Evaluating the evidence for motor-based interventions in developmental coordination disorder: A systematic review and meta-analysis.

BACKGROUND: As part of the process of creating an update of the clinical practice guidelines for developmental coordination disorder (DCD) (Blank, Smits-Engelsman, Polatajko, & Wilson, 2012), a systematic review of intervention studies, published since the last guidelines statement was conducted. AIM: The aim of this study was to 1) systematically review the evidence published from January 2012 to February 2017 regarding the effectiveness of motor based interventions in individuals with DCD, 2) quantify treatment effects using a meta-analysis, 3) examine the available information on different aspects of delivery including use of group intervention, duration and frequency of therapy, and 4) identify gaps in the literature and make recommendations for future intervention research. METHOD: An electronic search of 5 databases (PubMed, Embase, Pedro, Scopus and Cochrane) was conducted for studies that evaluated motor-based interventions to improve performance for individuals with DCD. RESULTS: Thirty studies covering 25 datasets were included, 19 of which provided outcomes on standardized measures of motor performance. The overall effect size (Cohen's d) across intervention studies was large (1.06), but the range was wide: for 11 interventions, the observed effect was large (>0.80), in eight studies moderate (>0.50), and in five it was small or negligible (<0.50). Positive benefits were evident for activity-oriented approaches, body function-oriented combined with activities, active video games, and small group programs. CONCLUSION: Results showed that activity-oriented and body function oriented interventions can have a positive effect on motor function and skills. However, given the varied methodological quality and the large confidence intervals of some studies, the results should be interpreted with caution.

Improved Learning a Coincident Timing Task With a Predictable Resisting Force.

The present study analyzes the learning in a coincident timing task with force perturbation. We aimed to verify whether a predictable load (constant spring) applied to hand movements could facilitate learning and, thus, performance improvement with respect to movements without any external load and an unpredictable load to perform a coincident timing task with a few number of repetitions (n = 28) under acquisition and transfer phases. The results showed that the group with a predictable load had a significant better performance with lower percentage of errors and smaller time variance in the acquisition and transfer phase. The groups with no load and unpredictable load had a similar performance in the transfer phase. It can be concluded that adding a predictable force to the coincident timing task results in performance improvement. Therefore, learning to reach a target at a correct time could be improved with the application of predictable external loads.