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Alharbi M, Du H, Harris D, Wood G, Dodd H, Buckingham G. Evaluating the impact of virtual reality game training on upper limb motor performance in children and adolescents with developmental coordination disorder: a scoping review using the ICF framework. J Neuroeng Rehabil 2024; 21:95. [PMID: 38840217 PMCID: PMC11151681 DOI: 10.1186/s12984-024-01393-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 05/30/2024] [Indexed: 06/07/2024] Open
Abstract
OBJECTIVE This scoping review aims to explore published literature testing Virtual Reality (VR) interventions for improving upper limb motor performance in children and adolescents with Developmental Coordination Disorder (DCD). Our primary focus was on the types of VR systems used and the measurement tools employed within the International Classification of Functioning, Disability and Health Children and Youth Version (ICF-CY) domains in these studies. METHODS A comprehensive search of six electronic databases up to 11th January 2024 was conducted using predefined terms. Inclusion and exclusion criteria were applied to determine study eligibility, with two authors independently assessing titles, abstracts, and full-text articles. RESULTS Out of 788 potential studies, 14 met the eligibility criteria. Studies predominantly utilized non-immersive VR (nVR) systems, for example, commercial platforms such as Nintendo Wii. Most interventions targeted general motor coordination or balance, with only four studies specifically focusing on upper limb motor performance. The Movement Assessment Battery for Children-2 was the predominant assessment tool. However, the use of game scores and trial durations raised concerns about the accuracy of assessments. The majority of studies reported no significant improvement in upper limb motor performance following VR interventions, though some noted improvements in specific tasks or overall outcomes. CONCLUSION The findings suggest that, while nVR interventions are being explored for paediatric motor rehabilitation, their impact on enhancing upper limb motor performance in children with DCD is unclear. The variability in intervention designs, outcome measures, and the predominant focus on general motor skills rather than specific upper limb improvements highlight the need for more targeted research in this area. IMPACT This review underscores the importance of developing precise and clinically relevant measurement tools in a broader range of VR technologies to optimize the use of VR in therapy for children with DCD. Future research should aim for more rigorous study designs and emerging immersive technologies to maximize therapeutic benefits.
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Affiliation(s)
- Mohammed Alharbi
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK.
- Department of Physical Therapy, Faculty of Applied Medical Sciences, University of Hail, Hail, Kingdom of Saudi Arabia.
| | - Haoyang Du
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK
| | - David Harris
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK
| | - Greg Wood
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - Helen Dodd
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK
| | - Gavin Buckingham
- Department of Public Health and Sport and Sciences, University of Exeter, Exeter, UK
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Draghi TTG, Smits-Engelsman B, Godoi-Jacomassi D, Cavalcante Neto JL, Jelsma D, Tudella E. Short- and Long-Term Changes in Balance After Active Video Game Training in Children With and Without Developmental Coordination Disorder: A Randomized Controlled Trial. Motor Control 2024:1-19. [PMID: 38290498 DOI: 10.1123/mc.2023-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 11/29/2023] [Accepted: 12/12/2023] [Indexed: 02/01/2024]
Abstract
Active video games (AVG) have been used as training tools and are known to ameliorate balance performance in children with Developmental Coordination Disorder (DCD). Our aim was to evaluate balance using clinical tests and by measuring body sway using a force plate with a mixed design of vision (eyes open/eyes closed), surface (rigid/soft), and support (stance/semitandem) before, and after, training and 4 months later (follow-up). Thirty-six DCD children and 40 typically developing children participated in the study, of which 50 children (26 DCD; 24 typically developing) were retested after 4 months. Balance improved on the clinical measures after the training, which was independent of type of AVG (Wii-Fit and Xbox Kinect) used, and this effect was still present after 4 months. The AVG training did not influence general sway behavior, but only sway in the eyes-open condition, corresponding with task demands of the training and indicating a training-specific effect. Overall, DCD children and typically developing children responded comparably to the AVG training, thereby maintaining the gap in performance between the two groups. The changes in postural sway are interpreted as a sign of more confidence and less freezing of the joints, enabling greater flexibility of movements and balance strategies as supported by the improved performance on balance tests in the DCD children. This is the first study that showed long-term effects of AVG training on balance performance. However, these follow-up results should be interpreted with caution given that 35% of the children were lost in follow-up.
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Affiliation(s)
- Tatiane Targino Gomes Draghi
- Núcleo de Estudos em Neuropediatria e Motricidade-NENEM, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Bouwien Smits-Engelsman
- Department of Health & Rehabilitation Sciences, Faculty of Health Sciences, Division of Physiotherapy, University of Cape Town, Cape Town, South Africa
- Physical Activity, Sport and Recreation, Faculty Health Sciences, North-West University, Potchefstroom, South Africa
| | - Daniela Godoi-Jacomassi
- Motor Behavior Laboratory, Department of Physical Education, Federal University of São Carlos, São Carlos, SP, Brazil
| | | | - Dorothee Jelsma
- Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Eloisa Tudella
- Núcleo de Estudos em Neuropediatria e Motricidade-NENEM, Department of Physical Therapy, Federal University of São Carlos, São Carlos, SP, Brazil
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Abdollahipour R, Valtr L, Banátová K, Bizovská L, Klein T, Svoboda Z, Steenbergen B, Wilson PH. Motor-cognitive coupling is impaired in children with mild or severe forms of developmental coordination disorder. Front Hum Neurosci 2023; 17:1252852. [PMID: 37941568 PMCID: PMC10628065 DOI: 10.3389/fnhum.2023.1252852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Children with developmental coordination disorder (DCD) show deficits in motor-cognitive coupling. However, it remains unclear whether such deficits depend on the severity of DCD. The aim of this study was to examine cognitive-motor coupling under different levels of inhibitory control in children with severe (s-DCD) or moderate DCD (m-DCD), compared with typically-developing children (TDC). The performance of 29 primary-school children aged 6-12 years with s-DCD (Mage = 9.12 ± 1.56 years), 53 m-DCD (Mage = 8.78 ± 1.67 years), and 201 TDC (Mage = 9.20 ± 1.50 years) was compared on a double jump reaching task (DJRT) paradigm, presented on a large 42-inch touchscreen. The task display had a circular home-base, centred at the bottom of the display, and three target locations at radials of -20°, 0°, and 20°, 40 cm above the home-base circle. For the standard double-jump reaching task (DJRT), children moved their index finger from home-base circle to touch the target stimulus as fast as possible; 20% were jump trials where the target shifted left or right at lift-off. For the anti-jump reaching task (AJRT), 20% of trials required an anti-jump movement, touching the contralateral target location. While no group differences were shown on the DJRT, the DCD group were slower to complete reaching movements than the TDC group on AJRT; on the latter, the two DCD sub-groups were not shown to differ. Results confirm the presence of motor inhibition deficits in DCD which may not be dependent on the motor severity of the disorder.
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Affiliation(s)
- Reza Abdollahipour
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Ludvík Valtr
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Kamila Banátová
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Lucia Bizovská
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Tomáš Klein
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Zdeněk Svoboda
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Bert Steenbergen
- Department of Pedagogical and Educational Sciences, Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Peter Henry Wilson
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
- 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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Bendixen JB, Biddinger BT, Simon JE, Monfort SM, Grooms DR. Effects of virtual reality immersion on postural stability during a dynamic transition task. Sports Biomech 2023:1-15. [PMID: 36597788 PMCID: PMC10847845 DOI: 10.1080/14763141.2022.2162434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 12/20/2022] [Indexed: 01/05/2023]
Abstract
Dynamic postural stability paradigms with virtual reality (VR) provide a means to simulate real-world postural challenges and induce customised but controlled perturbations. The purpose of this study was to determine the effects of a VR unanticipated perceptual sport perturbation on postural stability compared to traditional methods. Sixteen individuals between the ages of 18-23 years (19.5 ± 1.4 years) with no history of injury within 12 months were recruited. A double-leg to single-leg transition task was performed on a force plate in one of the following conditions: eyes open (EO), eyes closed (EC), a sport video with a standard non-immersive computer monitor (SV), and VR. The VR and SV conditions used a pre-recorded tackle avoidance task video where participants shifted to a leg in the opposite direction of a simulated opponent, while EC and EO were completed with auditory prompts. Relative to the EO condition, EC and VR induced greater postural instability. The largest effect sizes were between VR and EO for path length (g = 3.57), mean velocity anterior-posterior centre of pressure (CoP) (g = 3.65), and mean velocity medial-lateral CoP (g = 3.27). By including VR, the difficulty of a clinically based postural stability task was increased to the level of EC while accounting for the sporting environment.
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Affiliation(s)
- Jake B. Bendixen
- School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Ben T. Biddinger
- School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
| | - Janet E. Simon
- School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
| | - Scott M. Monfort
- Department of Mechanical and Industrial Engineering, Montana State University, Bozeman, MT, USA
| | - Dustin R. Grooms
- School of Applied Health Sciences and Wellness, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA
- School of Rehabilitation and Communications Science, College of Health Sciences and Professions, Ohio University, Athens, OH, USA
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Cheng YTY, Chung LMY, Chung JWY, Schooling CM, Gao Y, Bae YH, Tsang WWN, Fong SSM. Atypical adaptive postural responses in children with developmental coordination disorder: Implications for rehabilitation. Gait Posture 2022; 98:141-145. [PMID: 36122429 DOI: 10.1016/j.gaitpost.2022.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/28/2022] [Accepted: 09/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Adaptive postural control is an important yet underexamined area in children with developmental coordination disorder (DCD). This study compared adaptive postural responses between children with DCD and those with typical development. METHODS This was an exploratory cross-sectional study. Fifty-two children with DCD (aged 6-9 years) and 52 age- and sex-matched children with typical development participated in the study. Their adaptive postural (motor) responses were assessed using the Adaptation Test (ADT) on a computerized dynamic posturography machine. The sway energy score (SES) for each ADT trial and the average SES of five trials for both toes-up and toes-down platform inclination conditions were recorded. RESULTS The SESs were lower in the DCD group than in the control group in ADT toes-up trial 1 (p = 0.009) and on average (p = 0.044). In the control group, the SES decreased from trial 1 to trial 2 for both the ADT toes-up (p = 0.005) and toes-down conditions (p < 0.001). SIGNIFICANCE Adaptive postural responses were absent in children with DCD, and these children used less force (i.e., sway energy) to overcome postural instability. Therefore, both adaptive balance and neuromuscular training should be factored into rehabilitation programs for children with DCD.
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Affiliation(s)
- Yoyo T Y Cheng
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Louisa M Y Chung
- Department of Health and Physical Education, Education University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Joanne W Y Chung
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong Special Administrative Region of China
| | - Catherine Mary Schooling
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region of China; Graduate School of Public Health and Health Policy, City University of New York, New York, USA
| | - Yang Gao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong Special Administrative Region of China
| | - Young-Hyeon Bae
- Korea National Rehabilitation Center, Department of Healthcare and Public Health, Rehabilitation Research Institute, Seoul 01022, the Republic of Korea
| | - William W N Tsang
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong Special Administrative Region of China; Department of Rehabilitation Sciences, Hong Kong Polytechnic University, Hong Kong Special Administrative Region of China
| | - Shirley S M Fong
- School of Public Health, University of Hong Kong, Hong Kong Special Administrative Region of China; Department of Health and Physical Education, Education University of Hong Kong, Hong Kong Special Administrative Region of 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: 26] [Impact Index Per Article: 13.0] [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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