Mental Attention-neuromuscular Training for Children With Developmental Coordination Disorder

Study Overview
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Brief Summary
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Objective: To compare the effectiveness of EEG biofeedback mental attention-neuromuscular training (AT-NMT), neuromuscular training (NMT) alone, EEG biofeedback mental attention training (AT) alone, and no intervention for improving reactive balance performance among children with developmental coordination disorder (DCD). Design: A single-blinded, randomized controlled clinical trial. Sample: 172 children with DCD. Interventions: AT-NMT, NMT, AT, or no intervention for 12 weeks. Major outcomes: Outcomes will be evaluated at baseline, post-intervention, and 3-month follow-up. A motor control test (MCT) will give a composite latency score, prefrontal cortex EEG recordings during MCT will measure the mental attention level, and surface electromyography recordings during MCT will indicate the lower limb muscle onset latency.

Detailed Description
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Hypothesis: The Investigators hypothesize that the reactive balance performance in children with DCD can be best improved by treating both their mental attention and neuromuscular deficits. Objective: To compare the effectiveness of AT-NMT, NMT alone, AT alone, and no intervention for improving reactive balance performance among children with DCD. Design: A single-blinded, randomized controlled clinical trial. Sample: 172 children with DCD. Interventions: AT-NMT, NMT, AT, or no intervention for 12 weeks. Major outcomes: Outcomes will be evaluated at baseline, post-intervention, and 3-month follow-up. A motor control test (MCT) will give a composite latency score, prefrontal cortex EEG recordings during MCT will measure the mental attention level, and surface electromyography recordings during MCT will indicate the lower limb muscle onset latency. Anticipated results and clinical significance: Children with DCD who receive AT-NMT will have the best reactive balance performance outcomes. If the results are positive, this novel training regime can be readily adopted in clinical practice. AT-NMT will improve overall well-being in these children and have positive socio-economic implications such as shorter rehabilitation periods and reduced healthcare costs.

Official Title
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Improving Mental Attention, Timing of Muscle Activation and Reactive Balance Control in Children With Developmental Coordination Disorder: A Randomized Controlled Trial

Conditions
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Developmental Coordination Disorder

Intervention / Treatment
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* Other: EEG biofeedback mental attention-neuromuscular training
* Other: Neuromuscular training
* Other: EEG biofeedback mental attention training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 6 to 9 years old; a formal diagnosis of DCD based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) at a child assessment center; a Bruininks-Oseretsky Test of Motor Proficiency giving a gross motor composite score of ≤42; a Child Behavior Checklist attention problem subscale T score of ≥54.5, indicating an attention deficit; attending a local mainstream school; an intelligence level within the normal range; and no experience in using the Brain Computer Interface system or similar apparatus. Exclusion Criteria: a diagnosis of neurological or other movement disorder; any cognitive, psychiatric (comorbid ADHD will not be excluded), congenital, musculoskeletal or cardiopulmonary disorder that can affect motor performance; receiving active therapies or treatments including complementary and alternative medicine; demonstrating excessive disruptive behavior; or those unable to follow instructions adequately.

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 9 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: AT-NMT<br>AT-NMT group - will receive a 12-week EEG biofeedback mental attention-neuromuscular training | Other: EEG biofeedback mental attention-neuromuscular training<br>* Mental attention training using EEG biofeedback and neuromuscular training using physio-therapeutic exercises<br>|
| Experimental: NMT alone<br>NMT group - will receive a 12-week neuromuscular training | Other: Neuromuscular training<br>* Neuromuscular training using physio-therapeutic exercises<br>|
| Experimental: AT alone<br>AT group - will receive a 12-week EEG biofeedback mental attention training | Other: EEG biofeedback mental attention training<br>* Mental attention training using EEG biofeedback<br>|
| No Intervention: Control<br>Control group - no intervention for 12 weeks | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in motor control test composite latency score |  | Baseline (0 month), post-intervention (3 months), and 3-month follow-up (6 months) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in EEG mental attention level |  | Baseline (0 month), post-intervention (3 months), and 3-month follow-up (6 months) | 
| Change in surface EMG lower limb muscle onset latency |  | Baseline (0 month), post-intervention (3 months), and 3-month follow-up (6 months) |