Emergence and stability of interlimb coordination patterns in children with developmental coordination disorder

Interlimb coordination and spatiotemporal variability during walking and running in children with developmental coordination disorder and typically developing children

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.

Effect of verbal cues on the coupling and stability of anti-phase bimanual coordination pattern in children with probable developmental coordination disorder

The study of the emergence and stability of bimanual and interlimb coordination patterns in children with Developmental Coordination Disorder (DCD) has shown that they encounter greater difficulties in coupling their limbs compared to typically developing (TD) children. Verbal cues have been identified as strategies to direct children's attention to more relevant task information, thus potentially improving motor performance. Consequently, this study investigated the effect of providing verbal cues on the execution of bimanual tasks in children with and without probable DCD. Twenty-eight children aged 9-10, matched by age and gender, were divided into two groups: pDCD [n = 14] and TD. The children performed bilateral trajectory movements with both hands (horizontal back-and-forth), holding a pen on a tablet, in anti-phase (180°) coordination pattern, in two conditions: No cues and Verbal cues. In the last condition, children received verbal cues to maintain the anti-phase pattern even with an increase in hand oscillation frequency. Relative phase and variability of relative phase between the hands were calculated for analysis of pattern coupling and stability. Hand cycles, movement amplitude, and tablet pressure force were calculated to analyze pattern control parameters. All these variables were compared between groups and conditions. The results indicated that despite the pDCD group showing greater variability in the anti-phase coordination pattern compared to the TD group, both groups performed better in the Verbal cues than the No cues condition. Furthermore, the pDCD group exhibited more hand movement cycles and applied greater pressure force compared to the TD group, suggesting different motor control strategies during the bimanual task. It is suggested that the use of verbal cues during bimanual task execution improves children's performance, potentially by promoting interaction between attention, as a cognitive function, and intrinsic coordination dynamics, thereby reducing variability in the perceptual-motor system.

Effects of virtual reality training intervention on predictive motor control of children with DCD - A randomized controlled trial

It has been hypothesised that deficits in the functions of predictive motor control and internal modeling may contribute to motor control issues of children with Developmental Coordination Disorder (DCD). Virtual reality (VR) technologies have great potential to provide opportunity for Motor observation and motor imagery (MI) which could enhance learning and development of motor skills in children with DCD. Thus, the present study aimed to investigate the benefits of a VR training intervention to improve predictive motor control functions of children with DCD. Forty female children with DCD (aged 7-10) were randomly assigned to VR and control groups. In this study, an experimental pre-post and follow-up design was used, and Predictive motor control functions were measured before and after the VR intervention and two-months later. Predictive motor control was evaluated using MI (by hand rotation task), action planning (by sword placement task), and rapid and online control (by rotational tracking task) tests. VR intervention consisted of a selection of Xbox 360 Kinect games that were performed for sixteen 30-min sessions over 8 weeks. Compared to the control group, the VR group improved significantly on measures of MI, motor planning, and rapid and online control scores from pre- to post-test and retained their performance to follow-up. Overall, it seems that virtual reality training program may be used as an appropriate intervention approach for developing the ability of MI and predictive motor control functions in DCD children.

Gross motor proficiency and intellectual functioning: A comparison among children with Down syndrome, children with borderline intellectual functioning, and typically developing children

This cross-sectional study examines differences in gross motor proficiency as a function of different intellectual functioning profiles. Two motor areas have been investigated as being equally essential to gross motor functions in every-day life: locomotion and object control.It aims to compare gross motor skills endorsed by children with Down syndrome (DS), children with borderline intellectual functioning (BIF), and typically developing children (TDC).Group 1 was composed of 18 children with DS (chronological age = 8.22), group 2 was composed of 18 children with BIF (chronological age = 9.32), and group 3 was composed of 18 children with typical development (TD) (chronological age = 9.28).Gross motor skills were measured through the test of gross motor development (TGMD-Test) composed of locomotion and object control tasks.Children with DS showed worse gross motor skills compared with children with BIF and typically developing children by underscoring both on all locomotion (e.g., walking, running, hopping, galloping, jumping, sliding, and leaping) and all object control tasks (e.g., throwing, catching, striking, bouncing, kicking, pulling, and pushing).In DS group strengths were found on run and slide skills, in BIF group strengths were on run, long jump and slide skills and in TDC group strengths were on run and slide skills. For all of the 3 groups the locomotor worst performed task was jump forward with arm swing.Findings suggest implications for further practice to develop evidence-based exercise programs aimed to rehabilitate gross motor skills through the regular participation in structured exercise activities.

Variability in coordination patterns in children with developmental coordination disorder (DCD)

High motor variability is an often-found characteristic of Developmental Coordination Disorder (DCD). Still, the role of high motor variability in DCD needs further examination. This study focused on variability in coordination patterns, which is essential considering that DCD is a coordination disorder. We examined variability in coordination patterns of the arm over repetitions of trials in goal-directed reaching movements. This variability was partitioned into variability that does not affect the index fingertip position (V_ucm) and variability that does affect the index fingertip position (V_ort). This study aimed to increase the understanding of motor variability in DCD by comparing V_ucm and V_ort between children with DCD and typically developing (TD) children in a goal-directed reaching task. Twenty-two children (eleven with DCD) ages 6-11 performed 30 reaching movements. The Uncontrolled Manifold method was used to quantify V_ucm and V_ort. Results showed that children with DCD had more V_ucm than TD children while V_ort was similar between groups, showing that coordination patterns in children with DCD are more variable, but interestingly, this higher variability does not affect performance. This study indicates that high motor variability in DCD is not necessarily negative. Possible roles of motor variability in DCD are discussed.

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

AIM

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

METHOD

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

RESULTS

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

INTERPRETATION

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