The study will be a Randomized Controlled Trial including 22 children aged 6-10 years with deficits in functional mobility and gross motor skills. Participants will be randomly divided into an experimental group (n=11), receiving a seven-stage progressive Maze Balance Board protocol, and a control group (n=11), receiving conventional physical therapy. Both groups will undergo 30-minute sessions, three times per week, for 8 weeks. Eligible participants will be enrolled after guardian consent. Outcomes will be assessed using the Montreal Cognitive Assessment (MoCA) for cognition, Timed Up and Go (TUG) test for functional mobility, and Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) for gross motor skills. Ethical approval will be obtained from Riphah International University, Lahore, and data will be analyzed using SPSS version 27.0.
Difficulties with Functional Mobility, Gross and fine motor skills are common in children with Cognitive Impairment, significantly impacting their ability to perform everyday activities and acquire new motor skills. These difficulties often arise from impaired integration of sensory information and deficits in motor planning, resulting in poor functional mobility and increased risk of instability. As a result, affected children may struggle with maintaining upright positions, transitioning between movements, and executing coordinated actions, all of which are essential for functional mobility and participation in age-appropriate activities. To address these concerns, this study will assess the effects of Maze Balance Board Training on Functional Mobility and Gross Motor Skills in Children with Cognitive Impairment. The study design will be a Randomized Controlled Trial. The study will recruit 22 children aged 6-10 years with identified deficits in Functional Mobility and Gross motor skills. Participants will be randomly assigned to either the experimental group (n=11) which will follow a seven-stage progressive Maze Balance board protocol, and a control group (n=11) receiving standard Conventional physical therapy exercises. These interventions will be performed for 30 mins, thrice a week over 8 weeks. All the referred participants will be assessed on the basis of eligibility criteria. Guardians of participants fulfilling the eligibility criteria will be asked to sign the consent forms before entering them to study. This study will utilize three standardized assessment tools to objectively measure Cognition level, Functional Mobility and gross motor skills in children with Cognitive Impairment: Montreal Cognitive Assessment (MoCA) to measure cognition, Time Up and Go (TUG) Test for the functional mobility, While the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) for Gross Motor Skills. The synopsis will be presented to the Research Ethical Committee of Riphah International University, Lahore, for ethical approval to conduct this study. Data will be analyzed through SPSS version 27.0.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
22
The experimental group (n=11) will receive Maze Balance Board Training in a one-on-one setting, conducted three times per week for 8 weeks. A seven-stage progressive protocol will be followed, where participants advance only after successfully completing each stage, with earlier stages revisited to reinforce learning. Stage 1 involves rotating a marble with hands; Stage 2 focuses on manual maze navigation; Stage 3 develops static balance on a board; Stage 4 includes unassisted rotational balance; Stage 5 introduces foot-mediated marble rotation; Stage 6 requires foot-based maze navigation; and Stage 7 combines dynamic balance with precise marble placement as a dual task. Progression will depend on task performance over consecutive days, aiming to improve functional mobility and gross motor skills in children with cognitive impairment.
The control group (n=11) will receive conventional physical therapy as a standard-of-care baseline, conducted to improve postural control and gross motor skills. Sessions will include structured exercises performed regularly throughout the study. Activities include animal walks (bear walk, bunny hops, frog jumps) to enhance core and limb strength; bridging exercises to strengthen glutes and hamstrings; sit-to-stand training to improve lower limb strength and functional movement; tandem walking to challenge balance; standing on varied surfaces (foam/cushions) to improve proprioception; beam/line walking forward and backward for coordination and dynamic balance; and obstacle negotiation involving stepping over or around objects. These exercises will be consistently practiced to enhance mobility and motor performance in children with cognitive impairment.
Imran Amjad, PhD
Lahore, Punjab Province, Pakistan
RECRUITINGFunctional Mobility
Functional mobility will be assessed using the Timed Up and Go (TUG) test as the primary outcome measure. It evaluates a child's ability to stand up from a chair, walk a short distance, turn, return, and sit down, measuring mobility, balance, and functional movement efficiency.
Time frame: Baseline, 8 weeks
Gross motor Skills
Gross motor skills will be assessed using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) as a primary outcome measure. It evaluates motor abilities including balance, coordination, strength, and agility through standardized tasks, providing a reliable measure of overall gross motor performance in children with cognitive impairment.
Time frame: Baseline, 8 weeks
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