Children With Developmental Coordination Disorder Show Altered Visuomotor Control During Stair Negotiation Associated With Heightened State Anxiety

Does how I feel change how I move? The influence of anxiety, self-efficacy and resilience on movement in adults with Developmental Coordination Disorder

BACKGROUND

Anxiety and movement consistency both influence movement in individuals with Developmental Coordination Disorder (DCD).

AIMS

This study investigated the influence of anxiety, self-efficacy, resilience and movement variability on perceptions and actions of adults with and without DCD.

METHODS

17 adults with DCD and 17 adults with typical motor skills (TMS) (age and sex-matched) completed a questionnaire and three experimental tasks: two perceptual judgement tasks (static and dynamic conditions), and an executed action task involving judging and walking through different-sized gaps between doors.

RESULTS

No significant relationships were detected between general or movement-specific anxiety, self-efficacy or resilience and perceptual judgement or movement behaviour; however, movement consistency did significantly relate to movement execution in both groups. Correlations showed adults with DCD with lower movement-specific self-efficacy left bigger safety margins, and indicated stronger links between perception and action in TMS adults. In the adults with DCD there was no significant correlation between the point of behaviour change (critical ratio) in the perceptual judgement and executed action tasks, suggesting a less smoothly linked perception-action cycle than in the TMS adults.

CONCLUSIONS AND IMPLICATIONS

Results highlight the importance of movement variability and motor control in the movement behaviour of adults with DCD, while illustrating the importance of studying perception and action together, especially when comparing populations, to elucidate how these may be constrained differently by individual-, task- and environmental-based constraints.

Evaluating the Efficacy of Gross-Motor-Based Interventions for Children with Developmental Coordination Disorder: A Systematic Review

Objectives: This review quantitatively evaluates the effectiveness of gross-motor-based interventions in children with developmental coordination disorder (DCD), examining treatment aspects such as group interventions, therapy duration, and frequency. Methods: A systematic literature review, spanning January 2010 to December 2022, identified 11 relevant articles involving 492 children. Results: Positive outcomes were observed, with a moderate to large overall effect size (Cohen's d) indicating significant improvements in motor function through strategies emphasizing activity, bodily function, games, and small group events. Notably, interventions targeting complex motor skills were crucial for enhancing preparedness and activity engagement, improving fitness, and preventing obesity in children with DCD. Conclusions: The review underscores the effectiveness of activity-oriented and body-function-focused therapies in enhancing motor skills and functioning, emphasizing the need for interventions aligned with real-world activities. Future research should explore the long-term effects and retention of motor improvements, offering valuable insights for designing targeted interventions to promote overall well-being in children with DCD.

Children with developmental coordination disorders: a review of approaches to assessment and intervention

Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder characterized by deficits in motor skills, with gross and fine motor dysfunction being the main symptom. This condition greatly impairs children's daily life, learning, and social interaction. Symptoms typically appear during preschool or school age, and if left untreated, they can persist into adulthood. Thus, early assessment and intervention are crucial to improve the prognosis. This study aims to review the existing literature on DCD, providing a comprehensive overview of the assessment for children with DCD in terms of body functions and structures, activities and participation, and environmental factors within the framework of the International Classification of Functioning, Disability, and Health - Children and Youth (ICF-CY). Additionally, specific rehabilitation interventions will be described, offering valuable insights for the clinical assessment and intervention of children with DCD.

Locomotor-cognitive dual-tasking in children with developmental coordination disorder

Introduction

Children with Developmental Coordination Disorder (DCD) demonstrate deficits in predictive motor control and aspects of cognitive control compared with their typically developing (TD) peers. Adjustment to dynamic environments depends on both aspects of control and the deficits for children with DCD may constrain their ability to perform daily actions that involve dual-tasking. Under the assumption that motor-cognitive integration is compromised in children with DCD, we examined proportional dual-task costs using a novel locomotor-cognitive dual-task paradigm that enlisted augmented reality. We expect proportional dual-task performance costs to be greater for children with DCD compared to their TD peers.

Methods

Participants were 34 children aged 6-12 years (16 TD, 18 DCD) who walked along a straight 12 m path under single- and dual-task conditions, the cognitive task being visual discrimination under simple or complex stimulus conditions presented via augmented reality. Dual-task performance was measured in two ways: first, proportional dual-task costs (pDTC) were computed for cognitive and gait outcomes and, second, within-trial costs (p-WTC) were measured as the difference on gait outcomes between pre- and post-stimulus presentation.

Results

On measures of pDTC, TD children increased their double-limb support time when walking in response to a dual-task, while the children with DCD increased their locomotor velocity. On p-WTC, both groups increased their gait variability (step length and step width) when walking in response to a dual-task, of which the TD group had a larger proportional change than the DCD group. Greater pDTCs on motor rather than cognitive outcomes were consistent across groups and method of dual-task performance measurement.

Discussion

Contrary to predictions, our results failed to support dramatic differences in locomotor-cognitive dual-task performance between children with DCD and TD, with both groups tending to priorities the cognitive over the motor task. Inclusion of a within-trial calculation of dual-task interference revealed an expectancy effect for both groups in relation to an impending visual stimulus. It is recommended that dual-task paradigms in the future continue to use augmented reality to present the cognitive task and consider motor tasks of sufficient complexity to probe the limits of performance in children with DCD.

Qualitative age-related changes in fine motor skill performance among 3- to 6-year-old typically developing children

This study described intra-task fine motor skill components of the Manual Dexterity tasks (Posting Coins; PC, Threading Beads; TB, Drawing Trail; DT) of the Movement Assessment Battery for Children-2 Test for typically developing children and investigated age- and sex-related differences. Three- to six-year-old Dutch children (n = 182, Mage 4.5 ± 1.1 years, 51.1% boys) were observed with regard to intra-task fine motor skill components, and changes in intra-task components of the Manual Dexterity tasks were analyzed across age using of the Kruskal-Wallis test with post-hoc Mann-Whitney U tests, and differences between sexes using the Mann-Whitney U test. The following intra-task components were observed: grip type, manipulation, non-dominant or non-writing hand, grip position, posture, head, coin placement, placement of the bead on the lace tip and joint movement. Results showed that the younger children (3-year-olds) more frequently used a grasp with the full hand (PC, TB), more often put the coin on the container and sliding it in (PC), more often supported the side or top of the container (PC), used more bi-manual manipulation (transferring from hand-to-hand or hand, body or surface assist) (TB, DT), more frequently used primitive, too high grips, predominantly used their proximal joints, and did not support the paper (DT). This in comparison with more frequent use of three-point pinch, direct coin placement, grabbing the front or back of the container, in-hand-manipulation, mature grips and correct height, distal joint use and supporting the paper from the side or below by most 5- and 6-year-olds. Furthermore, most sex-related differences were found in the younger age-groups (3- and 4-year-olds) in the DT tasks with girls outperforming boys. Results from this study add to the knowledge on qualitative fine motor skill performance in a convenience sample of 3- to 6-year-old typically developing children. A limitation of the current study was the relatively small sample size of 6-year-old children. The strength of the current study is its novelty in providing qualitative descriptions of intra-task fine motor skill components in typically developing 3- to 6-year-old children.

Children with developmental coordination disorder have less variable motor unit firing rate characteristics across contractions compared to typically developing children

Introduction

Understanding the nuances of neuromuscular control is crucial in unravelling the complexities of developmental coordination disorder (DCD), which has been associated with differences in skeletal muscle activity, implying that children with DCD employ distinct strategies for muscle control. However, force generation and control are dependent on both recruitment of motor units and their firing rates and these fine details of motor function have yet to be studied in DCD. The purpose of this study was therefore to compare motor unit characteristics in a small muscle of the hand during low level, handgrip contractions in typically developing (TD) children and children with DCD.

Methods

Eighteen children (9 TD vs. 9 DCD) completed a series of manual handgrip contractions at 10 ± 5% of their maximum voluntary contraction. High density surface electromyography was used to record excitation of the first dorsal interosseus muscle. Recorded signals were subsequently decomposed into individual motor unit action potential trains. Motor unit characteristics (firing rate, inter-pulse interval, and action potential amplitude) were analysed for contractions that had a coefficient variation of <10%.

Results and Discussion

This study found few differences in average motor unit characteristics (number of motor units: TD 20.24 ± 9.73, DCD 27.32 ± 14.00; firing rate: TD 7.74 ± 2.16 p.p.s., DCD 7.86 ± 2.39 p.p.s.; inter-pulse interval: TD 199.72 ± 84.24 ms, DCD 207.12 ± 103 ms) when force steadiness was controlled for, despite the DCD group being significantly older (10.89 ± 0.78 years) than the TD group (9.44 ± 1.67 years). However, differences were found in the variability of motor unit firing statistics, with the children with DCD surprisingly showing less variability across contractions (standard deviation of coefficient of variation of inter-pulse interval: TD 0.38 ± 0.12, DCD 0.28 ± 0.11). This may suggest a more fixed strategy to stabilise force between contractions used by children with DCD. However, as variability of motor unit firing has not been considered in previous studies of children further work is required to better understand the role of variability in motor unit firing during manual grasping tasks, in all children.

An Integrated Eye-Tracking and Motion Capture System in Synchronized Gaze and Movement Analysis

Integrating mobile eye-tracking and motion capture emerges as a promising approach in studying visual-motor coordination, due to its capability of expressing gaze data within the same laboratory-centered coordinate system as body movement data. In this paper, we proposed an integrated eye-tracking and motion capture system, which can record and analyze temporally and spatially synchronized gaze and motion data during dynamic movement. The accuracy of gaze measurement were evaluated on five participants while they were instructed to view fixed vision targets at different distances while standing still or walking towards the targets. Similar accuracy could be achieved in both static and dynamic conditions. To demonstrate the usability of the integrated system, several walking tasks were performed in three different pathways. Results revealed that participants tended to focus their gaze on the upcoming path, especially on the downward path, possibly for better navigation and planning. In a more complex pathway, coupled with more gaze time on the pathway, participants were also found having the longest step time and shortest step length, which led to the lowest walking speed. It was believed that the integration of eye-tracking and motion capture is a feasible and promising methodology quantifying visual-motor coordination in locomotion.

Investigation with able-bodied subjects suggests Myosuit may potentially serve as a stair ascent training robot

Real world settings are seldomly just composed of level surfaces and stairs are frequently encountered in daily life. Unfortunately, ~ 90% of the elderly population use some sort of compensation pattern in order to negotiate stairs. Because the biomechanics required to successfully ascend stairs is significantly different from level walking, an independent training protocol is warranted. Here, we present as a preliminary investigation with 11 able-bodied subjects, prior to clinical trials, whether Myosuit could potentially serve as a stair ascent training robot. Myosuit is a soft wearable exosuit that was designed to assist the user via hip and knee extension during the early stance phase. We hypothesized that clinical studies could be carried out if the lower limb kinematics, sensory feedback via plantar force, and electromyography (EMG) patterns do not deviate from the user's physiological stair ascent patterns while reducing hip and knee extensor demand. Our results suggest that Myosuit conserves the user's physiological kinematic and plantar force patterns. Moreover, we observe approximately 20% and 30% decrease in gluteus maximus and vastus medialis EMG levels in the pull up phase, respectively. Collectively, Myosuit reduces the hip and knee extensor demand during stair ascent without any introduction of significant compensation patterns.

Short report presenting preliminary evidence of impaired corticomuscular coherence in an individual with Developmental Coordination Disorder

BACKGROUND

It has been suggested that developmental coordination disorder (DCD) could be caused by a 'dysconnection' in brain and skeletal muscle communication. To date no previous work has examined the integrity of this neuromuscular process in individuals with DCD.

AIMS

To conduct a feasibility study for measuring functional connectivity of the brain and muscle in an individual with DCD using corticomuscular coherence (CMC).

METHODS AND PROCEDURES

An individual with DCD and a typically developing (TD) participant completed a series of sustained 5-second voluntary isometric hand contractions (15 ± 5 % MVC) on a handheld dynamometer under both single and dual task (i.e., counting backwards) conditions. EEG, EMG and force data were collected.

OUTCOMES AND RESULTS

The participant with DCD displayed poorer force steadiness and higher mental demand compared to the TD participant and in dual task conditions. The TD participant displayed a commonly observed pattern of CMC that was highly localised over the contralateral hand area, the DCD participant displayed a less localised CMC across cortical regions.

CONCLUSIONS AND IMPLICATIONS

These findings support the feasibility of measuring CMC in DCD populations and offer some, albeit preliminary, evidence of impaired communication between the brain and muscles in these individuals.

Moving With Confidence: How Does Anxiety Impede Performance in Individuals With Developmental Coordination Disorder (DCD)?

Purpose of Review

It is well-established that anxiety levels are higher among people with developmental coordination disorder (DCD) compared to their peers. However, it is unclear whether this anxiety influences movement and behaviour. The purpose of this paper is to review studies demonstrating the influence of anxiety on movement and/or behaviour in non-DCD and DCD populations.

Recent Findings

When considering non-DCD literature, many studies have illustrated the influence of anxiety on movement. Only two papers were found which explicitly aimed to consider the influence of anxiety on movement in a DCD population. These findings are described and explored against a backdrop of the wider research field.

Summary

This paper has highlighted the potential role of anxiety in constraining movement patterns in DCD. While a great deal more evidence is needed before definitive conclusions, there is emerging evidence that motor behaviour may be related to task-specific anxiety in children with DCD.

Behavioral and Neuroimaging Research on Developmental Coordination Disorder (DCD): A Combined Systematic Review and Meta-Analysis of Recent Findings

AIM

The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD.

METHODS

The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis.

RESULTS

The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions.

INTERPRETATION

Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO, identifier: CRD42020185444.