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Blank R, Smits-Engelsman B, Polatajko H, Wilson P. European Academy for Childhood Disability (EACD): recommendations on the definition, diagnosis and intervention of developmental coordination disorder (long version). Dev Med Child Neurol 2012; 54:54-93. [PMID: 22171930 DOI: 10.1111/j.1469-8749.2011.04171.x] [Citation(s) in RCA: 381] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Consensus Development Conference |
13 |
381 |
2
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Wilson PH, Ruddock S, Smits-Engelsman B, Polatajko H, Blank R. Understanding performance deficits in developmental coordination disorder: a meta-analysis of recent research. Dev Med Child Neurol 2013; 55:217-28. [PMID: 23106668 DOI: 10.1111/j.1469-8749.2012.04436.x] [Citation(s) in RCA: 305] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIM Developmental coordination disorder (DCD) is a significant disorder of childhood, characterized by core difficulties in learning fine and/or gross motor skills, and the attendant psychosocial problems. The aim of the meta-analysis presented here (the first on DCD since 1998) was to summarize trends in the literature over the past 14 years and to identify and describe the main motor control and cognitive deficits that best discriminate children with DCD from those without. METHOD A systematic review of the literature published between January 1997 and August 2011 was conducted. All available journal papers reporting a comparison between a group of children with DCD and a group of typically developing children on behavioural measures were included. RESULTS One hundred and twenty-nine studies yielded 1785 effect sizes based on a total of 2797 children with DCD and 3407 typically developing children. Across all outcome measures, a moderate to large effect size was found, suggesting a generalized performance deficit in children with DCD. The pattern of deficits suggested several areas of pronounced difficulty, including internal (forward) modelling, rhythmic coordination, executive function, gait and postural control, catching and interceptive action, and aspects of sensoriperceptual function. INTERPRETATION The results suggest that the predictive control of action may be a fundamental disruption in DCD, along with the ability to develop stable coordination patterns. Implications for theory development and intervention are discussed.
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Meta-Analysis |
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305 |
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Smits-Engelsman B, Klerks M, Kirby A. Beighton score: a valid measure for generalized hypermobility in children. J Pediatr 2011; 158:119-23, 123.e1-4. [PMID: 20850761 DOI: 10.1016/j.jpeds.2010.07.021] [Citation(s) in RCA: 229] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Revised: 06/15/2010] [Accepted: 07/13/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the validity of the Beighton score as a generalized measure of hypermobility and to measure the prevalence of hypermobility and pain in a random population of school age children. STUDY DESIGN Prospective study of 551 children attending various Dutch elementary schools participated; 47% were males (258) and 53% (293) females, age range was 6 to 12 years. Children's joints and movements were assessed according to the Beighton score by qualified physiotherapists and by use of goniometry measuring 16 passive ranges of motion of joints on both sides of the body. RESULTS More than 35% of children scored more than 5/9 on the Beighton score. Children who scored high on the Beighton score also showed increased range of motion in the other joints measured. Moreover 12.3% of children had symptoms of joint pain, and 9.1% complained of pain after exercise or sports. Importantly, this percentage was independent of the Beighton score. There were no significant differences in Beighton score for sex in this population. CONCLUSION The Beighton score, when goniometry is used, is a valid instrument to measure generalized joint mobility in school-age children 6 to 12 years. No extra items are needed to improve the scale.
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Validation Study |
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229 |
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Wilson PH, Smits-Engelsman B, Caeyenberghs K, Steenbergen B, Sugden D, Clark J, Mumford N, Blank R. Cognitive and neuroimaging findings in developmental coordination disorder: new insights from a systematic review of recent research. Dev Med Child Neurol 2017; 59:1117-1129. [PMID: 28872667 DOI: 10.1111/dmcn.13530] [Citation(s) in RCA: 146] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/17/2017] [Indexed: 11/29/2022]
Abstract
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.
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Review |
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146 |
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Smits-Engelsman B, Vinçon S, Blank R, Quadrado VH, Polatajko H, Wilson PH. Evaluating the evidence for motor-based interventions in developmental coordination disorder: A systematic review and meta-analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 74:72-102. [PMID: 29413431 DOI: 10.1016/j.ridd.2018.01.002] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 01/07/2018] [Accepted: 01/13/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND As part of the process of creating an update of the clinical practice guidelines for developmental coordination disorder (DCD) (Blank, Smits-Engelsman, Polatajko, & Wilson, 2012), a systematic review of intervention studies, published since the last guidelines statement was conducted. AIM The aim of this study was to 1) systematically review the evidence published from January 2012 to February 2017 regarding the effectiveness of motor based interventions in individuals with DCD, 2) quantify treatment effects using a meta-analysis, 3) examine the available information on different aspects of delivery including use of group intervention, duration and frequency of therapy, and 4) identify gaps in the literature and make recommendations for future intervention research. METHOD An electronic search of 5 databases (PubMed, Embase, Pedro, Scopus and Cochrane) was conducted for studies that evaluated motor-based interventions to improve performance for individuals with DCD. RESULTS Thirty studies covering 25 datasets were included, 19 of which provided outcomes on standardized measures of motor performance. The overall effect size (Cohen's d) across intervention studies was large (1.06), but the range was wide: for 11 interventions, the observed effect was large (>0.80), in eight studies moderate (>0.50), and in five it was small or negligible (<0.50). Positive benefits were evident for activity-oriented approaches, body function-oriented combined with activities, active video games, and small group programs. CONCLUSION Results showed that activity-oriented and body function oriented interventions can have a positive effect on motor function and skills. However, given the varied methodological quality and the large confidence intervals of some studies, the results should be interpreted with caution.
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Review |
7 |
90 |
6
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Smits-Engelsman B, Hill EL. The relationship between motor coordination and intelligence across the IQ range. Pediatrics 2012; 130:e950-6. [PMID: 22987872 DOI: 10.1542/peds.2011-3712] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In both clinical practice and research, motor delay is understood to be explained, at least in part, by intellectual abilities; however, no data are available to operationalize these criteria to guide clinical decision making. This study provides data on IQ and motor skills in children to answer 3 research questions concerning the relationship between IQ and motor skill: (1) Can motor coordination impairment be explained in terms of general intellectual retardation? (2) What level of motor performance should be expected given the person's measured intelligence? (3) At what point are motor difficulties considered to be in excess of those usually associated with mental retardation? METHODS IQ and motor skill data were analyzed from a group of 460 children identified with/without motor difficulties from both clinical and educational settings. RESULTS Typical and atypical motor skill was seen at all IQ levels, 19% of the variance in motor outcomes was explained by IQ scores, and for each SD lower IQ, a mean loss of 10 percentile motor points should be expected. CONCLUSIONS Although individuals with a lower measured IQ more often showed poorer motor performance than those with a higher measured IQ, motor skill at all levels of proficiency was seen in all IQ categories. These findings have important implications for clinical judgments and decision-making, as well as for future research directions to further operationalize the criteria relating to motor disorders in both the Diagnostic and Statistical Manual of Mental Disorders, Fourth Revision, and the International Classification of Diseases, 10th Revision.
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56 |
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Wilson PH, Adams ILJ, Caeyenberghs K, Thomas P, Smits-Engelsman B, Steenbergen B. Motor imagery training enhances motor skill in children with DCD: A replication study. RESEARCH IN DEVELOPMENTAL DISABILITIES 2016; 57:54-62. [PMID: 27388492 DOI: 10.1016/j.ridd.2016.06.014] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 06/16/2016] [Accepted: 06/20/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Children with impaired motor coordination (or DCD) have difficulty using motor imagery. We have suggested that this difficulty is explained by the internal modeling deficit (IMD) hypothesis of DCD. Our previous training study lent support for this hypothesis by showing that a computerized imagery training protocol (involving action observation, and mental- and overt-rehearsal) was equally effective to perceptual-motor therapy (PMT) in promoting motor skill acquisition. AIMS The study presented here was designed to replicate and extend this finding, targeting a select group of children with moderate-to-severe DCD. METHODS AND PROCEDURES All 36 children with DCD who participated were referred to the study and scored below the 10th percentile for their age on the Movement Assessment Battery for Children (MABC). Using a randomized control trial, the referred children were assigned randomly to one of three groups using a blocked procedure: imagery training, perceptual-motor training (PMT), and wait-list control. Motor proficiency was measured using the MABC, pre and post-training. Individual training consisted of 60-min sessions, conducted once a week for 5 weeks. RESULTS Results showed that the imagery protocol was equally effective as PMT in promoting motor skill acquisition, with moderate-to-large effect sizes. Individual differences showed that the majority of children in the two intervention groups improved their motor performance significantly. CONCLUSIONS Overall, these results further support the use of motor imagery protocols in the treatment of DCD, and tentative support for the IMD hypothesis. Developmental and dose issues in the implementation of imagery-based intervention are discussed.
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Randomized Controlled Trial |
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54 |
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Smits-Engelsman B, Schoemaker M, Delabastita T, Hoskens J, Geuze R. Diagnostic criteria for DCD: Past and future. Hum Mov Sci 2015; 42:293-306. [DOI: 10.1016/j.humov.2015.03.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10 |
49 |
9
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Meyns P, Desloovere K, Van Gestel L, Massaad F, Smits-Engelsman B, Duysens J. Altered arm posture in children with cerebral palsy is related to instability during walking. Eur J Paediatr Neurol 2012; 16:528-35. [PMID: 22336190 DOI: 10.1016/j.ejpn.2012.01.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 01/13/2012] [Accepted: 01/24/2012] [Indexed: 10/14/2022]
Abstract
BACKGROUND Toddlers learning to walk adopt specific 'guard' arm postures to maintain their balance during forward progression. In Cerebral Palsy (CP), the cause of the altered arm postures during walking has not been studied. AIM To investigate whether the altered arm posture in children with CP is a compensation for instability during walking. METHODS Vertical and horizontal hand position, and upper arm elevation angle in the sagittal plane were determined in eleven children with unilateral CP, fifteen children with bilateral CP using 3D gait analysis and compared to twenty-four TD children. A correlation analysis of these measures of arm posture to step width was made to examine the relationship between arm posture and instability. RESULTS The hand position of children with CP was more elevated and anterior, and their upper arm was rotated more posterior than TD children. Children with unilateral CP held their most affected hand higher than their least affected. Increasing the speed accentuated the differences between groups for hand elevation. Step width correlated positively with horizontal hand position of the least affected arm in children with CP. CONCLUSION Children with CP appear to rely on 'guard' arm postures as a compensation strategy to maintain balance while walking comparable to newly walking toddlers. Importantly, this pattern is seen on the least affected side. The substantially altered arm posture on the most affected side in children with unilateral CP, however, suggests that spasticity and associated movements are also important contributing factors.
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39 |
10
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Adams ILJ, Smits-Engelsman B, Lust JM, Wilson PH, Steenbergen B. Feasibility of Motor Imagery Training for Children with Developmental Coordination Disorder - A Pilot Study. Front Psychol 2017; 8:1271. [PMID: 28798707 PMCID: PMC5526967 DOI: 10.3389/fpsyg.2017.01271] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 07/12/2017] [Indexed: 01/12/2023] Open
Abstract
Children with Developmental Coordination Disorder (DCD) experience movement difficulties that may be linked to processes involved in motor imagery (MI). This paper discusses recent advances in theory that underpin the use of MI training for children with DCD. This knowledge is translated in a new MI training protocol which is compared with the cognitive orientation to daily occupational performance (CO-OP). Children meeting DSM-5 criteria for DCD were assigned to MI (n = 4) or CO-OP (n = 4) interventions and completed nine treatment sessions, including homework exercises. Results were positive, with two children in the MI group and three in the CO-OP group improving their m-ABC-2 score by ≥ 2 standard scores, interpreted as a clinically meaningful change. Moreover, all children and parents noticed improvements in motor skills after training. This is the first study to demonstrate the feasibility of a theoretically principled treatment protocol for MI training in children with DCD, and extends earlier work. Trial registration: The complete trial is registered at the Dutch trial register, www.trialregister.nl (NTR5471). http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5471
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Journal Article |
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31 |
11
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Bonney E, Ferguson G, Smits-Engelsman B. The efficacy of two activity-based interventions in adolescents with Developmental Coordination Disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 71:223-236. [PMID: 29055242 DOI: 10.1016/j.ridd.2017.10.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Revised: 10/11/2017] [Accepted: 10/14/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Adolescents with Developmental Coordination Disorder (DCD) usually experience psychomotor difficulties that affect their participation in everyday tasks and sports. Without effective intervention, adolescents show persistent motor deficits through adulthood. It is therefore critical to develop interventions to address the specific needs of this population. Studies evaluating the impact of motor interventions among adolescents with DCD are limited. AIM The study evaluated the efficacy of two activity-based motor interventions in female adolescents with DCD. METHODS AND PROCEDURES Forty-three female participants (Mean±SD: 14.3±1.1years) were identified as having DCD using the DSM-5 criteria. They were randomly assigned to either Task-oriented Functional Training (TFT) or Wii training. Both groups received 45min training per week for 14 weeks. Outcome measures included isometric muscular strength, motor proficiency, functional performance and participation in activities of daily living (ADL). OUTCOMES AND RESULTS At the conclusion of the intervention, the two groups had significant improvement in muscular strength, motor proficiency, running and agility, predilection for physical activity and generalized self-efficacy. However, there was no difference in outcomes for the two interventions. CONCLUSIONS AND IMPLICATIONS The findings highlight the potential benefits of activity-based motor interventions in reducing impairments, improving functional performance, and enhancing participation. These results support previous findings on the efficacy of task-oriented interventions and demonstrate the value of these approaches at all levels of functioning.
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Randomized Controlled Trial |
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29 |
12
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Editorial |
24 |
26 |
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Bonney E, Jelsma D, Ferguson G, Smits-Engelsman B. Variable training does not lead to better motor learning compared to repetitive training in children with and without DCD when exposed to active video games. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 62:124-136. [PMID: 28157565 DOI: 10.1016/j.ridd.2017.01.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 01/12/2017] [Accepted: 01/14/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Little is known about the influence of practice schedules on motor learning and skills transfer in children with and without developmental coordination disorder (DCD). Understanding how practice schedules affect motor learning is necessary for motor skills development and rehabilitation. AIMS The study investigated whether active video games (exergames) training delivered under variable practice led to better learning and transfer than repetitive practice. METHODS AND PROCEDURES 111 children aged 6-10 years (M=8.0, SD=1.0) with no active exergaming experience were randomized to receive exergames training delivered under variable (Variable Game Group (VGG), n=56) or repetitive practice schedule (Repetitive Game Group (RGG), n=55). Half the participants were identified as DCD using the DSM-5 criteria, while the rest were typically developing (TD), age-matched children. Both groups participated in two 20min sessions per week for 5 weeks. OUTCOMES AND RESULTS Both participant groups (TD and DCD) improved equally well on game performance. There was no significant difference in positive transfer to balance tasks between practice schedules (Repetitive and Variable) and participant groups (TD and DCD). CONCLUSIONS AND IMPLICATIONS Children with and without DCD learn balance skills quite well when exposed to exergames. Gains in learning and transfer are similar regardless of the form of practice schedule employed. WHAT THIS PAPER ADDS This is the first paper to compare the effect of practice schedules on learning in children with DCD and those with typical development. No differences in motor learning were found between repetitive and variable practice schedules. When children with and without DCD spend the same amount of time on exergames, they do not show any differences in acquisition of motor skills. Transfer of motor skills is similar in children with and without DCD regardless of differences in practice schedules.
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Randomized Controlled Trial |
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22 |
14
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Heremans E, Smits-Engelsman B, Caeyenberghs K, Vercruysse S, Nieuwboer A, Feys P, Helsen W. Keeping an eye on imagery: the role of eye movements during motor imagery training. Neuroscience 2011; 195:37-44. [DOI: 10.1016/j.neuroscience.2011.07.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Revised: 07/08/2011] [Accepted: 07/12/2011] [Indexed: 11/30/2022]
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15
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Van Aken K, Caeyenberghs K, Smits-Engelsman B, Swillen A. The motor profile of primary school-age children with a 22q11.2 deletion syndrome (22q11.2DS) and an age- and IQ-matched control group. Child Neuropsychol 2012; 15:532-42. [PMID: 19280375 DOI: 10.1080/09297040902740678] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
In the early publications on the 22q11.2 Deletion Syndrome (22q11.2DS) motor abnormalities have been frequently reported. However, systematic studies on the motor performance of children with the 22q11.2DS, and especially of school-age children, are scarce. In this study the motor performance of primary school-age children with a 22q11.2DS (n = 28) was compared with an age- and IQ-matched control group (n = 28) using the Movement Assessment Battery for Children (MABC), the Körperkoordinationstest für Kinder (KTK) and the Beery-Buctenica test of Visual-Motor Integration (Beery). Children with a 22q11.2DS scored significantly lower than the age- and IQ-matched control group on the subsection Manual Dexterity (MABC) and the Visual Perception and Motor Coordination subtests of the Beery. When investigating the correlations between Intelligence quotient (IQ) and motor performance, a specific profile was found in the 22q11.2DS group when compared with the age- and IQ-matched control group. Because an IQ-matched control group was adopted, the deficits in visual-perceptual and visuomotor integration skills cannot fully be attributed to a general developmental delay and thus may be specific for the 22q11.2DS. Future studies that investigate the specificity of the visual-perceptual problems - both on the behavioral and brain level (functional Magnetic Resonance Imaging [fMRI] and Diffusion Tensor Imaging [DTI]) - are necessary to answer this question. Nonetheless, the importance of incorporating motor functioning into the study of the neuropsychological profile of children with a 22q11.2DS has to be stressed.
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Journal Article |
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Smits-Engelsman B, Verbecque E. Pediatric care for children with developmental coordination disorder, can we do better? Biomed J 2022; 45:250-264. [PMID: 34482014 PMCID: PMC9250084 DOI: 10.1016/j.bj.2021.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 08/18/2021] [Accepted: 08/27/2021] [Indexed: 02/03/2023] Open
Abstract
This paper adopts a method of narrative critical review based on a non-systematic search of the literature to provide insights into the trends of developmental coordination disorder (DCD) treatment and to point out some future alternative approaches to prevent secondary health implications in children with DCD. The cause of DCD is unknown, but evidence suggests that these children have atypical brain structure and function. Interventions to help children cope with their activity limitations are effective in improving motor competence and motor skill related fitness in the short term. Although activity-orientated interventions can improve motor outcomes in children with DCD, high quality intervention trials and evaluation of long-term effects are urgently needed. Importantly, motor coordination problems associated with DCD extend to exercise-related activities leading to reduced participation in play and sports, which causes secondary problems in muscular fitness and body composition. Hence, treatment goals should not be limited to the improvement of motor skills (in ADL), but should also focus on health-related quality of life. We therefore propose when noticing motor problems in a child, already before enrolling but also during intervention, to explore ways to adapt everyday physical activities to optimally match the child's skill level. Hence, such activities will not only train the skills and improve physical fitness but will lead to positive engagement, thereby preventing the child from opting out of active play and sports. This provides the child with chances for exercise-dependent learning and will also positively impact social-emotional well-being.
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Review |
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17
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Bonney E, Ferguson G, Smits-Engelsman B. Relationship between Body Mass Index, Cardiorespiratory and Musculoskeletal Fitness among South African Adolescent Girls. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1087. [PMID: 29843388 PMCID: PMC6025162 DOI: 10.3390/ijerph15061087] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/22/2018] [Accepted: 05/23/2018] [Indexed: 01/20/2023]
Abstract
Background: Cardiorespiratory and musculoskeletal fitness are important health indicators that support optimal physical functioning. Understanding the relationship between body mass index and these health markers may contribute to the development of evidence-based interventions to address obesity-related complications. The relationship between body mass index, cardiorespiratory and musculoskeletal fitness has not been well explored, particularly in female adolescents. The aim of this study was to investigate the association between body mass index, cardiorespiratory and musculoskeletal fitness among South African adolescent girls in low-income communities. Methods: This cross-sectional study included 151 adolescent girls, aged 13⁻16 years. Cardiorespiratory fitness was measured using the 20 m shuttle run test and musculoskeletal fitness was assessed using a variety of field-based tests. Height and weight were measured with standardised procedures and body mass index (BMI) was derived by the formula [BMI = weight (kg)/height (m)²]. Participants were categorised into three BMI groups using the International Obesity Task Force age- and gender-specific cut-off points. Pearson correlations were used to determine the association between body mass index, cardiorespiratory fitness and measures of musculoskeletal fitness at p ≤ 0.05. Results: Overweight and obese girls were found to have lower cardiorespiratory fitness, decreased lower extremity muscular strength, greater grip strength, and more hypermobile joints compared to normal-weight peers. BMI was negatively associated with cardiorespiratory fitness and lower extremity muscular strength. Conclusions: The findings indicate that increased body mass correlates with decreased cardiorespiratory and musculoskeletal fitness. Interventions should be developed to target these important components of physical fitness in this demographic group.
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research-article |
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18
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Verbecque E, Johnson C, Rameckers E, Thijs A, van der Veer I, Meyns P, Smits-Engelsman B, Klingels K. Balance control in individuals with developmental coordination disorder: A systematic review and meta-analysis. Gait Posture 2021; 83:268-279. [PMID: 33227605 DOI: 10.1016/j.gaitpost.2020.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/28/2020] [Accepted: 10/11/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Although it is recognized that the majority of children with developmental coordination disorder (DCD) have balance deficits, comprehensive insights into which balance domains are affected, are still lacking in literature. RESEARCH QUESTION To what extent is balance control deficient in individuals with DCD compared to controls? METHODS Pubmed, Scopus and Web of Science were systematically searched. Risk of bias was assessed with the Scottish Intercollegiate Guidelines Network checklist for case-control studies. Mean and standard deviations characterizing balance control were extracted to calculate standardized mean differences (SMD) and pooled, if possible, using Review Manager. RESULTS The results of 31 studies (1152 individuals with DCD, 1103 typically developing (TD) peers, mean age 10.4 years old) were extracted of which 17 were used for meta-analysis. The mean SMD for the balance subscale of the Movement Assessment Battery for Children was 1.63 (pooled 95 %CI =[1.30;1.97]), indicating children with DCD to perform significantly poorer than their TD peers. Force plate studies also revealed that children with DCD present with a larger sway path during bipedal stance with eyes closed (pooled mean SMD = 0.55; 95 %CI=[0.32;0.78]). Children with DCD tend to have direction-specific limited stability limits and task-independent delayed onset of anticipatory postural adjustments. INTERPRETATION Children with DCD perform poorer on different domains of balance compared to TD peers. Future research should focus on comprehensive balance assessment in these children, preferably using a longitudinal design.
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Meta-Analysis |
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Hoskens J, Klingels K, Smits-Engelsman B. Validity and cross-cultural differences of the Bayley Scales of Infant and Toddler Development, Third Edition in typically developing infants. Early Hum Dev 2018; 125:17-25. [PMID: 30172781 DOI: 10.1016/j.earlhumdev.2018.07.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 07/10/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND The Dutch translation of Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III-NL) is a comprehensive tool assessing cognitive, language and motor development in children up to 42 months. AIMS The first aim of this study was to evaluate concurrent validity of the Bayley-III-NL Gross Motor Scale (GMS) in relation to the Alberta Infant Motor Scale (AIMS). Secondly, divergent validity between the other subscales mutually and the AIMS was investigated. Finally, the importance of population-specific reference values was examined. METHODS AND PROCEDURES A sample of 122 healthy, typically developing Flemish children (mean age: 9 months 7 days), born full term was assessed with the Bayley-III-NL and the AIMS. OUTCOMES AND RESULTS Concurrent validity of the Bayley-III-NL GMS and the AIMS was moderate to high (0.59-0.98; p < 0.001). In addition, weak correlations (-0.10-0.27) between the non-motor-Bayley-III-NL subscales and the AIMS were found. Finally, significant differences were found between Bayley-III scores based on Flemish and American norms (p < 0.001), except for fine motor skills (p = 0.11). CONCLUSIONS AND IMPLICATIONS This study provides support for the concurrent validity of the Bayley-III-NL GMS and divergent validity of the different Bayley-III-NL subscales. Secondly, population-specific reference values should be used to avoid over- and under estimation of infant's development.
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Validation Study |
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Wilson PH, Smits-Engelsman B, Caeyenberghs K, Steenbergen B. Toward a Hybrid Model of Developmental Coordination Disorder. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2017. [DOI: 10.1007/s40474-017-0115-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Smits-Engelsman B, Bonney E, Ferguson G. Effects of Graded Exergames on Fitness Performance in Elementary School Children With Developmental Coordination Disorder. Front Sports Act Living 2021; 3:653851. [PMID: 33969297 PMCID: PMC8100245 DOI: 10.3389/fspor.2021.653851] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/24/2021] [Indexed: 01/03/2023] Open
Abstract
Developmental Coordination Disorder (DCD) is a common childhood disorder affecting movement and coordination skills, fitness, and academic performance. Increased physical fitness may have a positive influence on physical and mental health outcomes in children with DCD. Yet, little has been done to develop interventions to improve fitness performance in this group. The purpose of this study was to determine the effects of graded exergames in 7 to 12-year-old children with DCD and typically developing (TD) peers. Participants (32 DCD and 28 TD children) received a 30-min training session twice weekly for 10 weeks. Performance on motor coordination (MABC-2 test), balance, aerobic, and anaerobic fitness tests were assessed at the beginning and end of training. In addition, enjoyment and perception of exertion were measured for each participant during the training period. Both children with DCD and TD children significantly improved on motor coordination, balance, aerobic, and anaerobic fitness at the end of the training. A significant Group by Time interaction was observed on the MABC-2 total [F (1, 55) = 13.19; p < 0.001] and balance scores [F (1, 55) = 26.83; p < 0.0001], with the DCD group demonstrating larger improvements than the TD children. Both groups enjoyed the program throughout the training period even though they rated the training to be of high intensity. These findings indicate that graded exergames may serve as potential treatment for impaired fitness in children with DCD. Regular participation in graded exergames in school settings may be needed to enhance and maintain fitness performance in young children with and without DCD.
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research-article |
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Van Aken K, Swillen A, Beirinckx M, Janssens L, Caeyenberghs K, Smits-Engelsman B. Prospective control abilities during visuo-manual tracking in children with 22q11.2 Deletion syndrome compared to age- and IQ-matched controls. RESEARCH IN DEVELOPMENTAL DISABILITIES 2010; 31:634-641. [PMID: 20181458 DOI: 10.1016/j.ridd.2010.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 12/11/2009] [Accepted: 01/12/2010] [Indexed: 05/28/2023]
Abstract
To examine whether children with a 22q11.2 Deletion syndrome (22q11.2DS) are able to use prospective control, 21 children with 22q11.2DS (mean age=9.6+/-1.9; mean FSIQ=73.05+/-10.2) and 21 control children (mean age=9.6+/-1.9; mean FSIQ=73.38+/-12.0) were asked to perform a visuo-manual tracking task in which they had to track a cursor rhythmically between 2 target zones. Children with 22q11.2DS performed worse than the age- and IQ-matched controls (higher absolute time and distance errors) suggesting that the 22q11.2DS group experiences an additional (syndrome specific) processing deficit that cannot be attributed to their lower intellectual abilities. The 22q11.2DS group neither the control group improved their tracking performance throughout five identical full feedback conditions of the tracking task possibly due to a slow visuo-motor adaptation process, a short span of attention and cognitive flexibility impairments. The results showed that both the 22q11.2DS group and the controls had difficulties anticipating the movement of the target (prospective control) and thus are assumed to rely more on feedback instead of on an internal representation of the movement.
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Smits-Engelsman B, Cavalcante Neto JL, Draghi TTG, Rohr LA, Jelsma D. Construct validity of the PERF-FIT, a test of motor skill-related fitness for children in low resource areas. RESEARCH IN DEVELOPMENTAL DISABILITIES 2020; 102:103663. [PMID: 32408212 DOI: 10.1016/j.ridd.2020.103663] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/08/2020] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Given the relationship between physical fitness and motor performance a test battery was developed that measures both components combined. AIM Following the development of the Performance and Fitness (PERF-FIT) battery, this study investigated the construct validity with the ultimate aim of identifying attributes that discriminate between different levels of motor abilities and anaerobic or musculoskeletal fitness. METHODS In this cross-sectional study, 34 children with developmental coordination disorder (DCD) and 34 matched typically developing children participated (7-10 years). The PERF-FIT was used to examine known group validity. The PERF-FIT items were also compared to test items of well-known standardized tests to examine concurrent validity. RESULTS Concurrent validity was found to be of the expected low to moderate magnitude. Children with DCD were consistently found to have lower levels of motor skill-related fitness compared to typically developing children. CONCLUSION AND IMPLICATIONS The PERF-FIT seems to be a valid test to measure movement skills, musculoskeletal fitness and agility in children between the ages of 7 and 10 years in low resourced communities. The test seems to discriminate between gross motor skills, and agility and power in children with and without DCD.
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Bonney E, Ferguson G, Burgess T, Smits-Engelsman B. Benefits of Activity-Based Interventions Among Female Adolescents Who Are Overweight and Obese. Pediatr Phys Ther 2019; 31:338-345. [PMID: 31568378 DOI: 10.1097/pep.0000000000000636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The purpose of this study was to compare the effects of 2 activity-based motor interventions among female adolescents who are overweight and obese. METHODS This study was conducted in a low-income community of Cape Town, South Africa. The study involved 52 participants classified as overweight and obese. Participants were randomly assigned to task-oriented functional training or Wii Fit intervention. Both interventions were 45 minutes of active training once a week for 14 weeks. Outcome measures included aerobic fitness, motor coordination, and self-efficacy. Data were collected before and after the interventions. RESULTS Participants in both groups demonstrated significant improvement in aerobic fitness and motor coordination but not self-efficacy. However, no between-group differences were observed on any of the outcomes. CONCLUSIONS Activity-based interventions may improve aerobic fitness and motor coordination in female adolescents who are overweight and obese and may also help prevent declines in physical fitness and coordination in this population.
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Bonney E, Aertssen W, Smits-Engelsman B. Psychometric properties of field-based anaerobic capacity tests in children with Developmental Coordination Disorder. Disabil Rehabil 2018; 41:1803-1814. [PMID: 29509037 DOI: 10.1080/09638288.2018.1446189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: Assessment of anaerobic capacity in children with Developmental Coordination Disorder (DCD) is essential for treatment planning. However, available field-based measures have no established validity and reliability in this population. Purpose: To examine the psychometric properties of selected field-based anaerobic capacity tests in children with and without DCD. Methods: School-aged children (6-16 years) with and without DCD participated in the study. The children completed the shuttle run sub-item of the Bruninks-Oseretsky test of motor proficiency-second edition, the 10 × 5 m sprint tests (straight and slalom) and the muscle power sprint test (MPST). Results: The shuttle run test item of the Bruninks-Oseretsky test of motor proficiency-second edition and 10 × 5 m sprint tests possess good construct validity and test-retest reliability in children with DCD. The 10 × 5 m sprint test-slalom was found to be the most responsive test among children with DCD. However, the MPST was less reliable in children with DCD compared to their typically developing peers, leading to a very large Smallest Detectable Difference. Conclusions: The findings suggest that the selected anaerobic capacity measures have sound psychometric properties among children with DCD with the exception of the MPST. Clinicians working on children with DCD could use these tests in their practice, especially in situations where logistical resources are limited. Implications for Rehabilitation Field-based anaerobic capacity tests are suitable measures for assessing anaerobic capacity in children with Developmental Coordination Disorder, particularly in situations where laboratory assessments are not feasible. The shuttle run test item of the Bruninks-Oseretsky test of motor proficiency-second edition and the 10 × 5 sprint tests (straight and slalom) have good construct validity in this population. The 10 × 5 sprint test (slalom) is the most sensitive anaerobic capacity test among children with Developmental Coordination Disorder.
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