This randomized controlled study evaluated whether an 8-week balance-cognitive-strength training program improved balance ability, inhibitory control, and gait performance in preschool children aged 3 to 6 years. Children completed balance tests, single-task walking tests, dual-task walking tests, and an iPad-based Go/No-Go task before and after the intervention. The intervention group received exercise-cognitive integrated training 3 times per week for 8 weeks, and the control group maintained usual daily activities.
Preschool children aged 3 to 6 years were recruited from a kindergarten in Weifang, China. Eligible children completed baseline assessments of balance ability, gait performance, and inhibitory control. Balance was assessed using static and dynamic balance tasks on a Zebris force platform. Gait was assessed during single-task walking and dual-task walking while counting backward. Inhibitory control was assessed using an iPad-based Go/No-Go task. Participants were randomly assigned to a balance-cognitive-strength training group or a usual daily activity control group. The training group received an 8-week exercise-cognitive integrated training program, 3 sessions per week and 40 minutes per session. Training activities included balance exercises, lower-limb strength activities, brisk walking games, and embedded cognitive tasks such as counting, verbal naming, memory tasks, and response inhibition tasks. The control group maintained usual daily activities during the same period. Outcomes were assessed at baseline and immediately after the 8-week intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
65
The intervention was an 8-week exercise-cognitive integrated training program for preschool children. Sessions were conducted 3 times per week, 40 minutes per session, at moderate intensity. The program combined balance exercises, lower-limb strength activities, brisk walking or aerobic walking games, and embedded cognitive tasks involving counting, verbal naming, working memory, and response inhibition.
China Institute of Sport Science
Beijing, China
Change From Baseline in Single-Task Gait Index at Week 8
The Single-Task Gait Index was derived from gait variables measured during normal walking. Gait was assessed using a gait analysis system during single-task walking. Variables included stance time, stride time, double-support time, step width variability, loading rate, and related temporal-spatial gait parameters. Variables were standardized and direction-unified before construction of the gait index. Higher scores indicate better single-task gait performance. The change score was calculated as the post-intervention score minus the baseline score.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in Dual-Task Gait Index at Week 8
The Dual-Task Gait Index was derived from gait variables measured while children walked and performed a concurrent cognitive task. During dual-task walking, participants walked while counting backward from 10 to 1. Variables included stance time, stride time, double-support time, step width variability, loading rate, and related temporal-spatial gait parameters. Variables were standardized and direction-unified before construction of the gait index. Higher scores indicate better gait performance under cognitive load. The change score was calculated as the post-intervention score minus the baseline score.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in Balance Composite Score at Week 8
Balance ability was assessed using static and dynamic balance tasks on a Zebris force platform. The Balance Composite Score was constructed from standardized balance variables using principal component analysis. The composite score reflected anterior-posterior sway control, load symmetry, and dynamic postural adjustment. Negative indicators, such as center-of-pressure velocity and ellipse area, were direction-unified before score calculation. Higher scores indicate better overall balance ability. The change score was calculated as the post-intervention score minus the baseline score.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in Inhibitory Control Composite Score at Week 8
Inhibitory control was assessed using an iPad-based Go/No-Go task from the Early Years Toolbox. Children were instructed to respond to Go stimuli and inhibit responses to No-Go stimuli. Accuracy and reaction time were standardized and direction-unified to create an inhibitory control composite score. Higher scores indicate better inhibitory control. The change score was calculated as the post-intervention score minus the baseline score.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in MABC-2 Total Test Standard Score at Week 8
Motor development was assessed using the Movement Assessment Battery for Children, Second Edition (MABC-2), age band 1 for children aged 3 to 6 years. The total test standard score was derived from the manual dexterity, aiming and catching, and balance components. Higher standard scores indicate better motor development. The change score was calculated as the post-intervention score minus the baseline score.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in MABC-2 Manual Dexterity Component Score at Week 8
Manual dexterity was assessed using the MABC-2 age band 1 manual dexterity tasks, including fine motor tasks such as posting coins, threading beads, and drawing trail. Scores were converted according to the MABC-2 scoring manual. Higher component scores indicate better manual dexterity. The change score was calculated as the post-intervention score minus the baseline score.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in MABC-2 Aiming and Catching Component Score at Week 8
Aiming and catching ability was assessed using the MABC-2 age band 1 aiming and catching tasks, including catching and throwing tasks. Scores were converted according to the MABC-2 scoring manual. Higher component scores indicate better ball skill and object-control performance. The change score was calculated as the post-intervention score minus the baseline score.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in MABC-2 Balance Component Score at Week 8
Motor balance was assessed using the MABC-2 age band 1 balance tasks, including static and dynamic balance tasks such as one-leg balance, walking with heels raised, and jumping tasks. Scores were converted according to the MABC-2 scoring manual. Higher component scores indicate better balance-related motor development. The change score was calculated as the post-intervention score minus the baseline score.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in 10-Meter Shuttle Run Time at Week 8
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Agility and movement speed were assessed using the 10-meter shuttle run from the Chinese national physical fitness test battery for children aged 3 to 6 years. The outcome was recorded in seconds. Lower values indicate better performance. The change score was calculated as the post-intervention time minus the baseline time.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in Standing Long Jump Distance at Week 8
Lower-limb explosive strength was assessed using the standing long jump from the Chinese national physical fitness test battery for children aged 3 to 6 years. The outcome was recorded in centimeters. Higher values indicate better performance. The change score was calculated as the post-intervention distance minus the baseline distance.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in Tennis Ball Throw Distance at Week 8
Upper-limb power and object-control ability were assessed using the tennis ball throw from the Chinese national physical fitness test battery for children aged 3 to 6 years. The outcome was recorded in meters or centimeters according to the test record form. Higher values indicate better performance. The change score was calculated as the post-intervention distance minus the baseline distance.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in Double-Foot Continuous Jump Time at Week 8
Coordination and lower-limb jumping ability were assessed using the double-foot continuous jump test from the Chinese national physical fitness test battery for children aged 3 to 6 years. The outcome was recorded in seconds. Lower values indicate better performance. The change score was calculated as the post-intervention time minus the baseline time.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in Sit-and-Reach Distance at Week 8
Flexibility was assessed using the sit-and-reach test from the Chinese national physical fitness test battery for children aged 3 to 6 years. The outcome was recorded in centimeters. Higher values indicate better flexibility. The change score was calculated as the post-intervention distance minus the baseline distance.
Time frame: Baseline and immediately after the 8-week intervention
Change From Baseline in Balance Beam Walking Time at Week 8
Dynamic balance was assessed using the balance beam walking test from the Chinese national physical fitness test battery for children aged 3 to 6 years. The outcome was recorded in seconds. Lower values indicate better performance. The change score was calculated as the post-intervention time minus the baseline time.
Time frame: Baseline and immediately after the 8-week intervention