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Busquets A, Ferrer-Uris B, Durduran T, Bešlija F, Añón-Hidalgo M, Angulo-Barroso R. Study protocol to examine the effects of acute exercise on motor learning and brain activity in children with developmental coordination disorder (ExLe-Brain-DCD). PLoS One 2024; 19:e0302242. [PMID: 38722962 PMCID: PMC11081356 DOI: 10.1371/journal.pone.0302242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 03/25/2024] [Indexed: 05/13/2024] Open
Abstract
INTRODUCTION Developmental coordination disorder (DCD) is one of the most prevalent pediatric chronic conditions. Without proper intervention, significant delays in motor skill performance and learning may persist until adulthood. Moderate-to-vigorous physical exercise has been proven to improve motor learning (adaptation and consolidation) in children with or without disorders. However, the effect of a short bout of physical exercise on motor adaptation and consolidation in children with DCD has not been examined. Furthermore, the role of perceptual-motor integration and attention as mediators of learning has not been examined via neuroimaging in this population. OBJECTIVES Therefore, the primary aims of this project will be to compare children with and without DCD to (a) examine the effect of acute exercise on motor learning (adaptation and consolidation) while performing a rotational visuo-motor adaptation task (rVMA), and (b) explore cortical activation in the dorsolateral- and ventrolateral-prefrontal cortex areas while learning the rVMA task under rest or post-exercise conditions. METHODS One hundred twenty children will be recruited (60 DCD, 60 controls) and within-cohort randomly assigned to either exercise (13-minute shuttle run task) or rest prior to performing the rVMA task. Adaptation and consolidation will be evaluated via two error variables and three retention tests (1h, 24h and 7 days post adaptation). Cortical activation will be registered via functional near-infrared spectroscopy (fNIRS) during the baseline, adaptation, and consolidation. DISCUSSION We expect to find exercise benefits on motor learning and attention so that children with DCD profiles will be closer to those of children with typical development. The results of this project will provide further evidence to: (a) better characterize children with DCD for the design of educational materials, and (b) establish acute exercise as a potential intervention to improve motor learning and attention.
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Affiliation(s)
- Albert Busquets
- Institut Nacional d’Educació Física de Catalunya, University of Barcelona, Barcelona, Spain
| | - Blai Ferrer-Uris
- Institut Nacional d’Educació Física de Catalunya, University of Barcelona, Barcelona, Spain
| | - Turgut Durduran
- Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Spain
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Spain
| | - Faruk Bešlija
- Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, Castelldefels, Spain
| | - Manuel Añón-Hidalgo
- Institut Nacional d’Educació Física de Catalunya, University of Barcelona, Barcelona, Spain
| | - Rosa Angulo-Barroso
- Institut Nacional d’Educació Física de Catalunya, University of Barcelona, Barcelona, Spain
- Kinesiology, California State University, Northridge, California, United States of America
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Welsby E, Hordacre B, Hobbs D, Bouckley J, Ward E, Hillier S. Evaluating the influence of feedback on motor skill learning and motor performance for children with developmental coordination disorder: a systematic review. Front Pediatr 2024; 12:1327445. [PMID: 38706921 PMCID: PMC11066222 DOI: 10.3389/fped.2024.1327445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/01/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Children with developmental coordination disorder (DCD) have difficulties with learning and performing physical tasks. It is well known that task-specific practice is effective in improving motor skills. Additional feedback during practice may function as a quality improvement mechanism and therefore enhance motor skill outcomes. Aims To investigate the effect of different forms of feedback on motor learning and motor performance in children with DCD. Methods A systematic review was conducted (registration CRD42020175118) to investigate the effectiveness of different types of feedback, compared to other forms of feedback, or no additional feedback, on motor learning and motor performance outcomes in children with DCD. The search was run across six electronic databases (last search January 2024). Two reviewers independently screened studies for inclusion, assessed the quality of included studies, and extracted relevant data. A narrative synthesis was performed and included studies that assessed motor learning and/or performance outcomes following an intervention that delivered a specific form of feedback in comparison to another form of feedback or no specific feedback. Results 14 articles from 13 trials were included in this review. Feedback was delivered by providing various forms of feedback, including: knowledge of results, focus of attention and augmented feedback delivered via technology. No significant differences were found between different forms of feedback for motor learning or performance outcomes for children with DCD. Interventions that used technology (with augmented feedback) to deliver the intervention were found to be as effective as traditional therapy. All groups who participated in therapy, regardless of the presence or type of feedback received, improved in overall scores on a motor performance outcome assessment. Conclusion Despite the clear rationale for using feedback-oriented interventions for children with DCD, there is surprisingly limited and low-quality research. There is no clear evidence that one form of feedback is more effective than another, although it appears that feedback delivered via technology may be as effective as feedback delivered in traditional therapy interventions for children with DCD. Further exploration is required from appropriately powered and well-designed trials. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=175118, identifier (CRD42020175118).
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Affiliation(s)
- Ellana Welsby
- Innovation, Implementation, and Clinical Translation (IIMACT) in Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Brenton Hordacre
- Innovation, Implementation, and Clinical Translation (IIMACT) in Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
| | - David Hobbs
- Innovation, Implementation, and Clinical Translation (IIMACT) in Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
- College of Science and Engineering, Medical Device Research Institute, Flinders University, Adelaide, SA, Australia
| | - Joanne Bouckley
- Innovation, Implementation, and Clinical Translation (IIMACT) in Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Emily Ward
- Innovation, Implementation, and Clinical Translation (IIMACT) in Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Susan Hillier
- Innovation, Implementation, and Clinical Translation (IIMACT) in Health, Allied Health & Human Performance, University of South Australia, Adelaide, SA, Australia
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Maenhout A, Heijenk W, Glashouwer P, Quatacker L, Praet L, Borms D. Effect of a Novel Training Program in Patients With Chronic Shoulder Pain Based on Implicit Motor Learning: Pilot and Feasibility Study. Int J Sports Phys Ther 2024; 19:1503-1515. [PMID: 38179585 PMCID: PMC10761605 DOI: 10.26603/001c.90284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/30/2023] [Indexed: 01/06/2024] Open
Abstract
Background Implicit motor learning has been shown to be effective for learning sports-related motor skills. It facilitates automaticity of movements and thereby improves performance in multitasking and high-pressure environments. Motor learning to develop motor skills and neuroplastic capacities is not sufficiently incorporated in musculoskeletal rehabilitation. Especially in patients with chronic pain conditions like shoulder pain this approach might benefit over traditional exercise programs. Purpose/hypothesis The aim of this study was to investigate the feasibility and clinical outcome of a new implicit motor learning exercise program in a group of patients with chronic shoulder pain. Study design Pilot and feasibility cohort study. Methods Twenty-six patients with chronic shoulder pain performed a 6-week home exercise program with weekly remote follow up by a physiotherapist. The program comprised five exercises designed to challenge overall body balance, simultaneously engaging the upper limbs in a range of reaching tasks. The tasks included reaching above the head, at and below waist level, in various directions. No instructions on correct performance were provided to foster external focus. Feasibility was assessed by (1) recruitment rate, (2) follow up rate, (3) subjective experience, (4) self-reported adverse events and (5) self-reported adherence of subjects. Clinical effects of the program were assessed with (1) the Shoulder Pain and Disability Index (SPADI), (2) the Auto-Constant score, (3) the numeric rating scale (NRS) at rest and at night, (4) the patient specific functional scale (PSFS), (5) the avoidance endurance questionnaire (AEQ), (6) patient acceptable symptom state (PASS) and (7) a global rating of change (GROC). Results The study protocol was feasible in terms of follow up rate (16w for 28 patients), exercise adherence (77.1%± 29.41), and adverse events (no serious, 5 light adverse events). Statistically significant improvements were observed for SPADI (p<0.001), NRS at rest (p=0.033), at night (p=0.29), PSFS (p<0.001) and PASS (p<0.001) after only six weeks training. Conclusion This study reveals promising results of another way of looking at exercise for patients with chronic shoulder pain. Both feasibility and clinical effects of the program on pain and function was acceptable. Future studies should incorporate a control group, provide longer follow up and include objective measurements. Level of evidence 2b.
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Eguia KF, Ng SSM, Wong TWL. Attentional Focus Strategies for Promoting Children's Motor Learning: A Scoping Review With a Learner-Task-Environment Framework. Percept Mot Skills 2023; 130:2700-2722. [PMID: 37899527 DOI: 10.1177/00315125231210150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
There is emerging evidence that attentional focus instructions and feedback may help children with motor learning. However, information relevant to learner characteristics, settings, and contexts in which attentional focus strategies can be used has not been synthesized. Therefore, in this review, we adopted a learner-task-environment framework to map the evidence to date related to attentional focus strategies in children's motor learning. We adapted the framework for scoping reviews put forth by Arksey and O'Malley (2005) and the enhanced protocol recommended by the Joanna Briggs Institute (Peters et al., 2021). Two researchers (a) identified the research question, (b) identified relevant studies, (c) selected studies, (d) charted the data, and (e) collated, summarized, and reported these results. We included 30 papers, all of which used an experimental or quasi-experimental design. Most studies have focused on typically developing children and those in middle childhood as learners. The movement tasks in these studies included isolated fundamental movement skills and sport-related tasks. All but one study were situated in non-clinical settings (i.e., school, laboratory). We found limited use of attentional focus strategies for learning movement tasks in early childhood, especially among children with neurodevelopmental disorders. Movement tasks were mostly isolated skills, and there was extremely limited application to clinical settings.
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Affiliation(s)
- Kathlynne F Eguia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
- THINKids - Therapeutic Intervention for Kids, Quezon City, Philippines
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Thomson W L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
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van der Veer IPA, Bastiaenen CHG, Goetschalckx M, van der Wielen-Heezius NNF, Rameckers EAA, Klingels K. Therapists' Use of Instructions and Feedback in Motor Learning Interventions in Children with Developmental Coordination Disorder: A Video Observation Study. Phys Occup Ther Pediatr 2023; 43:678-696. [PMID: 37012672 DOI: 10.1080/01942638.2023.2194408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 03/02/2023] [Accepted: 03/20/2023] [Indexed: 04/05/2023]
Abstract
AIM This qualitative study explored therapists' use of instructions and feedback when teaching motor tasks to children with developmental coordination disorder (DCD) as a first step in developing practical recommendations. METHODS A conventional content analysis approach was used to analyze videotaped treatment sessions of physical therapists using a newly developed analysis plan. Inductive coding was used to code purposively selected video segments. The codes were sorted into categories to identify key themes. Analyses were performed independently by two researchers until data saturation was reached. RESULTS Ten video-taped sessions were analyzed and 61 segments were coded. Three key themes were identified: (1) therapists' intention with the instructions and feedback was to motivate or to provide information; (2) the preferred therapists' teaching style was either direct or indirect; and (3) parameters to shape specific instructions and feedback were the focus of attention, modality, information content, timing and frequency. CONCLUSION Therapists used numerous instructions and feedback with different information content, often shaped by multiple focuses and/or modalities to motivate children or to provide specific information about task performance. Although therapists adapted instructions and feedback to child and task, future research should explore how characteristics of child and task can guide therapists' clinical decision-making.
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Affiliation(s)
| | - Caroline H G Bastiaenen
- Department of Epidemiology, Functioning, Participation & Rehabilitation research line, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Mieke Goetschalckx
- Rehabilitation Research Centre - REVAL, Hasselt University, Hasselt, Belgium
| | | | - Eugene A A Rameckers
- Rehabilitation Research Centre - REVAL, Hasselt University, Hasselt, Belgium
- Department of Rehabilitation Medicine, Functioning, Participation & Rehabilitation research line, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
- Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, The Netherlands
| | - Katrijn Klingels
- Rehabilitation Research Centre - REVAL, Hasselt University, Hasselt, Belgium
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van der Veer IPA, Verbecque E, Rameckers EAA, Bastiaenen CHG, Klingels K. How can instructions and feedback with external focus be shaped to enhance motor learning in children? A systematic review. PLoS One 2022; 17:e0264873. [PMID: 36007080 PMCID: PMC9409566 DOI: 10.1371/journal.pone.0264873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/08/2022] [Indexed: 11/18/2022] Open
Abstract
Aim
This systematic review investigates the effectiveness of instructions and feedback with external focus applied with reduced frequency, self-controlled timing and/or in visual or auditory form, on the performance of functional gross motor tasks in children aged 2 to 18 with typical or atypical development.
Methods
Four databases (PubMed, Web of Science, Scopus, Embase) were systematically searched (last updated May 31st 2021). Inclusion criteria were: 1. children aged 2 to 18 years old; 2. Instructions/feedback with external focus applied with reduced frequency, self-controlled timing, and/or visual or auditory form as intervention, to learn functional gross motor tasks; 3. Instructions/feedback with external focus applied with continuous frequency, instructor-controlled timing, and/or verbal form as control; 4. performance measure as outcome; 5. (randomized) controlled studies. Article selection and risk of bias assessment (with the Cochrane risk of bias tools) was conducted by two reviewers independently. Due to heterogeneity in study characteristics and incompleteness of the reported data, a best-evidence synthesis was performed.
Results
Thirteen studies of low methodological quality were included, investigating effectiveness of reduced frequencies (n = 8), self-controlled timing (n = 5) and visual form (n = 1) on motor performance of inexperienced typically (n = 348) and atypically (n = 195) developing children, for acquisition, retention and/or transfer. For accuracy, conflicting or no evidence was found for most comparisons, at most time points. However, there was moderate evidence that self-controlled feedback was most effective for retention, and limited evidence that visual analogy was most effective for retention and transfer. To improve quality of movement, there was limited evidence that continuous frequency was most effective for retention and transfer.
Conclusion
More methodologically sound studies are needed to draw conclusions about the preferred frequency, timing or form. However, we cautiously advise considering self-controlled feedback, visual instructions, and continuous frequency.
Trial registration
Registration: Prospero CRD42021225723. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021225723.
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Affiliation(s)
- Ingrid P. A. van der Veer
- Faculty of Rehabilitation Sciences and Physiotherapy, Rehabilitation Research Centre—REVAL, Hasselt University, Hasselt, Belgium
- * E-mail:
| | - Evi Verbecque
- Faculty of Rehabilitation Sciences and Physiotherapy, Rehabilitation Research Centre—REVAL, Hasselt University, Hasselt, Belgium
| | - Eugene A. A. Rameckers
- Faculty of Rehabilitation Sciences and Physiotherapy, Rehabilitation Research Centre—REVAL, Hasselt University, Hasselt, Belgium
- Department of Functioning and Rehabilitation, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
- Centre of Expertise, Adelante Rehabilitation Centre, Valkenburg, The Netherlands
| | - Caroline H. G. Bastiaenen
- Department of Epidemiology, Functioning, Participation & Rehabilitation, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Katrijn Klingels
- Faculty of Rehabilitation Sciences and Physiotherapy, Rehabilitation Research Centre—REVAL, Hasselt University, Hasselt, Belgium
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Blais M, Jucla M, Maziero S, Albaret JM, Chaix Y, Tallet J. Specific Cues Can Improve Procedural Learning and Retention in Developmental Coordination Disorder and/or Developmental Dyslexia. Front Hum Neurosci 2021; 15:744562. [PMID: 34975432 PMCID: PMC8714931 DOI: 10.3389/fnhum.2021.744562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/23/2021] [Indexed: 11/25/2022] Open
Abstract
The present study investigates procedural learning of motor sequences in children with developmental coordination disorder (DCD) and/or developmental dyslexia (DD), typically-developing children (TD) and healthy adults with a special emphasis on (1) the role of the nature of stimuli and (2) the neuropsychological functions associated to final performance of the sequence. Seventy children and ten adults participated in this study and were separated in five experimental groups: TD, DCD, DD, and DCD + DD children and adults. Procedural learning was assessed with a serial reaction time task (SRTT) that required to tap on a specific key as accurately and quickly as possible when stimuli appeared on the screen. Three types of stimuli were proposed as cues: the classical version of the SRTT with 4 squares aligned horizontally on the screen, giving visuospatial cues (VS cues), and two modified versions, with 4 letters aligned horizontally on the screen (VS + L cues) and letters at the center of the screen (L cues). Reaction times (RT) during the repeated and random blocks allowed assessing three phases of learning: global learning, specific learning and retention of the sequence. Learning was considered as completed when RT evolved significantly in the three phases. Neuropsychological assessment involved, among other functions, memory and attentional functions. Our main result was that learning and retention were not influenced by the available cues in adults whereas learning improved with specific cues in children with or without neurodevelopmental disorders. More precisely, learning was not completed with L cues in children with neurodevelopmental disorders. For children with DD, learning was completed with the VS and VS + L cues whereas for children with DCD (with or without DD), learning was completed with combined VS + L cues. Comorbidity between DD and DCD had no more impact on procedural learning than DCD alone. These results suggest that learning depends on the nature of cues available during practice and that cues allowing learning and retention depend on the type of disorder. Moreover, selective attention was correlated with RT during retention, suggesting that this neuropsychological function is important for procedural learning whatever the available cues.
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Affiliation(s)
- M. Blais
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, Toulouse, France
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Alés, Montpellier, France
| | - M. Jucla
- Laboratory of Neuro Psycho Linguistics, University of Toulouse, Toulouse, France
| | - S. Maziero
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, Toulouse, France
- Laboratory of Neuro Psycho Linguistics, University of Toulouse, Toulouse, France
| | - J. -M. Albaret
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, Toulouse, France
| | - Y. Chaix
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, Toulouse, France
- Children’s Hospital, CHU Purpan, Toulouse, France
| | - J. Tallet
- Toulouse NeuroImaging Center, Toulouse University, Inserm, UPS, Toulouse, France
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Abstract
A growing body of research has addressed the application of movement-based biofeedback techniques for improving sports performers’ gross motor skills. Unlike in previous research, we aimed in this study to quantify the effects of this “external” biofeedback on selected performance and technique variables for the boxing jab among both novices and experts. The technical setup included two inertial measurement units linked wirelessly to a video game system with audio output. The units were configured to provide auditory external biofeedback, based on the peak acceleration of the bag (i.e., biofeedback with an external attentional focus). Sixteen participants (8 novices and 8 experts) performed boxing jabs against the bag in blocked phases of biofeedback. When compared to baseline, the acute effects of externally focused biofeedback on peak bag acceleration were possibly positive in both retention phases for novices (d = 0.29; d = 0.41) and likely positive for experts (d = 0.41; d = 0.30), respectively. The experts’ performance improvements were accompanied by substantive increases in trunk rotation, though this was not true for the novices. Thus, technique improvements can be promoted indirectly via externally focused biofeedback, but only when these actions are within the performers’ motor repertoire. Overall, biofeedback via inertial sensors appears to be a potent technique for modifying human movement patterns in both experts and novices. This low-cost technology could be used to support training across sports, rehabilitation and human-computer interactions.
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Affiliation(s)
- Mark A Chen
- University of Teesside, Department of Science, Middlesbrough, UK
| | - K Spanton
- University of Teesside, Department of Science, Middlesbrough, UK
| | - P van Schaik
- University of Teesside, Department of Science, Middlesbrough, UK
| | - I Spears
- University of Teesside, Department of Science, Middlesbrough, UK
| | - D Eaves
- University of Teesside, Department of Science, Middlesbrough, UK
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Psotta R, Abdollahipour R, Janura M. The Effects of Attentional Focus Instruction on the Performance of a Whole-Body Coordination Task in Children With Developmental Coordination Disorder. Res Dev Disabil 2020; 101:103654. [PMID: 32305722 DOI: 10.1016/j.ridd.2020.103654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 03/16/2020] [Accepted: 04/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND AIM Previous studies have supported the advantages of an external focus of attention (EFA) relative to an internal focus of attention (IFA) in healthly adults. However, effects of attentional focus instructions on skill performance and acquisition in children are equivocal. The aim of this study was to examine the effects of attentional focus instructions on performance of a whole body coordination task in children with and without developmental coordination disorder (DCD). METHODS Children with DCD (n = 18) and typically developing (TD) children (n = 21) (9-10 years) were asked to perform 3 countermovement vertical jumps in the IFA (Concentrate on the swing of your arms), EFA (Concentrate on getting as close to the ceiling as possible), and control conditions. RESULTS The results showed that regardless of children's motor development proficiency, the jump height and vertical take-off velocity (VTO) were higher in EFA relative to both IFA and Con conditions. In addition, VTO was significantly higher in the Con relative to IFA condition. CONCLUSION The results of the current study showed that EFA relative to IFA instructions could enhance the neuromuscular activation of dynamic contractions of the leg muscles in both children with and without DCD. The findings suggest that the beneficial effects of EFA relative to IFA instructions on children's motor performance is identical across children with different levels of motor proficiency.
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Affiliation(s)
- Rudolf Psotta
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11, Olomouc, Czech Republic.
| | - Reza Abdollahipour
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11, Olomouc, Czech Republic.
| | - Miroslav Janura
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, tř. Míru 117, 771 11, Olomouc, Czech Republic.
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Li LL, Li YC, Chu CH, Pan CY, Chen FC. External focus of attention concurrently elicits optimal performance of suprapostural pole-holding task and postural stability in children with developmental coordination disorder. Neurosci Lett 2019; 703:32-7. [PMID: 30872044 DOI: 10.1016/j.neulet.2019.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 01/09/2023]
Abstract
The aim of this study was to determine the effects of different attentional focus conditions (external focus (EF) vs. internal focus (IF) vs. no focus (NF)) on the performance of a pole-holding task and postural stability in children with developmental coordination disorder (DCD) and typically developing children (TDC), while addressing previous study limitations. A total of 186 participants were enrolled in the analysis comprising 91 children with DCD (28 in the EF, 32 in the IF, and 31 in the NF condition) and 95 TDC (31 in the EF, 33 in the IF, and 31 in the NF condition). Participants were required to hold a pole with their hands still and parallel to the floor while focusing on pole movement (EF), focusing on hands (IF), or without focus instructions (NF), while pole movements and postural sway were recorded. Results showed that pole movements were significantly smaller during the EF condition (p < 0.05) compared with IF and NF conditions for both the DCD and TDC groups. In addition, postural sway was significantly lower during the EF condition compared with IF and NF conditions (p < 0.05). This study verified that the EF condition can not only facilitate better performance in holding a pole horizontal and immobile, but also concurrently promote greater postural stability than both IF and NF conditions for children with DCD and TDC.
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van Cappellen – van Maldegem SJ, van Abswoude F, Krajenbrink H, Steenbergen B. Motor learning in children with developmental coordination disorder: The role of focus of attention and working memory. Hum Mov Sci 2018; 62:211-220. [DOI: 10.1016/j.humov.2018.11.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 10/31/2018] [Accepted: 11/01/2018] [Indexed: 11/16/2022]
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Marchant DC, Griffiths G, Partridge JA, Belsley L, Porter JM. The Influence of External Focus Instruction Characteristics on Children's Motor Performance. Res Q Exerc Sport 2018; 89:418-428. [PMID: 30257136 DOI: 10.1080/02701367.2018.1512075] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE Research has demonstrated that verbal instructions directing attention externally (i.e., toward the effect of the movement) significantly enhance motor skill performance, and this effect is enhanced when the distance of the external focus relative to the body is increased. However, few studies have investigated this distance-of-focus effect in children. The present study aimed to examine the effect of increasing the distance of an external focus on children's motor performance in 2 experiments. METHOD In Experiment 1, children performed standing long jumps under 3 instructional conditions (control, internal attentional focus, and external attentional focus). In Experiment 2, children performed standing long jumps under 4 instructional conditions (control, internal, proximal external attentional focus, and distal external attentional focus). RESULTS In Experiment 1, results revealed a statistically significant jump distance advantage for the external focus condition. In Experiment 2, a statistically significant jump distance advantage for the distal external focus condition was found. However, instructional and task characteristics beyond distance of focus may have been influential. CONCLUSIONS External focus instructions benefit children's jump performance, but specifically when they are supported by a concrete movement goal reflecting relevant performance criteria. These findings highlight the importance of examining the content of instructions and relevant task characteristics provided to children beyond attentional focus to consider their motivational characteristics.
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Fuelscher I, Caeyenberghs K, Enticott P, Williams J, Lum J, Hyde C. Differential activation of brain areas in children with developmental coordination disorder during tasks of manual dexterity: An ALE meta-analysis. Neurosci Biobehav Rev 2018; 86:77-84. [DOI: 10.1016/j.neubiorev.2018.01.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 12/29/2017] [Accepted: 01/08/2018] [Indexed: 02/01/2023]
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Smits-Engelsman B, Vinçon S, Blank R, Quadrado VH, Polatajko H, Wilson PH. Evaluating the evidence for motor-based interventions in developmental coordination disorder: A systematic review and meta-analysis. Res Dev Disabil 2018; 74:72-102. [PMID: 29413431 DOI: 10.1016/j.ridd.2018.01.002] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 01/07/2018] [Accepted: 01/13/2018] [Indexed: 06/08/2023]
Abstract
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.
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Affiliation(s)
- Bouwien Smits-Engelsman
- Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa.
| | - Sabine Vinçon
- Clinic for Child Neurology and Social Pediatrics, Child Centre Maulbronn, Maulbronn, Germany
| | - Rainer Blank
- Clinic for Child Neurology and Social Pediatrics, Child Centre Maulbronn, Maulbronn, Germany; University of Heidelberg, Heidelberg, Germany
| | - Virgínia H Quadrado
- Department of Health and Rehabilitation Sciences, University of Cape Town, Cape Town, South Africa
| | - Helene Polatajko
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Peter H Wilson
- School of Psychology, Australian Catholic University, Melbourne, Australia
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Wilson PH, Smits-Engelsman B, Caeyenberghs K, Steenbergen B, Sugden D, Clark J, Mumford N, Blank R. Cognitive and neuroimaging findings in developmental coordination disorder: new insights from a systematic review of recent research. Dev Med Child Neurol 2017; 59:1117-1129. [PMID: 28872667 DOI: 10.1111/dmcn.13530] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2017] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Peter H Wilson
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia.,Centre for Disability and Development Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Bouwien Smits-Engelsman
- Department of Health and Rehabilitation Services, University of Cape Town, Cape Town, South Africa
| | - Karen Caeyenberghs
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia.,Centre for Disability and Development Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Bert Steenbergen
- Centre for Disability and Development Research, Australian Catholic University, Melbourne, Victoria, Australia.,Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands
| | - David Sugden
- School of Special Needs Education, University of Leeds, Leeds, UK
| | - Jane Clark
- School of Public Health, University of Maryland, College Park, MD, USA
| | - Nick Mumford
- Centre for Disability and Development Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Rainer Blank
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany.,Child Centre, Maulbronn, Germany
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Preston N, Magallón S, Hill LJ, Andrews E, Ahern SM, Mon-Williams M. A systematic review of high quality randomized controlled trials investigating motor skill programmes for children with developmental coordination disorder. Clin Rehabil 2016; 31:857-870. [PMID: 27481937 PMCID: PMC5482383 DOI: 10.1177/0269215516661014] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Nick Preston
- 1 School of Psychology, University of Leeds, Leeds, UK
| | - Sara Magallón
- 1 School of Psychology, University of Leeds, Leeds, UK.,2 Faculty of Education and Psychology, University of Navarre, Pamplona, Spain
| | - Liam Jb Hill
- 1 School of Psychology, University of Leeds, Leeds, UK
| | | | - Sara M Ahern
- 3 Bradford Institute for Health Research, Bradford, UK
| | - Mark Mon-Williams
- 1 School of Psychology, University of Leeds, Leeds, UK.,3 Bradford Institute for Health Research, Bradford, UK
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McLeod KR, Langevin LM, Dewey D, Goodyear BG. Atypical within- and between-hemisphere motor network functional connections in children with developmental coordination disorder and attention-deficit/hyperactivity disorder. Neuroimage Clin 2016; 12:157-64. [PMID: 27419066 PMCID: PMC4936600 DOI: 10.1016/j.nicl.2016.06.019] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/21/2016] [Accepted: 06/24/2016] [Indexed: 01/02/2023]
Abstract
Developmental coordination disorder (DCD) and attention-deficit hyperactivity disorder (ADHD) are highly comorbid neurodevelopmental disorders; however, the neural mechanisms of this comorbidity are poorly understood. Previous research has demonstrated that children with DCD and ADHD have altered brain region communication, particularly within the motor network. The structure and function of the motor network in a typically developing brain exhibits hemispheric dominance. It is plausible that functional deficits observed in children with DCD and ADHD are associated with neurodevelopmental alterations in within- and between-hemisphere motor network functional connection strength that disrupt this hemispheric dominance. We used resting-state functional magnetic resonance imaging to examine functional connections of the left and right primary and sensory motor (SM1) cortices in children with DCD, ADHD and DCD + ADHD, relative to typically developing children. Our findings revealed that children with DCD, ADHD and DCD + ADHD exhibit atypical within- and between-hemisphere functional connection strength between SM1 and regions of the basal ganglia, as well as the cerebellum. Our findings further support the assertion that development of atypical motor network connections represents common and distinct neural mechanisms underlying DCD and ADHD. In children with DCD and DCD + ADHD (but not ADHD), a significant correlation was observed between clinical assessment of motor function and the strength of functional connections between right SM1 and anterior cingulate cortex, supplementary motor area, and regions involved in visuospatial processing. This latter finding suggests that behavioral phenotypes associated with atypical motor network development differ between individuals with DCD and those with ADHD. Resting-state fMRI was used to examine motor networks of children with DCD and ADHD. DCD and ADHD exhibited atypical within- and between-hemisphere motor network connections. Neuromuscular development was associated with functional connection strength in DCD, but not ADHD. Resting-state fMRI can identify shared and distinct neural mechanisms that underlie ADHD and DCD.
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Affiliation(s)
- Kevin R. McLeod
- Medical Science, University of Calgary, Calgary, Alberta, Canada
| | - Lisa Marie Langevin
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Behavioural Research Unit, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Deborah Dewey
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
- Owerko Centre at the Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
- Behavioural Research Unit, Alberta Children's Hospital, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Bradley G. Goodyear
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Seaman Family MR Research Centre, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Corresponding author at: Seaman Family MR Research Centre, Foothills Medical Centre, 1403 29th Street NW, Calgary, AB T2N 2T9, Canada.Seaman Family MR Research CentreFoothills Medical Centre1403 29th Street NWCalgaryABT2N 2T9Canada
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