body function-oriented combined with activities, active video games, and small group programs.

CONCLUSION

Results showed that activity-oriented and body function oriented interventions can have a positive effect on motor function and skills. However, given the varied methodological quality and the large confidence intervals of some studies, the results should be interpreted with caution.

A systematic review of high quality randomized controlled trials investigating motor skill programmes for children with developmental coordination disorder

OBJECTIVE

To identify effective motor training interventions for children with developmental coordination disorder from research graded as high quality (using objective criteria) for the purpose of informing evidence-based clinical practice.

DATA SOURCES

We followed the guidance for conducting systematic reviews issued by the Centre for Reviews and Dissemination. Six OvidSP electronic databases (AMED, All EBM reviews (including Cochrane), Embase, Ovid MEDLINE, PsychARTICLES Full Text, PsycINFO) were searched systematically. We aimed to retain only randomized control trials and systematic reviews of randomized control trials, defined as the highest level of evidence by the Oxford Centre for Evidence-Based Medicine. We searched reference lists of retained articles to identify further appropriate articles.

REVIEW METHODS

Two reviewers critically appraised and categorized articles by effect size (including confidence intervals), inclusion of power calculations and quality using the Physiotherapy Evidence Database (PEDro) scale. Only studies scoring seven or more on the PEDro scale (classed by the PEDro as high reliability) were retained.

RESULTS

No systematic reviews met our criteria for inclusion from 846 articles yielded by the systematic search. Nine randomized control trials investigating 15 interventions to improve motor skills met our inclusion criteria for 'high quality'. Nevertheless, not all included studies were adequately powered for determining an effect.

CONCLUSION

Large effect sizes associated with 95 % confidence intervals suggest that 'Neuromotor Task Training', 'Task-oriented Motor Training' and 'Motor Imagery + Task Practice Training' are the most effective reported interventions for improving motor skills in children with developmental coordination disorder.

Study of clinical characteristics in young subjects with Developmental coordination disorder

BACKGROUND

Developmental Coordination Disorder (DCD) is a chronic neurological disorder observed in children. DCD is characterized by slowness in activities and motor impairment that affects the children's daily living and academic achievements, and later their professional and social behavior. Our aim in this work was to report characteristics frequencies in a group of children with DCD and to propose a subtyping of DCD characteristics.

METHODS

Thirty three clinical DCD characteristics, the mostly reported in the literature, were assessed in 129 patients, boys and girls aged from 4years to 18years, and their subtyping was proposed. The statistical analyses were carried out with the Chi square, the t-test and the correlation for the statistical differences, and with the Ward clustering method for subtyping.

RESULTS

We found that there were 3.17 boys for one girl, all patients were characterized as slow, 47% were left-handers or ambidextrous, 36% and 26% had orofacial and verbal dyspraxia, respectively, 83% were found anxious, and 84% were described as being clumsy.

CONCLUSIONS

It appears from these results that a child with DCD expresses more than a single difficulty. Three subtypes emerged from the statistical analysis in this study: (1) clumsiness and other characteristics except language difficulties; (2) self-esteem and peer relation without clumsiness and language difficulties; (3) language difficulties and orofacial dyspraxia.