A systematic review of randomised and case-controlled trials investigating the effectiveness of school-based motor-skill interventions in 3-12-year-old children.

Abstract

BACKGROUND\nResearch suggests that children identified with impaired motor skills can respond well to intensive therapeutic interventions delivered via occupational and physical therapy services. There is, however, a need to explore alternative approaches to delivering interventions outside traditional referral-based clinic settings because limited resources mean such health services often struggle to meet demand. This review sets out to systematically assess the evidence for and against school-based interventions targeted at improving the motor skills of children aged between 3-12 years old.\n\n\nMETHOD\nFive electronic databases were searched systematically (AMED, CINAHL, Cochrane, Medline & PsycINFO) for peer-reviewed articles published between January 2012 and July 2018. Studies were eligible if they implemented a school-based motor skill intervention with a randomised or case-controlled trial design that objectively measured motor skills as an outcome, which were not specific to an athletic or sporting skill. Participants had to be aged between 3-12 years old and free from neurological disorders known to affect muscle function. Risk of bias was assessed using the Cochrane risk of bias tool.\n\n\nRESULTS\nTwenty-three studies met the inclusion criteria. These studies encompassed interventions targeted at training: fundamental movement skills; handwriting; fine; and global motor skills. The majority of these studies reported beneficial impact on motor function specifically, but some interventions also assessed subsequent impacts on activity and participation (but not wellbeing). A number of the studies had methodological shortcomings that means these results need to be interpreted with caution.\n\n\nCONCLUSIONS\nSchools appear to be an effective setting for motor skill interventions, but the extent of benefit likely depends on the type of intervention. Moreover, confirmation is needed as to whether benefits extend beyond motor function into everyday activities, participation and wellbeing. Future research should include follow-up measures to assess the longer-term efficacy of school-based interventions.