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

Focused attention and intrinsic motivation using animations for instruction of fundamental motor skills in children with Down syndrome

BACKGROUND

Children with Down syndrome (DS) demonstrate poorer performance in locomotor and ball skills than children with typical development. During motor assessment, keeping children's attention and motivation is challenging, especially for children with DS, which may affect the test outcomes. This study aimed first to examine the impact of examiner and App-animation demonstrations during the assessment on the performance of fundamental motor skills, focus of attention and intrinsic motivation for children with DS and neurotypical development (NTD). The secondary aim was to examine the differences in those outcomes between children with DS and neurotypical development.

METHODS

A sample of 24 children (10 with DS and 14 with NTD) aged between 3 and 10 years were subjected to two motor performance assessment protocols: a traditional protocol using the Gross Motor Development Test-3 (TGMD-3) and a protocol using animations from an application as support for TGMD-3 (AppP). The focus of attention was obtained from video recordings during protocol instruction (number of eye shifts, eye shift time, instruction focus time, number of instructions required and total instruction time). Intrinsic motivation was assessed by the Intrinsic Motivation Inventory (IMI) at the end of each protocol.

RESULTS

The results showed no significant differences between the protocols for locomotor skills, ball skills and gross motor index. However, children with NTD outperformed those with DS in these skills. When analysing the focus of attention, children with DS showed greater ocular deviations and longer instruction time requested in the traditional protocol compared with AppP, even when compared with NDT children. When comparing protocols in both groups, AppP demonstrated fewer ocular deviations and shorter ocular deviation times. Regarding intrinsic motivation, children with DS in the traditional protocol had lower motivation scores than those with NTD. Regarding the purchase of protocols, in both groups, the AppP presented higher scores for interest/pleasure, perceived competence and general motivation, with lower pressure/tension.

CONCLUSION

The animated application (AppP) proved effective as a visual support during the TGMD-3 assessment, particularly benefiting children with DS by enhancing motivation and attention.

Homogeneity in Motor Competence Among Youths With Intellectual Disability With and Without Down Syndrome

PURPOSE

To determine if there is a homogeneity of scores for youth with intellectual disability (ID) with and without Down syndrome (DS) in 19 test items of motor competence from the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2). Homogeneity was defined as the means for each of the 19 test items scores by sex and the presence or absence of DS sharing the same population mean.

METHOD

Participants were 622 youth with ID aged 6 to 21 years. Items for bilateral coordination, balance, and upper limb coordination were examined using the BOT-2.

RESULTS

For all 19 BOT-2 items, means between youth with and without DS did not differ from the population mean.

CONCLUSION

These results potentiate the development of expected BOT-2 motor competence scores for youth with ID independent of the presence of DS for clinical practice.

Comparing the fundamental movement skill proficiency of children with intellectual disabilities and typically developing children: a systematic review and meta-analysis

BACKGROUND

Children around the world, particularly those with intellectual disabilities (ID), are exhibiting poor motor skill proficiency. Compared with typically developing children (TDC), children with intellectual disabilities (CwID) are 65% more likely to exhibit low levels of motor competence. The purpose of this meta-analysis was to compare the motor skill proficiency levels, in terms of fundamental movement skills (FMS) of CwID to TDC. FMS are the building blocks required for lifelong participation in sport and physical activity.

METHOD

The meta-analysis was conducted according to PRISMA statement guidelines. 6 electronic databases were searched and 16, 679 studies were found. A total of 26 studies (total participants n = 3,525) met the inclusion criteria. A multivariate maximum likelihood multivariate random effects model was fitted to the data using the metafor package in R.

RESULTS

The study showed that the standardised mean difference (Hedges' g) in FMS between TDC and CwID is large (g = 1.24; CI 95% [.87, 1.62]). Specifically, significant differences between the two groups emerged in all five outcomes: (1) total locomotor score, (2) total object manipulation score, (3) balance, (4) run skill and (5) throw skill.

CONCLUSIONS

Further investigation into effective intervention strategies is required in order to reduce the magnitude of difference in motor skill proficiency between the two groups. In addition to developing, implementing and evaluating these interventions, researchers need to work hand in hand with national governing bodies (NGB) of sport and policy makers to ensure that teachers and coaches are being provided with opportunities to upskill in the area of FMS.

Structural modeling of EFL/ESL teachers' physical activity, mental health, psychological well-being, and self-efficacy

BACKGROUND

Physical activity (PA) is known to positively affect individuals' mental and physical health, especially those who experience high levels of stress, such as teachers. Previous studies have examined the relationship between teachers' PA, mental health, and well-being. Still, there is a lack of research on the direct and indirect effects of PA and self-efficacy.

PURPOSE

This study aimed to investigate the structural relationship between teachers' PA, mental health, well-being, and self-efficacy among ESL/EFL teachers. A total of 364 Chinese English language teachers were selected through convenience sampling. Mental health, physical activity, psychological well-being, and self-efficacy instruments were used.

METHODOLOGY

The data was analyzed using Smart PLS software, and the hypothesized model was evaluated. The results indicated an acceptable level of divergent and convergent validity and goodness of fit.

RESULTS

The findings revealed that PA directly predicts teachers' mental health and well-being, but the direct structural relationship between teachers' PA and self-efficacy was not confirmed. However, the results showed that teachers' PA contributes to their self-efficacy by enhancing their mental and psychological well-being. The total effect of teachers' PA on their self-efficacy was significant. Additionally, mental health and psychological well-being strongly influenced teachers' self-efficacy.

CONCLUSION

In conclusion, regular weekly physical activity can help EFL/ESL teachers foster their mental health, psychological well-being, and self-efficacy. These findings have theoretical and practical significance for teachers, trainers, and educational psychologists.

Effects of intervention integrating physical literacy into active school recesses on physical fitness and academic achievement in Chinese children

Background/Objective

The aim of this study was to examine the effects of school-based intervention integrating physical literacy (PL) into active school recesses (ASR) on physical fitness (i.e., body composition, 20-m shuttle run, 50-m run, rope skipping, sit and reach, handgrip) and academic achievement (i.e., academic result of Chinese and Mathematics) in Chinese children.

Methods

A total of 357 children (mean age: 7.8 ± 0.7 years; boys: 50.4%) were recruited from two schools and these two schools were randomly assigned as the intervention group (IG) and the control group (CG), respectively. The IG consisted of 155 children (mean age: 7.9 ± 0.7 years, boys: 51.0%), and 202 children (mean age: 7.8 ± 0.7 years; boys: 50%) were allocated to the CG. Children in the IG received a 10-week intervention integrating PL that was conducted during ASR. In the CG, children's regular school activity was remained during the intervention period. Generalized estimating equation was performed to compare the levels of physical fitness and academic achievement between the IG and the CG after intervention.

Results

Regarding physical fitness, there was a significant group × time interaction on 20-m shuttle run (β = -3.89, 95% CI [-5.08; -2.71], p < 0.001) and handgrip (β = -0.70, 95% CI [-1.20; -0.20], p = 0.006). After intervention, children in the IG had a greater increase than the CG (p < 0.001) in terms of 20-m shuttle run and handgrip. In addition, the post-test analysis indicated that performance of children in the IG was significantly greater than those in the CG (20-m shuttle run: p < 0.001, handgrip: p = 0.002). There was a significant group × time interaction on academic result of Chinese (β = -1.21, 95% CI [-1.91; -0.56], p = 0.001) and academic result of Mathematics (β = 16.71, 95% CI [15.14; 18.143], p < 0.001). Statistically significant positive difference in post-test was observed in academic result of Mathematics between the IG and the CG (p = 0.012).

Conclusion

The results of this intervention study indicate that intervention integrating PL into ASR could bring a promising effect on physical fitness and academic achievement in children. It is recommended that future studies are necessary to assess the effects of ASR-based PL intervention on physical and cognitive outcomes using a wide range of sample.

Associations between motor competence and physical activity levels of children with intellectual disabilities and/or autism spectrum disorder: Movement matters

Motor competence is important for lifelong physical activity (PA). The current study aimed to examine associations between PA and motor competence. In total, 43 children aged 7-12 years with intellectual disabilities and/or autism spectrum disorder completed anthropometric measures, the Bruininks-Oseretsky Test of Motor Proficiency-2, and wore a wrist accelerometer to capture total PA, moderate-to-vigorous PA (MVPA), average acceleration, and intensity gradient. No significant associations were found between PA outcomes and motor competence. Motor competence performance was commonly 'below average' or 'average'. The weakest subtests were upper limb coordination and strength. The strongest subtest was running speed and agility. Total weekly MVPA was 336.1 ± 150.3 min, higher than UK recommendations of 120-180 per week for disabled children and young people. Larger scale studies are needed to better understand the relationship between PA and motor competence. Future research should also consider the influence of environmental factors on PA in this group.

Participation, challenges and needs in children with down syndrome during cancer treatment at hospital: a qualitative study of parents' experiences

Background

Studies report that it can be challenging to assess and treat side-effects and symptoms among children who have impairments and difficulties in expressing their needs. Children with Down syndrome have an increased vulnerability and an increased risk for contracting leukaemia. There is sparse knowledge about the parental experience of how treatment and side-effects affect children with Down syndrome with leukaemia, as well as the role of participation during treatment.

Purpose

This study aimed to explore the perceptions of parents of children with Down syndrome and leukaemia regarding their child's treatment, side effects and participation during hospital care.

Methods

A qualitative study design was used, and interviews were conducted with a semi-structured interview-guide. Fourteen parents of 10 children with Down syndrome and acute lymphoblastic leukaemia from Sweden and Denmark, 1-18 years of age, participated. All children had completed therapy or had a few months left before the end of treatment. Data was analysed according to qualitative content analysis.

Results

Four sub-themes were identified: (1) Continuously dealing with the child's potential susceptibility; (2) Confidence and worries regarding decisions related to treatment regulation; (3) Challenges in communication, interpretation, and participation; and (4) Facilitating participation by adapting to the child's behavioural and cognitive needs. The sub-themes were bound together in an overarching theme, which expressed the core perception "Being the child's spokesperson to facilitate the child's participation during treatment". The parents expressed this role as self-evident to facilitate communication regarding the needs of the child, but also regarding how the cytotoxic treatment affected the vulnerable child. Parents conveyed the struggle to ensure the child's right to receive optimal treatment.

Conclusion

The study results highlight parental challenges regarding childhood disabilities and severe health conditions, as well as communication and ethical aspects regarding to act in the best interests of the child. Parents played a vital role in interpreting their child with Down syndrome. Involving parents during treatment enables a more accurate interpretation of symptoms and eases communication and participation. Still, the results raise questions regarding issues related to building trust in healthcare professionals in a context where medical, psychosocial and ethical dilemmas are present.

Fundamental motor skill proficiency among 7- to 10-year-old children with Down syndrome

[Purpose] The purposes of this study were to assess the fundamental motor skill (FMS) of children with Down syndrome (DS) and to compare their FMS proficiencies to those of chronological age-matched and gender-matched typically developing children (TDC). [Participants and Methods] This cross-sectional study involved a total of 60 participants (30 children with DS and 30 TDC). The FMS proficiency of participants was assessed by using the test of gross motor development, second edition (TGMD-2). The data were analyzed using independent samples t-tests to verify the differences between the two groups and gender. The effect size of Cohen's d was also determined for comparing the two groups. [Results] The results showed that there were significant differences between children with DS and the TDC on locomotor and object control standard scores, and the gross motor quotient (GMQ). However, there were no significant gender-based differences in the locomotor and object control standard scores and the GMQ in both groups. [Conclusion] Based on the current results, the FMS proficiency of children with DS is lower than the TDC. Therefore, a therapeutic intervention program is necessary for children with DS to improve their FMS proficiency.

Associations between Fundamental Movement Skills and Moderate-to-Vigorous Intensity Physical Activity among Chinese Children and Adolescents with Intellectual Disability

Higher physical activity (PA) levels will obtain more health-related benefits for children and adolescents with intellectual disabilities (ID). The mastery of fundamental movement skills (FMS) potentially correlates with PA. This study aimed to examine the associations of FMS with moderate-to-vigorous intensity physical activity (MVPA) levels in children and adolescents with moderate to severe ID. Moreover, this research analyzes whether there are gender and age differences in the association between these two variables. A total of 93 children and adolescents with ID, aged 8-17 years (mean age = 13.27; SD = 3.35), were recruited from a special school located in western China. The time spent in MVPA was measured using waist-worn accelerometers. FMS proficiency was assessed using the Test of Gross Motor Development 2 (TGMD-2). Children and adolescents with ID tend to have delayed maturity of FMS patterns (locomotor skills t (92) = -16.91, p < 0.001, d = 2.48; object control skills t (92) = -25.39, p < 0.001, d = 3.72; total FMS t (92) = -21.83, p < 0.001, d = 3.20) and lower proficiency in objective control skills (t (92) = 3.989, p < 0.001, d = 0.29). A significant positive correlation was found between MVPA and FMS, and this association was moderated by gender and age. For boys, object control skills were a significant predictor of MVPA time (B = 0.842, p < 0.01), whereas locomotor skills were a significant predictor of MVPA time (B = 0.472, p < 0.05) for girls. For children with ID, object control skills were a significant predictor of MVPA time (B = 0.736, p < 0.05). Proficiency in FMS has a positive effect on increasing the level of MVPA in children and adolescents with ID. Gender and age factors should be considered when implementing FMS intervention programs.

Motor Coordination and Global Development in Subjects with Down Syndrome: The Influence of Physical Activity

Background: Many research studies have investigated motor impairments and delayed development in children with Down Syndrome (DS). However, very few studies detected these features in adults with DS. Hence, this study aimed to investigate the relationship between motor coordination and global development in subjects with DS, including adults. Furthermore, the second aim was to detect any differences in motor coordination and global development as a function of the practice of physical activity (PA) in this population. Methods: Twenty-five participants with DS (10 f, 15 m), with a chronological mean age of 27.24 years and development mean age of cognitive area of 4.93 years, were enrolled and divided into a physically active group (PA-G; n = 15) and a physically inactive group (PI-G; n = 10). All participants performed the Movement Assessment Battery for Children (M-ABC) to assess fine and gross motor skills, while the Developmental Profile 3 (DP-3) checklist was administered to the parents in order to screen strengths and weaknesses of five developmental areas of their relatives with DS. Results: Our results showed positive correlations between the following variables: global motor coordination and global development, global motor coordination and adaptive behavior development area, aiming and catching skills and global development, aiming and catching skills and adaptive behavior development area. As for the practice of PA, PA-G showed higher scores than PI-G in all the tasks of both the M-ABC and the DP-3, though significant differences were found only for the global motor coordination, for the aiming and catching skills, as well as for the physical development area. Conclusions: The findings of this study reinforce the need to implement and encourage the practice of PA in order to promote well-being and social inclusion in subjects with DS.

Therapeutic exercise to improve motor function among children with Down Syndrome aged 0 to 3 years: a systematic literature review and meta‑analysis

The effects and the prescription parameters of therapeutic exercise are not clear. For this reason, is needed to determine the effect of therapeutic exercises on the motor function of children with Down Syndrome (DS) aged 0 to 3 years. The present study is systematic review and meta-analysis of effectiveness outcomes in this population: gait, balance, motor development, fine motor skills, and executive functions. The databases of PubMed, PEDro, EMBASE, SCIELO, Lilacs, Cochrane library were searched from January to December 2019. We recruited Randomized Controlled Trials (RCTs) which met the inclusion criteria in our study. Six studies and 151 participants were included. Two types of therapeutic exercises, aerobic and neuromuscular, were identified. Both types of exercise were effective in improving outcomes. There were no differences between the modes of application of the exercise. No differences were identified between the treadmill and the physiotherapy plan for the reduction of the time to reach independent walking, Mean Difference (MD) 46.79, 95% Confidence Interval (IC) (- 32.60, 126.19), nor for the increase in walking speed MD 0.10 IC (- 0.02, 0.21) m/s. This study suggests that aerobic exercise therapy has a potentially effective role to promote the gait and motor development of children with DS aged 0 to 3 years when it is applied using a treadmill with a frequency of 5 days, a duration of 6-8 min, and an intensity of between 0.2 and 0.5 m/s. Studies with less heterogeneity and larger sample sizes are required.

The Effects of Resistance Training on Physical Fitness and Neuromotor-Cognitive Functions in Adults With Down Syndrome

Adults with Down syndrome are an underserved population at high risk for a host of different pathologies from aging and lack of activity.

Assessing motor competence in kicking in individuals with Down syndrome through wearable motion sensors

BACKGROUND

Kicking a ball is a very frequent action in sport and leisure time activities and a low proficiency in this skill could limit the participation in recreational sport activities. This issue is emphasised in individuals with Down syndrome (IDS) for which data about motor competence in kicking are limited to children. Here, we aim at evaluating the kicking competence of IDS combining a qualitative and a quantitative method.

METHODS

Twenty-three adult IDS and 21 typically developed individuals (ITD) volunteered to participate in the study. Peak-to-peak 3D linear acceleration and angular velocity were recorded at 200 samples/s using two inertial measurement units placed on the lower back and lateral malleolus of the dominant limb during kicking. Motor competence in kicking was assessed according to the criteria proposed in the test of gross motor development version 3 (TGMD-3).

RESULTS

Individuals with Down syndrome showed lower motor competence (ITD: 5.9 ± 1.2; IDS: 3.2 ± 2.0) and lower angular velocities about the cranio-caudal (ITD: 3.0 ± 1.8; IDS: 2.1 ± 1.1 rad/s) and medio-lateral axes (ITD: 4.5 ± 1.5; IDS: 3.0 ± 1.1 rad/s) of the trunk compared with ITD. Shank angular velocity about the medio-lateral axis was lower in IDS (ITD: 14.3.6 ± 4.0; IDS: 9.9 ± 2.8 rad/s).

CONCLUSIONS

The lower trunk angular velocity in IDS may limit the possibility to rely on the proximal-to-distal sequencing commonly observed in kicking and generate high shank angular velocity upon ball impact. The lower trunk angular velocity may result from orthopaedic features of the pelvic girdle and possibly from a poorer neuromuscular control of core muscles.

Motor Competence in Individuals with Down Syndrome: Is an Improvement Still Possible in Adulthood?

In children, motor competence (MC) and the amount of physical activity are tightly interconnected. In adults with Down syndrome (DS), MC has been poorly addressed, resulting in a limited understanding of the possibility to improve MC over time. Here, we aim to: (1) investigate MC in adults with DS by comparing them with a group of typically developed peers and (2) verify the effect of an adapted karate program on MC. Adults with DS (DSG; n = 57) and typically developed adults (TDG; n = 21) performed the Test of Gross Motor Development version 3 (TGMD-3). The total TGMD-3 score (^TOTTGMD-3), the locomotor (^LOCTGMD-3), and object control (^OBJTGMD-3) scores were computed. After a 40 week adapted karate program, DSG (n = 37) underwent the post-training TGMD-3 assessment. Compared to TDG, DSG showed lower ^TOTTGMD-3 (DSG: 45.5 ± 17.3; TDG: 77.3 ± 9.5), ^LOCTGMD-3 (DSG: 22.2 ± 10.0; TDG: 36.2 ± 7.6) and ^OBJTGMD-3 (DSG: 23.3 ± 10.9; TDG: 41.1 ± 5.6). After the training, ^TOTTGMD-3, ^LOCTGMD-3 and ^OBJTGMD-3 increased by 35.6%, 30.0% and 40.7%, respectively. Our results suggest that MC acquisition does not evolve into a mature form in adulthood in individuals with DS. Moreover, a brief exposure to an adapted karate program induces an increase in motor competence in DS, even in adulthood.

Does the combination of physical activity and attention training affect the motor skills and cognitive activities of individuals with mild intellectual disability?

Individuals with mild intellectual disability (MID) were worse than their peers who typically develop in motor skills and attention-demanding assignments. In this study, effect of a 14-week physical activity and attention training practise on the motor skills, visual retention, perception and attention levels of students with MID were analysed. Twenty-two individuals between 7 and 14 ages participated voluntarily. Activities based on developing attention skills and physical activities enhancing fine-gross motor skills (40 + 60 min./2 days/14 weeks) were given to the experimental group. d2 Test of Attention, Benton Visual Retention and Bruininks-Oseretsky Test of Motor Proficiency-2nd version tests were used as data collection tools. There was significant difference in terms of total number of items processed, commissions, raw score of errors, total number of items minus error scores, concentration performance, Benton visual retention test and perception, fine motor skill precision, fine motor skill integration, manual dexterity and upper-limb coordination values regarding group and time dependant (p< .05). However, there was no significant difference in omissions and fluctuation rate values (p> .05). As a result; it is determined that the combination of physical activity and attention training practises features a positive effect on visual retention, perception, attention and motor skill levels of students with MID.

Comparison of Lower and Upper Quarter Y Balance Test Performance in Adolescent Students with Borderline Intellectual Functioning Compared to Age- and Sex-Matched Controls

The Lower (YBT-LQ) and Upper (YBT-UQ) Quarter Y Balance Test are well established assessment tools for the examination of dynamic balance and shoulder mobility/stability, respectively. However, investigations on YBT-LQ/UQ performance in students with borderline intellectual functioning (BIF) (i.e., intelligence quotient of 70–84 etc.) are lacking. Thus, the aim of the study was to compare YBT-LQ/UQ performance in students with and without BIF. Thirty students with BIF (age: 13.7 ± 1.2 years) and 30 age-/sex-matched students without BIF (age: 13.7 ± 1.3 years) performed the YBT-LQ and/or YBT-UQ. Normalized maximal reach distances (% leg/arm length) per reach direction and the composite score were used as outcome measures. A univariate analysis of variance was conducted to test for significant group differences. Irrespective of limb and reach direction, students with BIF compared to those without BIF showed significantly worse YBT-LQ (p ≤ 0.001–0.031; Cohen’s d = 0.57–1.26) and YBT-UQ (p ≤ 0.001–0.015; Cohen’s d = 0.68–1.52) performance with moderate to large effect sizes. Due to the poorer performance levels of students with BIF, specifically tailored interventions should be developed that have the potential to improve their dynamic balance and shoulder mobility/stability.

A New Perspective on the Role of Self-Confidence and Confidence in the Evaluation and Rehabilitation of Children With Adverse Life Experience and Borderline Intellectual Functioning: A Preliminary Study

The borderline intellectual functioning (BIF) is a neurodevelopmental condition characterized by a borderline intelligence quotient (range 70-85) with difficulties in cognitive and social domains. Children with BIF often live in adverse conditions and show academic and behavioral difficulties. Rehabilitation programs for these children focus mainly on cognitive aspects, sometimes with the aid of new technologies that are able to engage and motivate. In this framework, the affective development of children with BIF and its possible role both in the difficulties they manifest and in the rehabilitation is still poorly investigated. In this work, we investigate the characteristics of the internal working models of these children by applying the separation anxiety test, using both the classical and a new coding system to identify the specific features of the attachment representation. Results delineate a profile characterized by low self-confidence and high separation anxiety, with a tendency to somatization. In the light of these results, we suggest that this attachment profile has an impact on the therapeutic relationships and on the efficacy in the use of technological devices. We propose a new perspective in which the interpersonal relationship with the psychologist and the support of the self-confidence of children are crucial to treating cognitive and behavioral difficulties in children with BIF. Only in this case, the use of new technologies and tools may be effective in promoting the greatest possible benefit from therapeutic interventions.

A Pilot Study of a Parent-Mediated, Web-Based Motor Skill Intervention for Children With Down Syndrome: Project SKIP

To inform the development of scalable and sustainable fundamental motor skill interventions for children with Down syndrome, this study examined the feasibility and preliminary effectiveness of Project Skill Intervention Implemented by Parents (Project SKIP), a web-based, parent-mediated intervention intended to improve ball skills among children with Down syndrome. Twenty-four families enrolled in the study (including 13 boys and 11 girls; Mage = 4.92). Fourteen children were assigned to an experimental group and participated in the 6-week intervention, and 10 children served as the inactive comparison group. The Test of Gross Motor Development-3 was administered preintervention and postintervention. In addition, parents of children in the experimental group completed a postintervention survey to assess their perceptions of Project SKIP. Following the intervention, there was a significant improvement in ball skills (p = .023, d = 0.86) for children in the experimental group, whereas the comparison group did not show significant improvement. Moreover, parents perceived Project SKIP to be feasible and effective; all parents reported being satisfied with their overall experience in the program, and 11 parents indicated that their child's fundamental motor skills were positively influenced by the intervention. Engagement was high, with the majority of parents (n = 8, 57%) interacting with Project SKIP content three to four times a week.

Hopping skill in individuals with Down syndrome: A qualitative and quantitative assessment

INTRODUCTION

Individuals with Down syndrome (DS) show a delayed acquisition of gross motor skills. Among gross motor skills, hopping is a particular form of jumping that can be performed using one leg. Despite its large use during play and physical activity, this skill in adults with DS has not received much attention so far. Here, we aim at investigating hopping skill in adults with DS both from a quantitative and qualitative point of view.

METHODS

Center of mass and dominant leg kinematics during hopping over distance were recorded from 24 adult individuals with DS and from 21 typically developed adults (TD) using two inertial measurement units positioned on the posterior aspect of the lower back and on the lateral malleolus of the hopping leg. From linear acceleration and angular velocity signals, hopping frequency (HF), cycle, stance and flight duration (CD, SD, FD), vertical stiffness (K_V) and peak to peak linear acceleration and angular velocities about the cranio-caudal, antero-posterior and medio-lateral axes were extracted. A qualitative process assessment of the hopping skill was carried out using the performance criteria of the test for gross motor development (TGMD-3). The extracted parameters were submitted to analysis of covariance, with stature as a covariate to rule-out possible confounding effects.

RESULTS

The qualitative assessment highlighted a poorer hopping performance in the DS group compared to the TD group. DS participants showed higher HF and K_V, shorter CD, SD, FD and lower angular velocity about the cranio-caudal axis compared to the TD group. Significant correlations between the temporal parameters of the quantitative assessment and the results of the qualitative assessment were observed.

DISCUSSION

The poorer motor competence in hopping in individuals with DS compared to TD peers may be related to the shorter flight time and higher vertical stiffness observed in TD peers. The adopted instrumental approach, overcoming the limitations of subjective evaluations, represents a promising opportunity to quantify motor competence in hopping.

The Test-Retest Reliability of the Bruininks-Oseretsky Test of Motor Proficiency-Short Form in Youth with Down Syndrome-A Pilot Study

Background: It is unclear whether assessments of motor proficiency are reliable for individuals with Down syndrome. The purpose of the study was to evaluate the test–retest reliability of the Bruininks–Oseretsky Test of Motor Proficiency-Short Form (BOT-2 SF) in youth with Down syndrome. Methods: Ten youth (ages 13.1–20.7 years) with Down syndrome completed the BOT-2 SF (14 items) plus a standing long jump on two separate occasions. Intraclass correlation coefficients (ICC), 95% confidence intervals (CIs), and standard error of measurement (SEM) were calculated to determine the test–retest reliability of the BOT-2 SF and the standing long jump. Results: The test–retest reliability of the BOT-2 SF overall scores and percentile rankings were considered excellent. The test–retest reliability of each of the subtests varied with classifications of poor (n = 5), fair to good (n = 6), and excellent (n = 4). Conclusion: Current evidence suggests that children with Down syndrome have reduced motor skills. However, there appears to be a lack of assessment tools that reliably evaluate the motor skills of this population. The results from this investigation suggest that the BOT-2-SF provides “excellent reliability” (≥0.75) to assess the motor skills in youth with Down syndrome.

Bipedal hopping as a new measure to detect subtle sensorimotor impairment in people with multiple sclerosis

BACKGROUND

Bipedal hopping has the potential to detect subtle multiple sclerosis (MS)-related impairments, especially among patients who "pass" typical movement tests. In this narrative review, we outline the biomechanics of bipedal hopping and propose its usefulness as a novel outcome measure for people with MS having mild disability.

METHODS

We summarize articles that (1) examined the biomechanics of jumping or hopping and (2) tested the validity and/or reliability of hopping tests. We consolidated consistencies and gaps in research and opportunities for future development of the bipedal hop test.

RESULTS

Bipedal hopping requires immense power, coordination, balance, and ability to reduce co-contraction; movement components typically affected by MS. These impairments can be measured and differentiated by examining specific variables, such as hop length (power), symmetry (coordination), center of pressure (balance), and coefficient of variability (co-contraction/spasticity). Bipedal hopping challenges these aspects of movement and exposes sensorimotor impairments that may not have been apparent during walking.

CONCLUSIONS

Testing of bipedal hopping on an instrumented walkway may detect and monitor sensorimotor control in people with MS who do not currently present with clinical deficits. Early measurement is imperative for precise rehabilitation prescription to slow disability progression prior to onset of measurable gait impairment.Implications for rehabilitationJumping and hopping tests detect lower limb and balance impairments in children, athletes, and older adults.Bipedal hop test measures multiple domains: power, coordination, balance, and muscle timing.Bipedal hop test may expose subtle sensorimotor impairments in people with multiple sclerosis.Multiple variables measured can discern type of sensorimotor impairment to direct personalized rehabilitation programs.

EFFECTS OF KAYAKING ON MOTOR SKILLS IN CHILDREN AND ADOLESCENTS WITH DOWN SYNDROME

ABSTRACT Introdução A síndrome de Down (SD) é uma afecção genética que se caracteriza por distribuição numérica inadequada no pareamento cromossômico, com material genético extra relacionado com o par 21 que leva a alterações que afetam o desenvolvimento de diversos componentes motores. Objetivos Analisar os efeitos do treinamento de canoagem durante oito semanas sobre as habilidades motoras grossas em crianças e adolescentes com SD. Métodos Sete indivíduos com SD (10,8 ± 2 anos), quatro do sexo masculino e três do sexo feminino participaram do estudo. Para avaliar as habilidades motoras grossas, empregou-se a bateria de Teste de Coordenação Corporal para Crianças (Körperkoordination Test für Kinder, KTK). O teste de Wilcoxon foi usado para comparar os valores de habilidades motoras grossas antes e depois do KTK e o teste de Mann-Whitney foi usado para comparar os indivíduos por sexo. O tamanho do efeito foi calculado pela escala de Cohen (1977) e nível de significância de p < 0,05 foi adotado. Resultados Os indivíduos apresentaram resultados estatisticamente significativos em todas as tarefas do teste de coordenação motora grossa e o efeito produzido pela intervenção foi moderado. Conclusão Conclui-se que oito semanas de treinamento de canoagem são suficientes para produzir desenvolvimento das habilidades motoras grossas de crianças e adolescentes com Síndrome de Down. Nível de Evidência IV; Série de casos.

Walking capacity in boys with Down's syndrome in Saudi Arabia

Background/Aims

Children with Down's syndrome are often considered to be sedentary and less likely to engage in the recommended levels of physical activity. The aim of this study was to compare the walking capacity of male children with Down's syndrome with a group of typically healthy age-matched children in Saudi Arabia.

Methods

A total of 78 male children aged from 8 to 12 years participated in the study. They were divided into two groups. The first group comprised 37 male children with Down's syndrome, recruited from the Down's Syndrome Charitable Association and Al-Nahda Schools. The second group comprised 41 male children with typical development, who were recruited from regular schools in the same region. Walking capacity was measured with the 6-Minute Walk Test.

Results

The children with Down's syndrome had significantly reduced 6-Minute Walk Distance scores than children with typical development.

Conclusions

There is a need to establish good strategies, programmes and early interventions designed to promote physical activity levels and improve the quality of life for people with Down's syndrome.

Rehabilitation and Disability Spectrum From Adverse Childhood Experience: The Impact of the Movement Cognition and Narration of Emotions Treatment (MCNT) Version 2.0

Adverse Childhood Experiences (ACE) are associated with an increased risk of cerebral, behavioral, and cognitive outcomes, and vulnerability to develop a Borderline Intellectual Functioning (BIF). BIF is characterized by an intelligence quotient (IQ) in the range 70-85, poor executive functioning, difficulties in emotion processing, and motor competencies. All these difficulties can lead to mental and/or neurodevelopmental disorders that require long-term care. Accordingly, we developed an intensive and multidomain rehabilitation program for children with ACE and BIF, termed the Movement Cognition and Narration of emotions Treatment (MCNT1.0). The efficacy of MCNT1.0 on cognitive and social functioning was demonstrated with a previously reported randomized controlled trial (RCT). To extend the impact of the treatment also to the motor domain a new version, called MCNT2.0, was implemented. The present study aims to verify the feasibility of MCNT2.0 and its effects on the motor domain. A quasi-experimental approach was used in which a group of 18 children with ACE and BIF were consecutively recruited and participated in the MCNT 2.0 program. Participants were compared with the MCNT1.0 group as an active comparator, using the dataset of the RCT. The two groups received a full evaluation comprising: the Wechsler Intelligent Scale for Children-IV (WISC-IV), the Movement-ABC (M-ABC), the Test of Gross Motor Development (TGMD), the Social Skills from Vineland Adaptive Behavioral Scale-II (VABS-II) and the Child Behavior Check List 6-18 (CBCL). An ANCOVA was carried out on changes in the scale scores from baseline with age and baseline score as covariates. Results showed a mean adherence to treatment of 0.85 (sd = 0.07), with no differences between groups in IQ, and Social Skills changes, while greater improvements for motor abilities were shown in the MCNT 2.0 group: M-ABC (p = 0.002), and TGMD (p = 0.002). Finally, greater improvement in the CBCL scale was observed in the MCNT 1.0 group (p = 0.002). Results indicate that due to its positive effects on cognitive, social participation and motor domains, MCNT2.0 may represent a protective factor against maladaptive outcomes of children with ACE and BIF.