Obstacle Course Versus Neuromotor Task Training in Children With DCD

Developmental Coordination Disorder (DCD) is a prevalent neurodevelopmental disorder affecting approximately 5-6% of school-aged children worldwide. Marked by impairments in motor coordination, skill development, and functional performance. The complex etiology of Developmental Coordination Disorder (DCD) is linked to atypical neurodevelopment, genetic predispositions, and associated co-morbidities such as ADHD and ASD, further influenced by perinatal factors like prematurity and low birth weight. DCD is associated with long-term consequences, including difficulties in activities of daily living (ADLs), reduced participation in physical activities, and impaired psychosocial functioning, which collectively increase the risk of obesity and lower self-efficacy. Early, targeted, and task-specific interventions are crucial. Among these, Neuromotor Task Training (NTT) focuses on improving motor planning through structured, cognitive strategies, while Obstacle Course Training (OCT) provides a dynamic setting that promotes functional movement and real-time problem-solving.

This randomized clinical trial will compare the effects of both interventions. The study will be conducted over 10 months at the University of Lahore Teaching Hospital (ULTH) pediatric rehabilitation center and Sehat Medical Complex (SMC) Hanjarwal. The duration of the intervention will be 9 weeks, with 2 sessions per week. There will be two study groups, and convenient sampling techniques will be used. Eligible participants will be children aged 7 to 10 years, both males and females, diagnosed with DCD based on DSM-5 criteria, with a Mini-Mental State Examination (MMSE) score >24 and an IQ above 75 on the Raven Intelligence Scale. Screening for DCD will be done using the Developmental Coordination Disorder Questionnaire (DCDQ) and motor proficiency will be assessed using the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2). Children with a DCDQ score of ≤48 and a BOT-2 score of ≤40 will be included. Children with other neurological, psychiatric, or orthopedic conditions will be excluded. Participants will be randomly assigned to receive either Obstacle Course Training (OCT) or Neuromotor Task Training (NTT) to assess which intervention more effectively improves motor planning and functional mobility. SPSS version 27 will be used for data analysis.

Inclusion criteria

• • Diagnosis of DCD based on DSM4/5 criteria.

• Children aged 7-10.
• Gender male and female.
• Mini-Mental State Examination (MMSE) score >24 .
• Cognitive development appropriate for chronological age.
• Raven Intelligence Test Scale (IQ > 75) .
• Developmental Coordination Questionnaire ≤48 points: likely DCD (≤ 10th percentile).
• BOT-2 score ≤ 40.

Exclusion criteria

• History of surgery and lower limb injuries over the past 12 months.
• Use of assistive devices to balance and walk.
• Severe ADHD, Autism Spectrum Disorder (if it significantly interferes with participation), or major psychiatric disorders.
• Taking neuroleptics or any other medications that significantly alter muscle tone, coordination, or attention.