Developmental Coordination Disorder Clinical Trial
Official title:
Brain Plasticity and Motor Skill Competence Development in Young People With Development Coordination Disorder
The importance of play and physical activity include many benefits on positively improving
health and well-being, enhancing children's and young people's thinking and performance in
school, improving their sleep and enabling confidence and skill building. However, some
children find it hard to learn and perform motor skills, and are at risk of decreased
participation in sports and physical activity and subsequently decreased physical fitness and
overall health and well-being.
Previous studies from the research group have explored the impact and recovery following
acute exercise at different intensities in children and adolescents with and without movement
difficulties. Following this, a pathway promoting physical activity and engagement has been
successfully established within schools for those with and without movement difficulties.
Taking the previous studies further, we want to specifically focus on the children's
performance and learning of a sporting skill, such as stepping, and the associated brain
activity changes, using available high resolution imaging techniques. This will help us
understand how these children perform and learn motor and sporting skills. Evidence obtained
from imaging alongside measures of movement has helped the development of optimal therapeutic
approaches for other conditions such as stroke and Parkinson's and will help us to develop
approaches to help children best learn motor skills and hence gain confidence in performing
sporting activities.
Children with poor motor skill acquisition and execution despite having opportunity for
learning, are now described as having developmental coordination disorder (DCD). There is a
prevalence of 5-6% of young people who have normal intelligence who meet this category who
have problems affecting their activities of daily living (ADL's). Young people with lower
motor skills are one of a number of conditions affecting children identified by the Chief
Medical Officer as requiring an improved evidence base for management. Poor motor skill
acquisition and execution, whereby skills remain substantially lower than expected despite
opportunities for learning; interferes with participation in academic, sporting and leisure
activities. Motor performance is slower and of poor quality; and children may have
difficulties learning all kinds of motor skills including sporting activities. Importantly
people with poor motor skill acquisition and execution can fail to establish the fundamental
movement skills and literacy required to integrate in physical pursuits, such as sport, and
become exposed to long-term conditions associated with inactivity. Motor sporting skills can
be learnt if trained, but difficulties in performing and learning skills persist into
adulthood.
Brain imaging during rhythmic motor tasks which are essential in day-to-day (non-)sporting
activities, have established that children with poor motor skill acquisition and execution
show differences to healthy controls in grey and white matter functional connectivity and in
cortical activation patterns during performance of simple movement tasks . Provisional
evidence suggests that individuals with poor motor skill acquisition and execution utilise
activation processes when learning motor tasks that are more controlled and require extra
processing demands, but a systematic review of neural correlates of those with poor motor
skill acquisition and execution concludes that data is scarce and more studies are needed.
Performance of motor tasks requires a balance between automatic and controlled processes that
is dependent upon the demands of the task and the capabilities of the individual. Young
people need to be able to consider their environment when performing a sport rather than just
thinking about the skill, so that they can work out where the best place to kick a ball on a
football pitch is, not just kick the ball. Typically developing (TDC) children acquire motor
skills either implicitly or explicitly by observing and imitating other children and adults
or by trial and error. Acquisition of motor tasks requires plasticity in the nervous system
with improvements in motor performance underpinned by a move from cortically controlled
mechanism, towards more automatic performance, freeing up cortical resources. The ability to
automate certain parts of motor skills allows the execution of tasks in more complex
environments. Provisional evidence suggests that people with poor motor skill acquisition and
execution may learn motor skills in a more controlled manner and have a reduced ability to
move automatically. To date no studies have explored the brain changes underpinning
fundamental motor skills attainment over a training period in people with poor motor skill
acquisition and execution.
The main aim contribute evidence towards describing motor performance in relation to brain
structure and functioning in children with lower motor skills and DCD,. This study proposes
to test both the feasibility and determine the extent of the impact of learning a novel
coordination task on motor performance and brain structure and functioning in children with
DCD to inform a full-scale trial of skill acquisition.
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