Objectives: To compare the effectiveness of RAS-MPT, RAS alone, MPT alone, and usual care (as a control) for improving the overall gait performance of and reducing falls in children with developmental coordination disorder (DCD) and to explore the relationship between gait performance and falls in this population. Design: A randomized controlled trial. Sample: 76 children with DCD. Interventions: RAS-MPT, RAS alone, MPT alone, or usual care (12 weeks). Major outcomes: Outcomes will be evaluated at baseline, post-intervention, and a 6-month follow-up. Comprehensive gait analysis will produce spatiotemporal gait parameters (e.g., velocity and stride length), kinematic gait parameters (e.g., knee joint motions), and leg muscle EMG outcomes; an isokinetic test will quantify leg muscle strength and force production time; and fall histories will be obtained via interviews. Anticipated results and significance: The RAS-MPT group is predicted to display the best gait performance, which is associated with reduced fall incidents. This novel training regime can be readily adopted in school, clinical, or home settings to improve locomotor ability in children with DCD, an outcome with positive socioeconomic implications.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
76
The RAS-MPT group will attend a 60-minute training session once a week and home exercises (twice/week) for 12 weeks. Participants will receive two levels of training within each 60-minute session: (1) RAS-treadmill training and (2) MPT.
The RAS group will attend a 60-minute training session once a week and home exercises (twice/week) for 12 weeks. Participants will receive RAS-treadmill training repeatedly within each 60-minute session.
The MPT group will attend a 60-minute training session once a week and home exercises (twice/week) for 12 weeks. Participants will receive muscle power training repeatedly within each 60-minute session.
Participants in the control group will receive no intervention during the study period, but continue with their normal daily activities and usual medical care. They will receive the same training as the RAS-MPT group after the study.
University of Hong Kong
Hong Kong, Hong Kong
Changes in spatiotemporal gait parameter - gait velocity (m/s)
Time frame: 9 months
Changes in spatiotemporal gait parameter - stride length (cm)
Time frame: 9 months
Changes in spatiotemporal gait parameter - cadence (steps/min)
Time frame: 9 months
Changes in spatiotemporal gait parameter - stance phase duration (% gait cycle)
Time frame: 9 months
Changes in spatiotemporal gait parameter - swing phase duration (% gait cycle)
Time frame: 9 months
Changes in spatiotemporal gait parameter - single-limb support durations (% gait cycle)
Time frame: 9 months
Changes in spatiotemporal gait parameter - double-limb support duration (% gait cycle)
Time frame: 9 months
Changes in kinematic gait parameters
Maximum knee and ankle angles during different gait phases
Time frame: 9 months
Changes in leg muscle peak electromyographic values
Changes in leg muscle peak electromyographic values (in % of maximal voluntary isometric contraction) of rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius medialis muscles
Time frame: 9 months
Changes in leg muscle maximum strength
Changes in maximum muscle strength of knee extensors and flexors and ankle plantar flexors and dorsiflexors of the dominant leg as measured by dynamometry.
Time frame: 9 months
Changes in leg muscle force production time
Changes in muscle force production time of knee extensors and flexors and ankle plantar flexors and dorsiflexors of the dominant leg as measured by dynamometry.
Time frame: 9 months
Changes in self-reported falls
Children and parents will report the number of falls within the study period.
Time frame: 9 months
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