Effect of taekwondo training on sensori-motor performance and postural control in children with and without developmental coordination disorder

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Effect of taekwondo training on sensori-motor performance and postural control in children with and without developmental coordination disorder

 

Author: Fong, Siu Ming
Title: Effect of taekwondo training on sensori-motor performance and postural control in children with and without developmental coordination disorder
Degree: Ph.D.
Year: 2012
Subject: Tae kwon do.
Equilibrium (Physiology)
Motor ability in children.
Apraxia -- China -- Hong Kong.
Hong Kong Polytechnic University -- Dissertations
Department: Dept. of Rehabilitation Sciences
Pages: xliii, 381 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2522727
URI: http://theses.lib.polyu.edu.hk/handle/200/6615
Abstract: Developmental coordination disorder (DCD) is a common motor dysfunction, affecting approximately 6% of children at primary school age. A reported 73% to 87% of children with DCD exhibit balance problems. Suboptimal balance ability demonstrated in a child with DCD requires attention because any impairment in postural control may limit the child's participation in daily activities, increase the risk of falls and affect development of motor skills. Training in dynamic sports such as dancing is reported to improve postural control in young people. Taekwondo (TKD) is a popular sport famous for its fast kicking techniques. Practitioners are frequently required to stand and pivot on one foot. This manoeuvre is of interest as a potential therapeutic activity to improve balance control in children with DCD. However, the effects of TKD training on postural control have not been fully explored, particularly in children with DCD. Therefore, this thesis explores the effects of TKD training on postural control and sensori-motor performance in children with DCD. Two cross-sectional studies (studies 1 and 2) were conducted to investigate and identify deficits in postural control status, i.e. (1) sensory organization, (2) motor strategy, and (3) standing postural control, in children with DCD. Three additional cross-sectional studies (studies 3 to 5) were then conducted to investigate the potential effects of TKD training in terms of (1) sensory organization, (2) knee joint proprioception, (3) knee muscle strength, and (4) unipedal stance stability, in typically developing adolescents. Finally, a randomized controlled trial (study 6) was performed to verify the effects of specific TKD exercises on postural control and sensory organization in children with DCD.
Results from studies 1 and 2 revealed that children with DCD rely on somatosensory information for postural control as effectively as typically developing children (p>0.05). However, children with DCD were shown to be below their normal counterparts in their ability to integrate visual (p<0.01) and vestibular inputs (p<0.01), in their motor strategy used under conflicting sensory conditions (p<0.05), and in their static bipedal (p<0.001), unipedal (p<0.01) and functional standing balance (p<0.001). When the effects of short-term TKD training were investigated (studies 3 to 5), it was found that trainees were better able than their non-trained counterparts to integrate visual (p<0.05) and vestibular inputs (p<0.05) under conflicting sensory conditions and better able to control unipedal standing balance (p<0.05). Knee muscle strength and joint position sense in the TKD trainees were also found to be greater (effect sizes=0.58-0.88 between short-term TKD trainees and their non-trained counterparts) and more accurate (p<0.01), respectively. Results suggest that TKD may be appropriate for balance training in the DCD population. Finally, our main study (study 6, a randomized controlled trial) showed that three-month specific TKD intervention, aimed at improving sensory organization and balance control in children with DCD, yielded favourable results. This is, (1) somatosensory function in children with DCD was not influenced by TKD training (p>0.05); however, somatosensory function in children with DCD is normal; (2) TKD training improved visual function for balance control in DCD-affected children (p<0.01), and the effect of training was more profound than the effect of physiological maturation; (3) after the TKD training, less standing sway occurred when only vestibular input was available in children with DCD (p<0.01) and the performance was comparable to that of children with normal motor development (p>0.05). TKD was therefore considered effective for vestibular training. In addition, (4) unilateral stance stability in children with DCD improved (p<0.01) and reached the status of typically developing children after training (p>0.05); and (5) although bipedal standing balance improved after TKD training in children with DCD (p<0.01), the effect of maturation was more profound than the training effect. Results indicate that clinicians can confidently suggest TKD exercise as a combined therapeutic-leisure activity to improve sensory organization and balance control in children with DCD.

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