Developmental Coordination Disorder Clinical Trial
Official title:
Enhancing Neuromuscular Performance and Central Nervous System Plasticity Through Functional Movement-power Training to Improve Balance Strategies in Children With Developmental Coordination Disorder: A Randomised Controlled Trial
Objective: To compare the effectiveness of functional movement-power training (PT-FMT),
functional movement training (FMT) alone and no intervention in improving balance strategies
and performance among children with developmental coordination disorder (DCD).
Design: A randomised controlled clinical trial. Sample: 87 children with DCD. Interventions:
12 weeks of PT and FMT or FMT alone in the two intervention groups.
Major outcomes: Sensory organisation test - balance strategy and composite scores; Movement
Assessment Battery for Children - total impairment score and balance subscore; hand-held
dynamometer measurements of lower limb muscle strength and time to peak force.
With the growing numbers of children with dyspraxia in Hong Kong, the focus of paediatric
rehabilitation services has shifted from severe motor disorders (e.g., cerebral palsy) to
relatively minor motor problems such as developmental coordination disorder (DCD).
Evidence-based treatment strategies must be developed to suit this changing need. Children
diagnosed with DCD are characterised by marked impairment in motor functions. Poor balance
ability is a major concern because it may predispose children to falls and affect their
motor skill development. At present, rehabilitation regimes for DCD-affected children use
functional movement training (FMT) to induce neural plastic changes in the central nervous
system (CNS) and thus enhance functional (balance) performance. Less emphasis is placed on
treating the neuromuscular impairments that might also affect functional outcomes. Recently,
the investigators research team discovered that slowed hamstring muscle force production, a
neuromuscular deficit, may be one of the causes of poor balance strategies in children with
DCD, but no effective treatment strategy has yet been examined. Power training (PT) has been
found to be effective in increasing the speed of muscle force production and balance in
adults through various neuromuscular mechanisms. In this study, the investigators intend to
treat both the CNS and peripheral neuromuscular deficits in DCD-affected children.
Therefore, the investigators will incorporate PT into a conventional FMT regime. The
investigators hypothesise that balance strategies and functional performance in children
with DCD will be improved most by treating both the CNS and neuromuscular deficits. This
hypothesis will be supported by the finding that PT with FMT is superior to FMT alone in
improving balance strategies and functional performance in children with DCD.
Objective: To compare the effectiveness of PT-FMT, FMT alone and no intervention in
improving balance strategies and performance among children with DCD. Design: A randomised
controlled clinical trial. Sample: 87 children with DCD. Interventions: 12 weeks of PT and
FMT or FMT alone in the two intervention groups.
Major outcomes: Sensory organisation test - balance strategy and composite scores; Movement
Assessment Battery for Children - total impairment score and balance subscore; hand-held
dynamometer measurements of lower limb muscle strength and time to peak force.
Anticipated results and clinical significance: DCD-affected children who receive FMT
together with PT will have the best balance performance outcomes. If the results are
positive, this training programme could be readily transferrable to clinical practice. This
could have positive socio-economic implications, such as shorter treatment periods and
reduced healthcare costs.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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