Effects of Developmental Gymnastics Exercise Program on Preschoolers' Motor Skills: a Randomized Controlled Trial
Phase: NA
Conditions: Motor Activity, Child Development, Exercise
Sponsor: University of Novi Sad

Effects of developmental gymnastics exercise program on preschoolers' motor skills: 
a randomized controlled trial 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
March, 7, 2024 

Study Overview 
Brief Summary 
Background: During childhood, physical activity (PA) is considered indispensable for 
developing motor skills through movement in the early stages of human development. Being 
active helps individuals develop fine and gross motor skills (GMS) by promoting an active 
lifestyle. Notably, this phase, characterized by regular PA and attaining motor competence, 
is associated with many health-related benefits. Early motor intervention programs have 
garnered attention for their positive influence on children's motor skills, as evidenced by 
various studies. A spectrum of more specialized methods is available alongside these general 
approaches, including programs designed to augment the time dedicated to general PA 
within school environments. Previous research has demonstrated the efficacy of 
incorporating experimental exercise interventions, grounded in enjoyable activities and 
game drills, into the curriculum, significantly improving children's basic motor skills. Many 
research articles have explored the impact of developmental gymnastics (DG) on children's 
fitness, indicating that gymnastics training can produce numerous beneficial outcomes for 
children's physical fitness. 
Method and Materials: Three hundred preschool children were assigned to either a gender-
balanced group participating in a DG exercise program (EG; n=99) or a control group (CG; 
n=121). While individuals in the CG followed three structured extracurricular physical 
activities per week in kindergarten, the EG participants received 60 minutes of the DG 
exercise program two days a week. We used the Test of Gross Motor Development-2 (TGMD-
2) to assess GMS. 
Aim: The study aimed to determine if participation in a structured DG program could 
improve GMS among preschool children compared to those in a group that attended 
extracurricular physical activities in a kindergarten. 
 
 
 

Detailed Description 
Study design 
Developmental gymnastics (DG) presents a specialized form of gymnastics focusing on 
individuals' physical, cognitive, and motor development, typically children. The study aimed 
to determine the effects of DG, which lasts nine months, on preschoolers' gross motor skills 
(GMS). The study presents an Interventional study to improve motor abilities, and the main 
objective is prevention. The study model is parallel with two groups. 
 
Participants 
The initial sample of respondents (n=350) was recruited through an open project application 
lasting two months (from 1 July 2021 to 1 September 2021), from which 300 preschool 
children aged 4–7 were selected for this randomized, controlled interventional study. The 
recruitment process was completed after the selection process, and the optimal sample of 
subjects was filled out. The study sample underwent stratified randomization, resulting in 
the division into either EG (Experimental Group - 1) or CG (Control Group - 2). When 
stratifying, researchers used proportionate sampling to maintain the correct proportions of 
genders in every group. The intervention program started with a group of 150 children in 
EG, and at the same time, 150 children in CG started a kindergarten educational program in 
a Preschool Institution. Throughout the nine months of the experimental program, 51 
children from the intervention group and 29 from the control group were excluded from the 
final analyses due to injury, flu, illness, or attendance at classes falling below 80%. Finally, 
99 children (54 boys & 45 girls) who composed the EG and 121 children (64 boys & 57 girls) 
who composed the CG were analyzed for the effects of the DG. After nine months, a total of 
220 participants were included in the final analysis. The parents or guardians of each child 
provided written informed consent, and the study received approval from the institutional 
ethics committee at the Faculty of Sport and Physical Education, University of Novi Sad 
(ethical approval number: 46-06-04/2020-1). 
 

The exclusion criteria were:  
- History of neurological or musculoskeletal disorders 
- Clinical conditions that could affect balance, such as motor disorders, diabetes, heart 
disease, stroke, vision problems, thyroid issues, or issues with nerves or blood vessels. 
 
The inclusion criteria for this study were: 
- No injuries within the past six months 
- No other medical conditions, including COVID-19 
- No scheduled physical activity in the previous three months 
- Considered valid for the experimental programs if participants completed at least 80% of 
all training sessions. 
 
Figure 1 illustrates the flow of participants through the study. 
 
 

 
Testing procedures 
 
Secondary outcome – Anthropometric measures 
Anthropometric data, including height and weight, were collected before the motor 
competence and physical fitness assessment. Following Martin's guidelines, body height was 
measured using a fixed anthropometer (GPM Anthropometer 100; DKSH Switzerland Ltd., 
Zurich, Switzerland; ± 0.1 cm). Body mass was measured with a digital balance (BC1000, 
Tanita, Japan; ± 0.1 kg), following the guidelines proposed by the International Biological 
Program (IBP). The body mass index (BMI) was calculated using the weight/height^2 
(kg/m^2) formula based on the provided height and weight values. 
Primary outcome - TGMD-2 
The Test of Gross Motor Development – 2 (TGMD-2) is a standardized test to assess gross 
motor functioning in children aged 3 through 10. Researchers have previously utilized the 
TGMD-2, which demonstrates high reliability and minimal test error, instilling confidence in 
its application (Butler et al., 2023; Lopes et al., 2018; Nagy et al., 2023). The TGMD-2 
measures 12 fundamental motor skills divided into two subcategories. The locomotor 
subtest consists of six skills: run, hop, gallop, leap, horizontal jump, and slide. The object 
control subtest includes six skills: hitting a stationary ball, dribbling while stationary, 
catching, kicking, throwing overhand, and rolling underhand. Motor competence was 
assessed with the TGMD-2 using the detailed instruction manual by examiners trained in 
physical education with prior experience in TGMD-2 measurements (Ulrich, 2000). 
Experienced researchers in test assessments coordinated and supervised the assessments. 
Each test took approximately 15-20 minutes and was performed indoors. The assessments 
were carried out, recorded, and coded at the Gymnastics Center, Faculty of Sport and 
Physical Education, University of Novi Sad, Serbia, from 1. September 2021 to 15. September 
2021. Following a visual demonstration, each participant performed all 12 skills of the 
TGMD-2, receiving one practice attempt and two assessment trials for each skill. Each skill 

consists of three to five performance criteria, with one score assigned if the criterion is 
present and zero if not. Total scores for each skill and subtest were calculated, ranging from 
0 to 48. 
Interventions 
 
The Developmental Gymnastics Exercise Program  
The nine-month DG exercise program (from 15 September 2021 to 15 May 2022) was 
conducted indoors in a well-equipped gymnasium. Trained physical education teachers and 
gymnastics experts led the training sessions twice weekly (on Tuesday and Thursday) 
without a break throughout the experimental period. Each session lasted for 60 minutes and 
covered a range of gymnastics activities and exercises, with each week focusing on specific 
categories of GMS, such as stability (trunk strength), locomotor skills (running, hopping, 
skipping), and manipulation (ball skills). The program also introduced children to 
fundamental elements of DG and was meticulously structured, incorporating frontal and 
group work, primarily circuit training (polygon) or repetitive (station) training. Obstacle 
courses were designed to incorporate various gymnastic apparatus and props, encouraging 
problem-solving through gymnastic and athletic exercises and elementary games. The 
number of repetitions, sets, and complexity of exercises and routines gradually increased in 
the central part of the session as children could perform them quickly, accompanied by 
external cues such as sweating, blushing, spontaneous breaks, and heart rates. The training 
structure consisted of three parts: I) A 15-minute warm-up with diverse movements, speed-
varied exercises, activities for flat feet, stretching, corrective and preventive exercises for 
posture improvement, and a focus on proper performance awareness. II) The central part 
lasted 40 minutes and included reviewing and practising previous skills, introducing and 
practising new skills, engaging in competitive activities, and conditioning exercises. III) A 5-
minute cool-down involving stretching, coaching feedback, and informal discussion about 
sports, exercise, and daily activities. A positive and friendly atmosphere was maintained 
throughout each training session, accompanied by suitable kids' music, especially during the 

introduction and preparation phases. Basic principles and procedures were adapted from 
previous research (Bala, 1996; Radanovic, 2018). 
In contrast, the CG adhered to their routine, engaging in three structured extracurricular 
physical activity sessions per week, each lasting approximately 45 minutes. A physical 
education specialist and a kindergarten teacher led these sessions. They were designed to 
enhance fundamental locomotor skills (e.g., hopping, skipping, jumping, crawling, and 
navigating obstacles) and manipulative skills involving balls, bricks, and toys. The primary 
objective was to create an environment where children could enjoy and have fun during 
exercise. According to the National Program for Kindergarten Physical Education Classes, 
the standardized program predominantly featured frontal and group activities, 
encompassing traditional games and dances, and included different training forms. The 
authors did not thoroughly provide detailed information about the intervention program. 
 
Statistical analyses 
Unless otherwise specified, we present data as mean and 95% confidence intervals [95% 
CIs]. We conducted an independent samples t-test to examine whether the baseline study 
outcomes varied among the groups. Normality was confirmed using the Kolmogorov-
Smirnov test, and homogeneity of variances and covariance matrices were accepted through 
Levene's and Box's tests, respectively. We first modelled raw scores of each study outcome 
using a 2x (girls vs. boys), 2x (EG vs. CG), and 2 (initial vs. final testing) mixed ANCOVA 
(Model 1) to test confounding effects of gender, age, and BMI on intervention effects. We 
inspected the main effects of gender, age, and BMI to assess whether the study outcomes 
depended on these factors. This examination aimed to determine whether gender, age, and 
BMI could control the effects of the DG program on the study outcomes. Hence, respecting 
the significance of control variables effects (p≤0.05), we modelled each study outcome using 
either a 2x (girls vs boys) 2x (EG vs CG) 2 (initial vs final testing) mixed ANCOVA with age 
and BMI or only with age to find whether study outcome mean changes [95% CIs] from initial 
to final testing depended on whether subjects completed DG program or not (Model 2). We 
assessed potential gender confounding effects on changes in the study outcomes by 

examining a time*group*gender interaction effect, followed by a time*group interaction 
effect for boys and girls, respectively. The time*group interaction effects allowed the 
evaluation of DG program effects followed by the simple main effects of time, which 
designated mean changes [95% CIs] from initial to final testing for each group. In addition, 
we estimated the parameters (beta coefficients, β and partial eta2, ŋ2) of ANCOVA models. 
Games-Howel tests corrected multiple comparisons, and a p-value of ≤0.05 designated 
statistical significance. Partial eta squared (partial ŋ2) is reported as a measure of effect size 
and classified as small (0.01), medium (0.06), and large (0.14), according to Cohen. We 
conducted all analyses using SPSS (v.23, IBM Corporation, New York, USA). 
 
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