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Banwell HA, Tsiros M, Coventry J, Ryan N, Williams CM. Textured insoles may improve some gross motor balance measures but not endurance measures in children with motor coordination issues. A randomised controlled feasibility trial. J Foot Ankle Res 2024; 17:e12036. [PMID: 38951733 DOI: 10.1002/jfa2.12036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/05/2024] [Accepted: 06/13/2024] [Indexed: 07/03/2024] Open
Abstract
BACKGROUND Motor coordination concerns are estimated to affect 5%-6% of school-aged children. Motor coordination concerns have variable impact on children's lives, with gait and balance often affected. Textured insoles have demonstrated positive impact on balance and gait in adults with motor coordination disorders related to disease or the ageing process. The efficacy of textured insoles in children is unknown. Our primary aim was to identify the feasibility of conducting a randomised controlled trial involving children with motor control issues. The secondary aim was to identify the limited efficacy of textured insoles on gross motor assessment balance domains and endurance in children with movement difficulties. METHODS An assessor-blinded, randomised feasibility study. We advertised for children between the ages of 5-12 years, with an existing diagnosis or developmental coordination disorder or gross motor skill levels assessed as 15th percentile or below on a norm-referenced, reliable and validated scale across two cities within Australia. We randomly allocated children to shoes only or shoes and textured insoles. We collected data across six feasibility domains; demand (recruitment), acceptability (via interview) implementation (adherence), practicality (via interview and adverse events), adaptation (via interview) and limited efficacy testing (6-min walk test and balance domain of Movement ABC-2 at baseline and 4 weeks). RESULTS There were 15 children randomised into two groups (eight received shoes alone, seven received shoes and textured insoles). We experienced moderate demand, with 46 potential participants. The insoles were acceptable, however, some parents reported footwear fixture issues requiring modification. The 6-min walk test was described as problematic for children, despite all but one child completing. Social factors impacted adherence and footwear wear time in both groups. Families reported appointment locations and parking impacting practicality. Underpowered, non-significant small to moderate effect sizes were observed for different outcome measures. Improvement in balance measures favoured the shoe and insole group, while gait velocity increase favoured the shoe only group. CONCLUSION Our research indicates that this trial design is feasible with modifications such as recruiting with a larger multi-disciplinary organisation, providing velcro shoe fixtures and using a shorter timed walk test. Furthermore, progressing to a larger well-powered randomised control trial is justified considering our preliminary, albeit underpowered, efficacy findings. TRIAL REGISTRATION This trial was retrospectively registered with the Australian and New Zealand Clinical Trial Registration: ACTRN12624000160538.
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Affiliation(s)
- Helen A Banwell
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- Innovation, Implementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia
| | - Margarita Tsiros
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- Innovation, Implementation and Clinical Translation in Health (IIMPACT), University of South Australia, Adelaide, South Australia, Australia
- Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Adelaide, South Australia, Australia
| | - Jessica Coventry
- Monash University, School of Primary and Allied Health, Frankston, Victoria, Australia
| | - Narelle Ryan
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Cylie M Williams
- Monash University, School of Primary and Allied Health, Frankston, Victoria, Australia
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Goetschalckx M, Moumdjian L, Feys P, Rameckers E. Interlimb coordination and spatiotemporal variability during walking and running in children with developmental coordination disorder and typically developing children. Hum Mov Sci 2024; 96:103252. [PMID: 39018699 DOI: 10.1016/j.humov.2024.103252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 04/11/2024] [Accepted: 07/11/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND A different interlimb coordination and higher variability in movement patterns is evident in children with Developmental Coordination Disorder (DCD). The impact of DCD on interlimb coordination during walking and running is unknown. AIM To assess interlimb coordination and spatiotemporal variability during overground walking and running in children with and without DCD. METHODS Children with DCD and typically developing children (TDC), from 8 to 12 years participated. Children were equipped with portable sensors. Participants walked and ran for 3 min in an oval-path at their comfortable pace. Interlimb coordination, expressed by the phase coordination index (PCI), and spatiotemporal variability (coefficient of variance (CoV)) were collected. RESULTS Twenty-one children with DCD and 23 TDC participated. During walking, PCI showed similar values in both groups, but a higher spatiotemporal variability was observed in children with DCD. During running, PCI was higher (reduced coordination) in children with DCD than TDC and a higher spatiotemporal variability was shown. CONCLUSIONS AND IMPLICATIONS Only during running, interlimb coordination of children with DCD was lower than TDC. During both walking and running tasks, spatiotemporal variability was higher in DCD. Current results implicate that difficulties in children with DCD is more prominent when motor coordination is more challenged. WHAT THIS PAPER ADDS This paper adds to the literature on coordination and gait pattern in children with Developmental Coordination Disorder (DCD) through a cross-sectional analysis of interlimb coordination and variability of spatiotemporal measures of overground walking and running. Overground walking and running were performed in a large oval-path allowing the assessment of coordination and gait patterns in an ecological valid set-up. Our results indicate that during a more demanding task, namely running, children with DCD display a less coordinated running pattern, expressed by a significantly higher phase coordination index, than typically developing peers. During walking, the interlimb coordination was similar between both groups. The current result is in accordance with the hybrid model of DCD that states that motor coordination difficulties in DCD are dpendent on the interaction of the task, individual and environment. This highlights the importance of implementing running assessments in children with DCD and the need for task-oriented running training in clinical practice The study also supports previous findings that children with DCD show a higher variability in their gait pattern of both walking and running, expressed by higher coefficient of variance of spatiotemporal measures, than typically developing peers. Further understanding in the normal development of interlimb coordination during walking and running from childhood into adulthood will enhance interpretations of the phase coordination index in children with and without DCD.
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Affiliation(s)
- Mieke Goetschalckx
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium.
| | - Lousin Moumdjian
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; IPEM, Institute of Psychoacoustic and Electronic music, Faculty of Art and Philosophy, Gent University, Gent, Belgium
| | - Peter Feys
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
| | - Eugene Rameckers
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; CAPHRI, Maastricht University, Maastricht, the Netherlands; Centre of Expertise, Adelante Rehabilitation centre, Valkenburg, the Netherlands
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Maw KJ, Beattie G, Burns EJ. Cognitive strengths in neurodevelopmental disorders, conditions and differences: A critical review. Neuropsychologia 2024; 197:108850. [PMID: 38467371 DOI: 10.1016/j.neuropsychologia.2024.108850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 03/04/2024] [Accepted: 03/07/2024] [Indexed: 03/13/2024]
Abstract
Neurodevelopmental disorders are traditionally characterised by a range of associated cognitive impairments in, for example, sensory processing, facial recognition, visual imagery, attention, and coordination. In this critical review, we propose a major reframing, highlighting the variety of unique cognitive strengths that people with neurodevelopmental differences can exhibit. These include enhanced visual perception, strong spatial, auditory, and semantic memory, superior empathy and theory of mind, along with higher levels of divergent thinking. Whilst we acknowledge the heterogeneity of cognitive profiles in neurodevelopmental conditions, we present a more encouraging and affirmative perspective of these groups, contrasting with the predominant, deficit-based position prevalent throughout both cognitive and neuropsychological research. In addition, we provide a theoretical basis and rationale for these cognitive strengths, arguing for the critical role of hereditability, behavioural adaptation, neuronal-recycling, and we draw on psychopharmacological and social explanations. We present a table of potential strengths across conditions and invite researchers to systematically investigate these in their future work. This should help reduce the stigma around neurodiversity, instead promoting greater social inclusion and significant societal benefits.
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Dominguez-Vega ZT, de Quiros MB, Elting JWJ, Sival DA, Maurits NM. Instrumented Gait Classification Using Meaningful Features in Patients with Impaired Coordination. SENSORS (BASEL, SWITZERLAND) 2023; 23:8410. [PMID: 37896504 PMCID: PMC10611111 DOI: 10.3390/s23208410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/29/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023]
Abstract
Early onset ataxia (EOA) and developmental coordination disorder (DCD) both affect cerebellar functioning in children, making the clinical distinction challenging. We here aim to derive meaningful features from quantitative SARA-gait data (i.e., the gait test of the scale for the assessment and rating of ataxia (SARA)) to classify EOA and DCD patients and typically developing (CTRL) children with better explainability than previous classification approaches. We collected data from 18 EOA, 14 DCD and 29 CTRL children, while executing both SARA gait tests. Inertial measurement units were used to acquire movement data, and a gait model was employed to derive meaningful features. We used a random forest classifier on 36 extracted features, leave-one-out-cross-validation and a synthetic oversampling technique to distinguish between the three groups. Classification accuracy, probabilities of classification and feature relevance were obtained. The mean classification accuracy was 62.9% for EOA, 85.5% for DCD and 94.5% for CTRL participants. Overall, the random forest algorithm correctly classified 82.0% of the participants, which was slightly better than clinical assessment (73.0%). The classification resulted in a mean precision of 0.78, mean recall of 0.70 and mean F1 score of 0.74. The most relevant features were related to the range of the hip flexion-extension angle for gait, and to movement variability for tandem gait. Our results suggest that classification, employing features representing different aspects of movement during gait and tandem gait, may provide an insightful tool for the differential diagnoses of EOA, DCD and typically developing children.
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Affiliation(s)
- Zeus T. Dominguez-Vega
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Z.T.D.-V.); (M.B.d.Q.); (J.W.J.E.)
| | - Mariano Bernaldo de Quiros
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Z.T.D.-V.); (M.B.d.Q.); (J.W.J.E.)
| | - Jan Willem J. Elting
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Z.T.D.-V.); (M.B.d.Q.); (J.W.J.E.)
| | - Deborah A. Sival
- Department of Paediatrics, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
| | - Natasha M. Maurits
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Z.T.D.-V.); (M.B.d.Q.); (J.W.J.E.)
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Ke L, Su X, Yang S, Du Z, Huang S, Wang Y. New trends in developmental coordination disorder: Multivariate, multidimensional and multimodal. Front Psychiatry 2023; 14:1116369. [PMID: 36778631 PMCID: PMC9911460 DOI: 10.3389/fpsyt.2023.1116369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 01/16/2023] [Indexed: 01/28/2023] Open
Abstract
Developmental coordination disorder (DCD) is a motor development disorder that affects an individual's growth and development, and may persist throughout life. It is not caused by intellectual or physical disability. Studies have suggested DCD often occurs in childhood, resulting in a series of abnormal manifestations that hinder children's normal development; cohort studies suggest a higher incidence in boys than in girls. Early diagnosis and appropriate interventions can help relieve symptoms. Unfortunately, the relevant research still needs to be further developed. In this paper, we first start from the definition of DCD, systematically investigate the relevant research papers in the past decades and summarize the current research hotspots and research trends in this field. After summarizing, it is found that this research field has attracted more researchers to join, the number of papers published has increased year by year and has become a hot spot in multidisciplinary research, such as education, psychology, sports rehabilitation, neurobiology, and neuroimaging. The continuous development of the correlation between perinatal factors and DCD, various omics studies, and neuroimaging methods also brings new perspectives and working targets to DCD research. DCD-related research will continue to deepen along the research direction of multivariate, multidimensional, and multimodal.
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Affiliation(s)
- Li Ke
- Collaborative Innovation Center of Assessment for Basic Education Quality, Beijing Normal University, Beijing, China
| | - Xueting Su
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Sijia Yang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Zhihao Du
- College of Physical Education and Sports, Beijing Normal University, Beijing, China
| | - Shunsen Huang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Yun Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
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Subara-Zukic E, Cole MH, McGuckian TB, Steenbergen B, Green D, Smits-Engelsman BCM, Lust JM, Abdollahipour R, Domellöf E, Deconinck FJA, Blank R, Wilson PH. Behavioral and Neuroimaging Research on Developmental Coordination Disorder (DCD): A Combined Systematic Review and Meta-Analysis of Recent Findings. Front Psychol 2022; 13:809455. [PMID: 35153960 PMCID: PMC8829815 DOI: 10.3389/fpsyg.2022.809455] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/03/2022] [Indexed: 01/16/2023] Open
Abstract
AIM The neurocognitive basis of Developmental Coordination Disorder (DCD; or motor clumsiness) remains an issue of continued debate. This combined systematic review and meta-analysis provides a synthesis of recent experimental studies on the motor control, cognitive, and neural underpinnings of DCD. METHODS The review included all published work conducted since September 2016 and up to April 2021. One-hundred papers with a DCD-Control comparison were included, with 1,374 effect sizes entered into a multi-level meta-analysis. RESULTS The most profound deficits were shown in: voluntary gaze control during movement; cognitive-motor integration; practice-/context-dependent motor learning; internal modeling; more variable movement kinematics/kinetics; larger safety margins when locomoting, and atypical neural structure and function across sensori-motor and prefrontal regions. INTERPRETATION Taken together, these results on DCD suggest fundamental deficits in visual-motor mapping and cognitive-motor integration, and abnormal maturation of motor networks, but also areas of pragmatic compensation for motor control deficits. Implications for current theory, future research, and evidence-based practice are discussed. SYSTEMATIC REVIEW REGISTRATION PROSPERO, identifier: CRD42020185444.
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Affiliation(s)
- Emily Subara-Zukic
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Michael H. Cole
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Thomas B. McGuckian
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Bert Steenbergen
- Department of Pedagogical and Educational Sciences, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Dido Green
- Department of Health Sciences, Brunel University London, London, United Kingdom
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Bouwien CM Smits-Engelsman
- Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Jessica M. Lust
- Department of Pedagogical and Educational Sciences, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Reza Abdollahipour
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Erik Domellöf
- Department of Psychology, Umeå University, Umeå, Sweden
| | | | - Rainer Blank
- Heidelberg University, Heidelberg, Germany
- Klinik für Kinderneurologie und Sozialpädiatrie, Kinderzentrum Maulbronn gGmbH, Maulbronn, Germany
| | - Peter H. Wilson
- Healthy Brain and Mind Research Centre, School of Behavioural and Health Sciences, Faculty of Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
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Gait Parameters in Healthy Preschool and School Children Assessed Using Wireless Inertial Sensor. SENSORS 2021; 21:s21196423. [PMID: 34640743 PMCID: PMC8512031 DOI: 10.3390/s21196423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/12/2022]
Abstract
Background: The objective gait assessment in children has become more popular. Basis parameters for comparison during the examination are advisable. Objectives: The study aim was to investigate the typical gait parameters of healthy preschool and school children, using a wireless inertial sensor as the reference for atypical gait. The additional aim was to compare the specific gait parameters in the younger and older group of children. Methods: One hundred and sixty-one children’s gait parameters were evaluated by a G-Walk BTS G-SENSOR smart analyzer. The children were walking barefoot, at a self-selected speed, on a five-meter walkway, and they turned around and go back twice. Results: Age significantly influences most of the spatiotemporal parameters. The support phase becomes shorter with age. Accordingly, the swing phase becomes longer with age. The results also show that older children need shorter double support and have longer single support. Moreover, the pelvic tilt symmetry index is higher with increasing age. In each age division, the smallest variation in all gait parameters within the oldest group of examined children was observed. A comparison between the left and right side gait parameters shows the higher difference in boys than in girls. A significant difference was calculated in the pelvic obliquity symmetry index. Girls had significantly more symmetrical obliquity than boys. Conclusions: the research indicates the basic parameters of typical children’s gait, which may be a reference to atypical gait in the case of trauma or disability.
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