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Stania M, Emich-Widera E, Kamieniarz-Olczak A, Kazek B, Swatowska-Wenglarczyk M, Juras G. Postural control before and after transitional locomotor tasks in children on the autism spectrum: A case-control study. Clin Biomech (Bristol, Avon) 2024; 115:106251. [PMID: 38626570 DOI: 10.1016/j.clinbiomech.2024.106251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Instrumented measurements of postural control provide a more accurate insight into the motor development of children with autism. This study aimed to identify postural control deficits in autistic children during quiet standing before and after transient locomotor task. It was hypothesized that the parameters that characterize the trajectory of center of foot pressure (COP) displacement would be higher in autistic children compared to typically developing children. METHODS Sixteen autistic children aged 6-10 but without a comorbidity diagnosis, were enrolled in the study group. The control group comprised 16 typically developing peers. The assessment of the transitional task comprised four different conditions: unperturbed and perturbed transition, stepping up, and stepping down tasks. Analysis of the COP signal was carried out for three distinct phases, i.e., phase 1 - quiet standing before step initiation, phase 2 - transit, and phase 3 - quiet standing until measurement completion. FINDINGS The two-way ANOVA with a 2 × 4 factorial design (group × testing condition) revealed a group effect on all posturographic variables in the antero-posterior and medio-lateral directions of phase 1 and in the antero-posterior direction of phase 3. The Bonferroni post-hoc test showed the means of all those variables were significantly higher for the autistic than for typically developing children. Group allocation also had an effect on the time of transit and step length, which turned out to be significantly longer in autistic children compared to healthy peers. INTERPRETATION Autistic children show increased postural sway before and after transitional locomotor tasks compared to typically developing children. The trial was prospectively registered in the Australian and New Zealand Clinical Trials Registry (no. ACTRN12621001113842; date registered: 23.08.2021).
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Affiliation(s)
- Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland.
| | - Ewa Emich-Widera
- Department of Pediatric Neurology, Faculty of Medical Sciences, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
| | - Anna Kamieniarz-Olczak
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
| | - Beata Kazek
- Persevere - Child Development Support Center, Kępowa 56, 40-583 Katowice, Poland
| | | | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
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Date S, Munn E, Frey GC. Postural balance control interventions in autism spectrum disorder (ASD): A systematic review. Gait Posture 2024; 109:170-182. [PMID: 38320424 DOI: 10.1016/j.gaitpost.2024.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/01/2024] [Accepted: 01/28/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Postural control (PC) disturbances in autism spectrum disorder (ASD) are associated with its severity. Varied sensorimotor interventions have been used for the management of these symptoms. However, there is a lack of a review elucidating all the available postural control interventions in ASD. RESEARCH QUESTION To comprehensively present the variety of interventions targeted at improving PC in ASD and to provide future research recommendations. METHODS PubMed, SCOPUS, Embase, Cochrane, ScienceDirect and Web of Science databases were searched for publications examining the effects of PC targeting interventions in those with ASD. Included articles were in English, published after 2000 in the peer-reviewed journals with full text available and used intervention targeted at improving PC or balance with a predefined objective outcome measure for accessing PC or balance. Initial database search yielded 1022 studies and 21 articles were included in this review after screening. RESULTS We identified diverse PC interventions including animal assisted therapies, karate/martial arts, aquatic exercises, virtual reality-based training, standard and customized exercises, and physical activity programs. The effect of long- and short-term interventions on PC improvement in children and adults with ASD is mixed. Future research should focus on undertaking randomized controlled trials with large sample size and participants with varying severity of ASD to improve generalizability of the study findings. The lack of population-specific, reliable, and validated motor outcome measures including neuro-imaging techniques should be addressed. SIGNIFICANCE While many of the interventions improved PC in those with ASD, the sample size and methodological quality of the studies was highly variable. There are limited studies exploring the long-term effects of the interventions. Rigorous study methods with population-specific objective outcome measures are warranted to draw generalizable conclusions regarding the PC interventions in individuals with ASD.
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Affiliation(s)
- Surabhi Date
- Department of Kinesiology, Indiana University Bloomington, 1025 E 7th Street, Bloomington, IN 47405, USA.
| | - Emily Munn
- Department of Physical Education, University of South Carolina, 820 Main Street, Columbia, SC 29208, USA
| | - Georgia C Frey
- Department of Kinesiology, Indiana University Bloomington, 1025 E 7th Street, Bloomington, IN 47405, USA
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González León N, González-Olguín A. [Motor intervention strategies on postural control in children and youth with autism spectrum disorder: A systematic review]. Rehabilitacion (Madr) 2024; 58:100820. [PMID: 37913716 DOI: 10.1016/j.rh.2023.100820] [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: 09/15/2022] [Revised: 12/17/2022] [Accepted: 01/16/2023] [Indexed: 11/03/2023]
Abstract
Autism spectrum disorder (ASD) has varied characteristics with an impact at the social, communicative and sensorimotor (SM) level. An SM feature is postural control (PC) problems. There are various motor intervention strategies (MIS), but the benefit over LC is something that has been analyzed less extensively. The objective was to describe the MIS and its results on the PC of children and adolescents with ASD. A search of PubMed, Scopus, Web of Science and Cochrane was performed. A total of eight articles met the eligibility criteria. All MIS showed beneficial results on the improvement of PC. The MIS were of a varied nature (dance practice, personalized physical activity, video games, Tai Chi Chuan, Taekwondo and virtual reality). It is necessary to improve the designs and consider the risks of bias, since they limit the scope of the results.
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Affiliation(s)
- N González León
- Facultad de Ciencias de la Rehabilitación, Universidad Andrés Bello, Santiago, Chile
| | - A González-Olguín
- Escuela de Kinesiología, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile; Escuela de Kinesiología, Facultad de Salud y Ciencias Sociales, Universidad de Las Américas, Santiago, Chile; Centro de Estudios del Movimiento Humano, Facultad de Salud y Odontología, Universidad Diego Portales, Santiago, Chile.
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Ben Hassen I, Abid R, Ben Waer F, Masmoudi L, Sahli S, Driss T, Hammouda O. Intervention Based on Psychomotor Rehabilitation in Children with Autism Spectrum Disorder ASD: Effect on Postural Control and Sensory Integration. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1480. [PMID: 37761443 PMCID: PMC10529430 DOI: 10.3390/children10091480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 08/04/2023] [Accepted: 08/14/2023] [Indexed: 09/29/2023]
Abstract
Postural stability and control are essential motor skills for successfully performing various activities of daily living. However, children with autism spectrum disorder (ASD) exhibit significant sensorimotor impairments. The aim of this study was to investigate the efficacy of psychomotricity training on postural control (PC) of children with ASD. We recruited thirty children (age = 8.01 ± 1.2; weight = 31.66 ± 8.1 kg; height = 129.7 ± 10.8 cm) diagnosed with ASD (intellectual quotient > 50) to participate in this study. They were divided into two groups: the experimental group (n = 16) and control group (n = 14). Children in the experimental group were trained with psychomotor activities two times a week for nine weeks. Statistic postural balance was assessed before and after intervention and on different vision conditions. The results showed that the psychomotor training significantly improved PC in standing position under different conditions when compared to the control group, in all parameters (CoPA; CoPLX; CoPLy) (p < 0.01). Our preliminary findings suggest the usefulness of the psychomotor training in children with ASD on static PC.
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Affiliation(s)
- Imen Ben Hassen
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax 3026, Tunisia; (I.B.H.); (O.H.)
| | - Rihab Abid
- Research Unit, Physical Activity, Sport and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia;
| | - Fatma Ben Waer
- Research Laboratory, Education Motricité Sport et Santé EM2S LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (F.B.W.); (L.M.); (S.S.)
| | - Liwa Masmoudi
- Research Laboratory, Education Motricité Sport et Santé EM2S LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (F.B.W.); (L.M.); (S.S.)
| | - Sonia Sahli
- Research Laboratory, Education Motricité Sport et Santé EM2S LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (F.B.W.); (L.M.); (S.S.)
| | - Tarak Driss
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, UFR STAPS, Paris Nanterre University, 92001 Nanterre, France
| | - Omar Hammouda
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Sfax 3026, Tunisia; (I.B.H.); (O.H.)
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, UFR STAPS, Paris Nanterre University, 92001 Nanterre, France
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Gowen E, Earley L, Waheed A, Poliakoff E. From "one big clumsy mess" to "a fundamental part of my character." Autistic adults' experiences of motor coordination. PLoS One 2023; 18:e0286753. [PMID: 37267374 DOI: 10.1371/journal.pone.0286753] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 05/22/2023] [Indexed: 06/04/2023] Open
Abstract
Altered motor coordination is common in autistic individuals affecting a range of movements such as manual dexterity, eye-hand coordination, balance and gait. However, motor coordination is not routinely assessed leading to undiagnosed and untreated motor coordination difficulties, particularly in adults. Few studies have investigated motor coordination difficulties and their impact from the viewpoint of autistic people. Therefore, the current study used FGs and thematic analysis to document the experience of motor coordination difficulties from the viewpoint of 17 autistic adults. Four main themes were identified. First, motor coordination difficulties were pervasive and variable, being present life-long and within multiple movements and affecting many aspects of life. Furthermore, the nature of the difficulties was variable within and between participants along with differing awareness of coordination ability. Second, participants described motor coordination as an active process, requiring concentration for most actions and at a level seemingly greater than other people. Third, motor coordination difficulties impacted upon social and emotional wellbeing by placing strain on relationships, prompting bullying and exclusion, putting safety at risk and causing a range of negative emotions. Fourth, in the absence of any support, participants described multiple learning and coping strategies. Findings highlight how it is essential to address the current lack of support for motor coordination considering the significant social and emotional consequences described by our participants. Further investigation of motor learning and interactions between sensory and motor performance in autistic adults is also warranted.
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Affiliation(s)
- Emma Gowen
- Division of Psychology, Communication and Human Neuroscience, School of Health Science, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Louis Earley
- Division of Psychology, Communication and Human Neuroscience, School of Health Science, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Adeeba Waheed
- Division of Psychology, Communication and Human Neuroscience, School of Health Science, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Ellen Poliakoff
- Division of Psychology, Communication and Human Neuroscience, School of Health Science, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
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Stania M, Emich-Widera E, Kazek B, Kamieniarz A, Swatowska-Wenglarczyk M, Juras G. Modulation of center-of-pressure signal in children on the autism spectrum: A case-control study. Gait Posture 2023; 103:67-72. [PMID: 37119687 DOI: 10.1016/j.gaitpost.2023.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 04/15/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Proper postural and motor control plays a fundamental role in the child's ontogenetic development. So far, the postural control in children on the autism spectrum has mainly been assessed with standard posturographic measurements of center of pressure (COP) displacements. RESEARCH QUESTION What are the differences in postural control between autistic and typically developing children? METHODS The study group comprised 16 autistic children aged 6-10 years, identified by a psychiatrist. The control group consisted of 16 typically developing children aged 6-10 years with no posture deformities, no pervasive developmental disorder and no history of postural control or movement deficits. The data were collected during quiet standing with eyes open using a force plate. To gain a better insight into the postural control processes, the rambling-trembling and sample entropy analyses were used in COP data processing. RESULTS Compared to typically developing children, those with autism spectrum had significantly higher values of COP and rambling trajectory parameters in the antero-posterior direction during quiet standing. The variables of the trembling trajectory did not differ significantly between the groups. The autistic children had significantly lower values of sample entropy in the antero-posterior direction compared to typically developing children. SIGNIFICANCE More advanced measures of COP displacements including the rambling-trembling method and sample entropy revealed differences in postural control between autistic and typically developing children. These methods may therefore contribute to functional assessment of postural control deficits in children on the autism spectrum.
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Affiliation(s)
- Magdalena Stania
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland.
| | - Ewa Emich-Widera
- Department of Pediatric Neurology, Faculty of Medical Sciences, Medical University of Silesia, Medyków 18, 40-752 Katowice, Poland
| | - Beata Kazek
- Persevere - Child Development Support Center, Kępowa 56, 40-583 Katowice, Poland
| | - Anna Kamieniarz
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
| | | | - Grzegorz Juras
- Institute of Sport Sciences, Academy of Physical Education, Mikołowska 72A, 40-065 Katowice, Poland
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Hariri R, Nakhostin-Ansari A, Mohammadi F, Memari AH, Oskouie IM, Haghparast A. An Overview of the Available Intervention Strategies for Postural Balance Control in Individuals with Autism Spectrum Disorder. AUTISM RESEARCH AND TREATMENT 2022; 2022:3639352. [PMID: 36452121 PMCID: PMC9705119 DOI: 10.1155/2022/3639352] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 10/30/2022] [Accepted: 11/15/2022] [Indexed: 04/03/2024]
Abstract
BACKGROUND Postural instability is a prevalent issue among individuals with autism spectrum disorder (ASD) that affects the development of their perceptual-motor skills and social functioning. Visual and somatosensory processing deficits, hypotonia, basal ganglia dysfunction, and anxiety are some of the concurrent disorders in individuals with ASD. Nevertheless, a definite management protocol for postural instability in ASD has not been introduced yet. Hence, we aim to shed light on the available intervention strategies for postural instability in individuals with ASD. METHODS Even though several studies have been conducted on the effects of various interventions for balance control in individuals with ASD, no study has compared their efficacy, limitations, and clinical implications. RESULTS This review discusses diverse proposed interventions contributing to ASD postural instability, including martial arts, water-based interventions, animal-assisted therapies, trampoline, balance training, vestibular therapy, transcranial direct current stimulation, sports, play, and active recreation for kids (SPARK), and square-stepping exercise (SSE). CONCLUSION Enhancing motor skills, cerebellum function, and sensory input integration were some of the main mechanisms of these interventions to improve balance control in ASD. Some interventions, such as water-based exercises and video games, were enjoyable for children with ASD and could raise their treatment adherence. In most studies, small sample sizes and the lack of a control group represented their major limitations. Therefore, future well-designed randomized controlled trials are required to assess the effects of available interventions on postural control in ASD.
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Affiliation(s)
- Rabeeh Hariri
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Mohammadi
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Hossein Memari
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Iman Menbari Oskouie
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Afarin Haghparast
- Sports Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Roșca AM, Rusu L, Marin MI, Ene Voiculescu V, Ene Voiculescu C. Physical Activity Design for Balance Rehabilitation in Children with Autism Spectrum Disorder. CHILDREN 2022; 9:children9081152. [PMID: 36010043 PMCID: PMC9406473 DOI: 10.3390/children9081152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 11/29/2022]
Abstract
One of the characteristics of autism spectrum disorder (ASD) subjects is postural control deficit, which is significant when somatosensory perception is affected. This study analyzed postural stability evolution after physical therapy exercises based on balance training. The study included 28 children with ASD (average age 8 years, average weight 32.18 kg). The rehabilitation program involved performing balance exercises twice a week for three months. Subject assessment was carried out using the RSScan platform. The parameters were the surface of the confidence ellipse (A) and the length of the curve (L) described by the pressure center, which were evaluated before and after the rehabilitation program. Following data processing, we observed a significant decrease in the surface of the confidence ellipse by 92% from EV1 to EV2. Additionally, a decrease of 42% in the curve length was observed from EV1 to EV2. A t test applied to the ellipse surface showed a p = 0.021 and a Cohen’s coefficient of 0.8 (very large effect size). A t test applied to the length L showed p = 0.029 and Cohen’s coefficient of 1.27 mm. Thus, the results show a significant improvement in the two parameters. The application of the program based on physical exercise led to an improvement in the balance of children with autism under complex evaluation conditions.
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Affiliation(s)
- Andreea Maria Roșca
- Faculty of Physical Education and Sport, University of Craiova, 200585 Craiova, Romania; (A.M.R.); (V.E.V.)
| | - Ligia Rusu
- Faculty of Physical Education and Sport, University of Craiova, 200585 Craiova, Romania; (A.M.R.); (V.E.V.)
- Correspondence:
| | - Mihnea Ion Marin
- Faculty of Mechanics, University of Craiova, 200585 Craiova, Romania;
| | - Virgil Ene Voiculescu
- Faculty of Physical Education and Sport, University of Craiova, 200585 Craiova, Romania; (A.M.R.); (V.E.V.)
| | - Carmen Ene Voiculescu
- Faculty of Physical Education and Sport, Ovidius University of Constant, 900470 Constanța, Romania;
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