Strengths and weaknesses of the MABC-2 as a diagnostic tool for developmental coordination disorder: An online survey of occupational therapists and physiotherapists.

The Movement Assessment Battery for Children-2 (MABC-2) is the most widely used instrument for aiding the diagnosis of developmental coordination disorder (DCD). Despite being shown to have strong validity and reliability, it has received criticism for aspects of its scoring system, the lack of formal training, and its susceptibility to overlook higher functioning DCD children. To aid the development of future diagnostic tools and/or iterations of the MABC-2, the present study attempted to draw upon the experience of key stakeholders and determine the strengths and weaknesses of the MABC-2. Using a short online questionnaire, occupational therapists (n = 14) and physiotherapists (n = 3) with experience using the MABC-2 for DCD diagnosis completed a series of Likert scale and free-text questions. Braun and Clarke's six-phase process to thematic analyses was used to identify main themes obtained across quantitative and qualitative data. Results indicate that whilst the MABC-2 is easy to administer and interpret, the scores can misrepresent true motor difficulties due to (a) daily variations in mental and physical state, (b) the reliance on non-functional tasks, (c) negative interference from parents, (d) changes in motor competency due to practice, and (e) a lack of formal examiner training to ensure the test is effectively lead. Further work is needed to more reliably determine how perceptions of the MABC-2 might vary across levels of expertise, profession, and cultural differences.

Recovery From a Forward Falling Slip: Measurement of Dynamic Stability and Strength Requirements Using a Split-Belt Instrumented Treadmill.

Aim: Falls commonly occur from trips and slips while walking. Recovery strategies from trips and backward falling slips have been extensively studied. However, until recently, forward falling slips (FFSs) have been considered less dangerous and have been understudied. This study aimed first to create an application to realistically simulate FFSs using a split-belt instrumented treadmill and then to understand the biomechanical requirements for young adults to recover from an FFS. Methods: We developed a semi-automatic custom-made application on D-Flow that triggered FFSs by briefly and unexpectedly increasing the speed (a = 5 m·s-2) of the right belt during stance. To validate the protocol, we tested against criteria defined for an ecologically and experimentally valid FFS: unexpected occurrence of the slip, increased foot velocity, forward loss of balance during the slip and consistent perturbation timing. We evaluated the recovery strategies of 17 young adults by measuring dynamic stability, joint moments and ground reaction force (GRF) vector angles before, during and on 15 steps following the FFS. Results: The application successfully triggered FFSs, according to the criteria we defined. Participants' balance returned to normal for a minimum of three consecutive steps in 10.9 (7.0) steps. Recovery from the FFSs was characterised by larger hip flexor and knee extensor moments to support the centre of mass during the slip, and a longer first recovery step with large hip extensor moments to arrest the fall followed by large knee extensor moments to raise and advance the centre of mass into the next step (p < 0.001 compared with normal gait). Subsequent steps progressively returned to normal. Conclusion: This is the first study to experimentally simulate FFSs meeting the aforementioned criteria, and to measure their effects on the dynamic balance and kinetic parameters. The split-belt instrumented treadmill proved a promising tool to better study the mechanisms of falls and recovery. The required large hip and knee joint moments generally agree with findings on trips and backward falling slips and provide an indication of the functional capacities that should be targeted in fall-prevention interventions. These findings should be used to better understand and target the mechanisms of balance loss and falls in older adults following FFSs.