The main objective of the study is to quantify functional gait abilities in children with DCD. The second goal is to evaluate whether their gait abilities can be improved by training.
ID
Source
Brief title
Condition
- Movement disorders (incl parkinsonism)
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Case control study (part 1)
Gait will be measured during overground walking and while walking on the
C-mill. The C-mill is a treadmill with embedded force plates. On this treadmill
visual stimuli can be projected. During undisturbed walking, gait
characteristics, like step length, width and variability, will be determined.
An obstacle avoidance (C-mill) task will be performed with and without dual
tasks, with failure rate as main outcome measure. For all these measures the
scores of the children with DCD will be compared to reference data.
Intervention study (part 2)
The measurements as described in part 1 are the main study parameters in the
evaluation of the intervention. These outcomes will be measured directly after
the intervention and after 6 months follow up.
Secondary outcome
case control study (part 1)
Secondary outcomes are determined during a motor plan and online correction
task (for further description of the tasks see paragraph 6.2 in the protocol).
During the motor plan task, step length, width and time (both mean and standard
deviation) in the two steps before the target and the lead step that contacts
with the target are measured, as well as the approach distance. The main
outcome for the online correction task is the error in foot placement relative
to the target position.
To compare the results of the gait measurements on the C-mill, also overground
walking and obstacle avoidance performance will be assessed. This will be done
by means of a 10 meter walking test (comfortable and fast walking), a
standardized obstacle course based on the obstacle subtask of the Emory
Functional Ambulation Profile and stepping in a step ladder. For all three
measurements time will be assessed and for the latter two also number of
failures and losses of balance will be determined (for further description of
the tasks see paragraph 6.2 in the protocol).
Furthermore, the Motorische Competentiebelevingsschaal voor Kinderen(CBSK-M)
will be used to measure perceived athletic competence.
Intervention study (part 2):
During the intervention study, fall incidence will be measured as secondary
outcome measure. The parents will be assessed regarding fall problems of their
child. Information regarding the fall frequency and injuries related to falls
in the prior 6 months before participating in the study will be collected.
During the 6 months follow-up after intervention parents will be asked to
register the falls of their children on monthly fall calendars. On this
calendar parents can write on each day whether a fall incident has taken place.
This way of registering falls is recommended by the Prevention of Falls Network
Europe (ProFaNe) . After a fall has taken place, parents are requested to fill
out a questionnaire regarding the circumstances, causes and consequences of the
fall.
Background summary
Children with Developmental Coordination Disorder (DCD) are impaired in the
coordination of movements, and experience problems with both gross and fine
movements. This impairs them in activities of daily life, such as sports, games
and school activities. Parents report their children to be very *clumsy* and to
trip and/or fall frequently. Until now most studies and measurement instruments
in children with DCD focus on fine motor activities, such as writing. However,
the reported problems involve also whole body coordination during ambulatory
activities. Therefore, it is important to gain insight into the nature of the
reported problems in children with DCD during more dynamic tasks, such as
walking and avoiding obstacles. Furthermore, it is relevant to investigate
whether these problems respond to training, which might lead to improvement in
self-experienced skill in ADL tasks and falls reduction.
Study objective
The main objective of the study is to quantify functional gait abilities in
children with DCD. The second goal is to evaluate whether their gait abilities
can be improved by training.
Study design
The study consists of two parts: a case-control study and an intervention
study. In the first part of the study, functional gait abilities of children
with DCD will be measured. Functional gait is defined as gait during complex
situations, as during the avoidance of obstacles or with dual tasks. Outcomes
will be compared to data of a reference group, consisting of typically
developing children of comparable age. Data of this reference group has been
collected prior to this study.
Children with DCD who perform worse than the reference group will be invited to
participate in the intervention part of the study. This intervention consists
of 3 weeks gait training on the C-mill (2 times a week, 30 minutes per
session). After the intervention and after 6 months follow-up the same
measurements as conducted in part 1 of the study will be repeated.
Study burden and risks
The burden and risks associated with participation are minor. The included
children will be asked to perform a measurement with tests and equipment that
are common in rehabilitation practice. All of them are asked to participate in
one test session of maximal 2 hours. Children who show gait problems, as
compared to the reference group, are offered an intervention (6x 30 min) and
are asked to perform a post and follow up measurement. This will make the total
duration of their participation 9 hours during 7-8 months. All tasks are
playful and, in our experience, the children enjoy performing both the
overground tasks and the measurements on the C-mill. The treatment is aimed at
improving functional gait in the children with DCD who show problems in their
gait. Therefore, it is hypothesized that they will benefit from participation
in this study.
Because there is hardly any evidence regarding gait and fall problems in
children with DCD, this study is of importance and it is not possible to
perform this with other patient groups, for instance adults, because the
results will have no external validity to children with DCD.
reinier postlaan 4
Nijmegen 6525 JV
NL
reinier postlaan 4
Nijmegen 6525 JV
NL
Listed location countries
Age
Inclusion criteria
-age 6 to 12 years;In order to be eligible to participate in this study, a subject must meet all of the following criteria (according to the DSM-V criteria for DCD):
- the Movement Assessment Battery for Children (mABC - second edition) assesses the motor abilities of the children. Children can only be diagnosed with DCD group if they have a total mABC-2 score at or below the 16th percentile or the score at the balance component of the mABC-2 is at or below the fifth percentile.
- Motor impairment significantly interferes with daily life and/or academic achievement. This is judged by the medical specialist and can be further assessed by using the Developmental Coordination Disorder Questionnaire (DCD-Q) or Groninger Motoriek Observatieschaal (GMO).
- The motor impairment is not caused by a medical condition. The diagnosis cannot be made if the IQ is 70 or lower. ;If the diagnosis DCD is not made by a medical specialist, the research criteria for DCD are used as inclusion criteria:
- M-ABC-2: total score <= 16 or a score of <= 5 on the balance component of the test.
- Score *indication for DCD* or *suspection of DCD* on the Dutch version of the DCD-Q, filled in by the parents.
- the parents are asked to state whether the symptoms exists from early childhood, that child attends a regular school and did not repeat a class, and that the child has no visual or neurological problems.
Exclusion criteria
- Neurologic, orthopedic or severe visual problems
- Severe behavioral problems
- Temporary physical complaints that might influence walking
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL59150.091.16 |