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Smulders E1,2, Kuijpers R1, Weerdesteyn V1,3
1Radboud University Medical Centre, Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, Netherlands, 2Avans+, Master Geriatric Physical Therapy, Breda, Netherlands, 3Sint Maartenskliniek, Research, Nijmegen, Netherlands
Background: Children with Developmental Coordination Disorder (DCD) have problems in their fine and gross motor skills, which causes difficulties in activities of daily life (ADL; e.g. while playing or participating in sports and school activities). Parents often report that their children are clumsy and often trip and/or fall. Additionally, children with DCD more often have accidents and fractures compared to their peers. Research until now mainly focused on fine motor skills, ball skills and static balance in children with DCD. However, their frequent falls point at problems in whole body coordination during ambulatory tasks. Since walking in daily life involves interacting with the physical environment and may also include several forms of distraction, it is necessary to investigate the gait problems that children with DCD experience under such circumstances. This is called functional gait.
Purpose: To compare functional gait between children with DCD and typically developing (TD) children.
Methods: Functional gait assessments were conducted in 23 children with DCD and 57 TD children (6-12 years old), both on the C-mill and overground. The C-mill (Roerdink & Beek, 2009 Forcelink BV) is a treadmill, with embedded force plates, that evokes gait adjustments by projecting visual context (i.e. stepping targets or obstacles). We measured obstacle avoidance performance (with and without motor and cognitive dual tasks) on the C-mill. Overground functional gait tasks involved the obstacle avoidance item of the Emory Functional Ambulation Profile and the Timed Agility Ladder-test. In addition, we also measured spatiotemporal characteristics and variability during regular walking. Scores of the DCD and TD children were compared by means of Mann-Whitney U tests.
Results: Children with DCD performed worse on all functional gait tasks, both on the C-mill and overground (p 0.01). They showed no differences compared to TD children regarding regular walking characteristics, except for a larger step width and greater gait variability (p 0.05).
Conclusion(s): During regular walking, children with DCD show relatively minor differences compared to their TD peers. Yet, during more complex ADL-related tasks (also including different forms of distraction), the problems of children with DCD become apparent. These problems may contribute to the large number of trips and falls in this population.
Implications: Children with DCD have more problems with functional gait than TD children. From other populations it is known that functional gait can be improved by training. Therefore, we recommend future studies evaluating the efficacy of functional gait training in children with DCD.
Keywords: functional gait, gait adaptability, DCD
Funding acknowledgements: Revalidatiefonds, Johannakinderfonds, Kinderrevalidatiefonds Adriaanstichting
Purpose: To compare functional gait between children with DCD and typically developing (TD) children.
Methods: Functional gait assessments were conducted in 23 children with DCD and 57 TD children (6-12 years old), both on the C-mill and overground. The C-mill (Roerdink & Beek, 2009 Forcelink BV) is a treadmill, with embedded force plates, that evokes gait adjustments by projecting visual context (i.e. stepping targets or obstacles). We measured obstacle avoidance performance (with and without motor and cognitive dual tasks) on the C-mill. Overground functional gait tasks involved the obstacle avoidance item of the Emory Functional Ambulation Profile and the Timed Agility Ladder-test. In addition, we also measured spatiotemporal characteristics and variability during regular walking. Scores of the DCD and TD children were compared by means of Mann-Whitney U tests.
Results: Children with DCD performed worse on all functional gait tasks, both on the C-mill and overground (p 0.01). They showed no differences compared to TD children regarding regular walking characteristics, except for a larger step width and greater gait variability (p 0.05).
Conclusion(s): During regular walking, children with DCD show relatively minor differences compared to their TD peers. Yet, during more complex ADL-related tasks (also including different forms of distraction), the problems of children with DCD become apparent. These problems may contribute to the large number of trips and falls in this population.
Implications: Children with DCD have more problems with functional gait than TD children. From other populations it is known that functional gait can be improved by training. Therefore, we recommend future studies evaluating the efficacy of functional gait training in children with DCD.
Keywords: functional gait, gait adaptability, DCD
Funding acknowledgements: Revalidatiefonds, Johannakinderfonds, Kinderrevalidatiefonds Adriaanstichting
Topic: Paediatrics
Ethics approval required: Yes
Institution: RadboudUMC
Ethics committee: Medical Ethics Committee for the region Arnhem-Nijmegen
Ethics number: 2016/2885
All authors, affiliations and abstracts have been published as submitted.
