Effects of Music on Motor Skills of Children With Attention Deficit and Hyperactivity Disorder

Study Overview
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Brief Summary
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Physiotherapists have positive effects on motor skills, executive functions and symptoms of children with attention deficit and hyperactivity disorder. However, progression takes time due to the symptoms of the disease. Physiotherapists need strategies to manage the symptoms of ADHD. Music can be used as a strategy because music is known to reduce the symptoms of children in this group. There is no study in the literature on how motor skills will be affected with musical accompaniment. The aim of this study is to compare motor skills performed with and without music in children with ADHD. When we evaluate motor skills like in a treatment session, the usability of music as an environmental factor will be investigated according to the positive, negative or ineffective results of the music effect.

Detailed Description
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The American Psychiatric Association defines attention deficit and hyperactivity disorder (ADHD) as one of the most common mental disorders affecting children and adults. The etiology of ADHD is not fully known. Attention deficit, hyperactivity and/or impulsivity are seen as the main symptoms of ADHD. ADHD is grouped into three subtypes according to these symptoms. These three subtypes consist of attention-deficit-dominant type, hyperactivity-dominant type, and combined type with both hyperactivity and inattention symptoms. Researchers reported that 45-70% of children with ADHD have problems in fine and gross motor skills. It is known that problems in motor skills are associated with main symptoms. Balance, gait and postural control are affected in terms of gross motor skills. It has been observed that they perform more slowly in activities that require fine motor skills such as cutting, doing crafts or drawing, and in consecutive finger movements. In addition, handwriting disorders such as dysgraphia are seen in 70% of children with ADHD. During the dual tasks, the sources of attention are divided. Due to this division, the secondary task affects postural performance. Music is one of the therapy options in some conditions and known as music therapy. It is used in many diseases and conditions such as dementia-alzamer, autism, cerebral palsy, cancer, prematurity, depression and ADHD. Now that music is known to reduce the symptoms of children with ADHD, physical therapists may use music as a strategy. Thus, the purpose of this study is to compare motor skills of children with ADHD with and without music conditions.

Official Title
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Motor Skills in Children With Attention Deficit and Hyperactivity Disorder

Conditions
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Attention Deficit Hyperactivity Disorder

Intervention / Treatment
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* Other: Music


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Having been diagnosed with ADHD combined type by a child psychiatrist Having adequate cognitive skills to understand the commands of the physiotherapist Exclusion Criteria: Having hearing and/or vision problems Having any neurological and/or orthopedic problems that would prevent him from performing the tests Having a psychiatric disorder other than ADHD

Ages Eligible for Study
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Minimum Age: 6 Years
Maximum Age: 11 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: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Group with music<br>L400 Over Ear Music Headset Glowing Cat Ear Headphones 7 branded headphones will be used for music intervention. | Other: Music<br>* L400 Over Ear Music Headset Glowing Cat Ear Headphones 7 branded headphones will be used for musical measurements (70-80 bpm music).<br>|
| No Intervention: Group without music<br>Music will not be used while performing motor skills. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Static balance | Stork static balance test will be used. Children will be asked to stand comfortably on both feet with their hands on their hips. They will then be asked to raise their non-dominant legs. This test will be repeated 3 times. The test will be measured in time (seconds) with a stopwatch and the best result from three attempts will be recorded. | change from baseline to after 30-minute from the first measurement | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dynamic balance | Timed up and go (TUG) test will be used. The TUG test is administered using 2 standard chairs and children are asked to walk in a self preferred speed. Time is recorded in seconds. | change from baseline to after 30-minute from the first measurement | 
| Nine hole peg test | The test consists of a square board with 9 holes. First, the child will be asked to insert the nails into the holes as quickly as possible using the dominant hand, and to quickly remove all the nails from the holes as soon as they are all inserted. Insertion, removal and total time of nails will be recorded in seconds via stopwatch. | change from baseline to after 30-minute from the first measurement | 
| Blocking with jenga game | Jenga game involves attention and hand eye coordination. The children will be asked to make a standard shape made using six of the game's blocks and the completion time will be recorded in seconds. | change from baseline to after 30-minute from the first measurement | 
| Puzzle game | A standard wood puzzle will be used to test fine motor skills. The time to complete the puzzle will be recoded in seconds with a stopwatch. | change from baseline to after 30-minute from the first measurement | 
| Bruininks-Oseretsky Test of Motor Proficiency-Brief Form (BOTMP-BF) | It consists of composite scores of fine motor control, manual coordination, body coordination, strength and agility motor domain. Scoring is done for each subheading. The maximum score that can be obtained from the entire test is 88. | change from baseline to after 30-minute from the first measurement | 
| Dual task skill | Dual task is based on distraction while doing two tasks at the same time. Performance decreases in dual tasks due to sharing of attention. For the dual task, the child will carry a water filled bottle (500 ml) in his dominant hand while performing the 10-meter walking test. The dual duty will be calculated with the dual duty cost formula. This formula is as follows; Dual Task Cost = ((Dual Task Performance - Single Task Performance) X 100/Single Task Performance) The number from calculation will be recorded. | change from baseline to after 30-minute from the first measurement |