Effective Interventions for Improving Coordination

The purpose of this systematic literature review titled “Effectiveness of Interventions for Children With Developmental Coordination Disorder in Physical Therapy Contexts: A Systematic Literature Review and Meta-Analysis,” is to explore the types of physical therapy interventions used to help children with developmental coordination disorder (DCD), and whether they are effective in improving coordination and balance. This review looked at 29 different research articles to create a summary of what interventions are effective, as well as what factors contributed to positive results.

Developmental coordination disorder (DCD), sometimes referred to as dyspraxia, is “a condition in which difficulties in motor skills exist but are not due to overall intellect, primary sensor, or motor neurology of the individual.”¹

Physical Therapy Categories

This review separated physical therapy into three different categories of intervention: traditional, contemporary, and task-oriented training. The research reviewed showed that all three categories of physical therapy are effective for DCD to improve “balance, motor coordination and timing, muscle strength and function, and motor function/performance”²

Traditional physical therapy included interventions such as motor skills training, strength training, and core stability training. Contemporary physical therapy involved active virtual gaming (AVG), Interactive Metronome (IM) training, hippotherapy, and aquatic and rebound therapy. Task-oriented training studies focused on neuromotor task training (NTT).

Traditional Physical Therapy

The overall consensus was that all methods improved balance, gross motor function, strength, and endurance. With more endurance and power, the children were able to improve their quality of life and perform more motor movements. The only intervention that did not seem to improve balance was Tae Kwon Do training.

Contemporary Physical Therapy

Since these contemporary methods are more novel, not as much research is done on them. However, overall all contemporary methods showed an improvement in motor skills and balance. It’s important to note that each of these novel methods targets specific areas. For example, Active virtual gaming (AVG) used programs associated with the PlayStation 3 Move, and improvements were seen mostly in hand and wrist movements, probably due to how the controller is held. Hippotherapy is equine therapy, and greatly improved balance as the child had to hold themselves up on the horse as it moved around.

Task-Oriented Training

The task-oriented training focused mostly on NTT, which is observing how a child interacts with the task and environment and manipulating different factors to help a child complete a movement to the best of their ability. For more information on NTT, visit the site here. This intervention type was effective to improve fine and gross motor skills, but its effectiveness relied on how well the therapists were able to provide instruction and feedback.³

Clinical Implications

Motivation and duration played a big role in how effective intervention was. When the kids were motivated and engaged, they were more likely to participate. Duration is also a critical factor because therapy needs to be performed consistently and for the right amount of time to see improvement, especially in physical therapy cases. Additionally, “longer duration means more practice, and more practice means an increased chance of retaining information and storing it in the long-term memory.”⁴

There are many different categories of physical therapy, and all are effective in their way. The implications here are that for children with DCD “task-oriented approaches (NTT) and motor training-based interventions of traditional and contemporary PT contexts are beneficial,” and “interventions based on motor skills training and NTT are best for gross motor problems.”⁵

Bilateral Coordination Exercises

It’s not only the kids with DCD that need help with coordination. Bilateral coordination is something used in so many daily activities, such as tying shoes or throwing a ball.

Pink Oatmeal lists several different exercises that target bilateral coordination such as seated side arm raises, midline crossing exercises, scissor steps, wall stickers, and more. Their page also shows video examples of each exercise. Check them out here.

• References

  1. “Offor, Nkechi, et al., “Effectiveness of Interventions for Children With Developmental Coordination Disorder in Physical Therapy Contexts: A Systematic Literature Review and Meta-Analysis,” Journal of Motor Learning and Development, 4, no. 2 (2016): 169, http://dx.doi.org/10.1123/jmld.2015-0018.

  2. Offor, “Effectiveness of Interventions,” 188.

  3. Ibid, 185.

  4. Ibid, 187.

  5. Ibid, 189.