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S.M. Fong1,2, M.Y. Chung2, C.M. Schooling1,3, Y.H. Wong4, H.Y. Lau1, W.Y. Chung2
1The University of Hong Kong, School of Public Health, Hong Kong, Hong Kong, 2The Education University of Hong Kong, Department of Health and Physical Education, Hong Kong, Hong Kong, 3City University of New York, Graduate School of Public Health and Health Policy, New York, United States, 4The University of Hong Kong, School of Nursing, Hong Kong, Hong Kong
Background: Children with developmental coordination disorder (DCD), who comprise about 6% of the primary school population, display inferior leg neuromuscular control and marked balance difficulties. Tai Chi (TC) in conjunction with muscle power training (MPT) may be an ideal therapy to remediate their neuromuscular and balance problems.
Purpose: To compare the effectiveness of a novel TC-MPT, TC alone, MPT alone, and usual care (control) in improving the limits of stability (LOS) of balance control and knee muscle strength in children with DCD.
Methods: A single-blinded, randomized controlled trial was performed. Children with probable DCD were recruited from the local community and screened. Then, they were randomly assigned to either a TC-MPT group, a TC group, a MPT group, or a control group. The TC-MPT group received both Tai Chi training (including five basic TC movements and their applications) and muscle power training for the lower limbs for 3 months (3 times/week, 90 minutes/session); the TC group received Tai Chi training only with the same total training volume; the MPT group received muscle power training only with the same total training volume; and the control group received no training for 3 months. Outcomes were assessed at baseline and after the intervention period. The primary outcomes were LOS score and time taken to complete the LOS balance test as measured on a Biosway computerized dynamic posturography system. Secondary outcomes include peak torque and time taken to reach peak torque of both quadriceps and hamstring of the dominant leg. Two-way repeated measures analysis of covariance and intention to treat analysis were used in data analysis.
Results: 159 children with DCD were recruited and screened for eligibility; 121 qualified and underwent randomization – 30 to the TC-MPT group (mean age: 9.5 years; 25 boys and 5 girls), 30 to the TC group (mean age: 9.9 years; 26 boys and 4 girls), 30 to the MPT group (mean age: 9.8 years; 25 boys and 5 girls), and 31 to the control group (mean age: 9.7 years; 25 boys and 6 girls). The demographics were balanced among the 4 groups. Results revealed that there were no group, time, or group-by-time interaction effects in LOS score and completion time (all p>0.05). However, maximum muscle strength of hamstring improved in the MPT group overtime (p=0.032) and the TC group demonstrated greater hamstring maximum muscle strength than the other 3 groups at post-test (TC v.s. control: p=0.015; TC v.s. MPT: p=0.040; TC v.s. TC-MPT: p=0.001). No significant changes were noted in other secondary outcome measures. No adverse events were reported.
Conclusion(s): Short-term TC-MPT, TC and MPT could not improve LOS of balance control in children with DCD. MPT or TC training could improve maximum muscle strength of hamstring, but not quadriceps, in this group of children.
Implications: Three months of TC or MPT improved hamstring muscle strength in children with DCD. However, with respect to LOS of balance control and other knee neuromuscular performances, 3 months of TC-MPT, TC or MPT may not be sufficient to induce any significant changes.
Funding, acknowledgements: General Research Fund (17112018), Research Grants Council, Hong Kong Special Administrative Region, China.
Keywords: postural control, neuromuscular, dyspraxia
Topic: Paediatrics
Did this work require ethics approval? Yes
Institution: University of Hong Kong
Committee: Institutional Review Board
Ethics number: UW 16-507
All authors, affiliations and abstracts have been published as submitted.
