Eva D'Hondt

Gross motor coordination in relation to weight status and age in 5- to 12-year-old boys and girls: a cross-sectional study.

OBJECTIVE The purpose of this study was to investigate differences in gross motor coordination in healthy-weight, overweight, and obese children of different ages. METHODS Using a cross-sectional design, data were collected in 954 Flemish primary school children (500 girls, 454 boys) stratified in consecutive age groups (5-7 years, 8-9 years, 10-12 years). Weight status (healthy-weight, overweight, obese) was defined according to the International Obesity Task Force body mass index (BMI) cut-off points for children. Gross motor coordination was assessed by means of the Körperkoordinationstest für Kinder (KTK). RESULTS Childhood overweight and particularly obesity were found to result in poorer KTK performances (p < 0.001), with the most apparent effect of BMI on items requiring physical properties next to dynamic body coordination. Expressed as an age-related Motor Quotient (MQ), overall KTK performance was featured by a BMI × AGE interaction (p < 0.01). Healthy-weight children displayed similar MQs across age groups (p = 0.999). Overweight and obese children in the 10-12-year-old group showed significantly poorer motor coordination performance compared with the corresponding 5-7-year-old group (p < 0.01). Less than 20% of the healthy-weight participants was identified as being motor impaired, while that proportion increased to 43.3% and up to 70.8% in children with overweight and obesity, respectively. CONCLUSION Results indicate that BMI-related differences in gross motor coordination were more pronounced as children belonged to an older age group. Although this outcome needs to be confirmed in future longitudinal research, it emphasizes the need of an early focus on motor skill improvement to encourage overweight and obese children to be physically active.

A longitudinal analysis of gross motor coordination in overweight and obese children versus normal-weight peers

Background:The relationship of childhood overweight (OW) and obesity (OB) with motor skill and coordination is gaining due attention; however, longitudinal evidence is currently lacking.Objective:The dual purpose of this study was (1) to investigate the short-term evolution in the level of gross motor coordination according to childrens weight status, and (2) to identify those factors predicting their gross motor coordination performance over a 2-year interval.Subjects:Participants were 50 children with OW, including 8 with OB (aged 6–10 years at baseline, with 52% boys), and 50 with normal-weight (NW) matched for gender and age.Measurements:Anthropometrics (body height, body weight, body mass index (BMI), %body fat) and level of gross motor coordination (Körperkoordinationstest für Kinder, KTK) were assessed in 2007 (baseline) and 2 years later in 2009 (follow-up). At baseline, participants completed a survey based on the Flemish Physical Activity Questionnaire (FPAQ) to obtain socio-demographic information and to determine physical activity levels in diverse domains.Results:The evolution in the level of gross motor coordination over time was strongly related to childrens weight status. Participants in the NW group showed more progress than their OW/OB peers, who demonstrated significantly poorer performances. Accordingly, between-group differences in KTK outcomes (that is, raw item scores and total motor quotient) became more evident over time. Multiple linear regression analysis further indicated that, in addition to BMI per se (negative predictor), participation in organized sports within a sports club (positive predictor) determines gross motor coordination performance(s) 2 years later.Conclusion:Our results provide conclusive evidence for an increasingly widening gap of OW/OB childrens gross motor coordination relative to NW peers across developmental time in the absence of targeted initiatives. Special attention is thus needed for OW/OB children, especially for those not practicing sports in a club environment, in terms of motor skill improvement to promote regular participation in physical activity.

Childhood obesity affects fine motor skill performance under different postural constraints.

The main purpose of this study was to investigate fine motor control in obese and overweight children compared to normal-weight peers under different postural constraints. Peg placing performance of normal-weight (n=273), overweight (n=202) and obese (n=65) children (aged 5.0-12.8 years) was evaluated in two different postural conditions: sitting and standing in tandem stance on a balance beam (BB). Being overweight or obese was detrimental for fine motor skill performance in the standing on BB condition, which confirms the postural control difficulties observed in overweight and obese children. Remarkably, obese participants also produced lower scores in the sitting condition, i.e. when the complexity of postural organization was restricted to a minimum. Although this could result from the mechanical demands related to the movement of the arm itself, it also leads to the tentative suggestion that obese children might suffer from underlying perceptual-motor coordination difficulties.

A longitudinal study of gross motor coordination and weight status in children

This longitudinal study investigated the interrelationship between childrens weight status and level of gross motor coordination over time, taking baseline physical activity (PA) into account as a possible mediator.

Postural balance under normal and altered sensory conditions in normal-weight and overweight children

BACKGROUND little or no research has been done in the overweight child on the relative contribution of multisensory information to maintain postural stability. Therefore, the purpose of this study was to investigate postural balance control under normal and experimentally altered sensory conditions in normal-weight versus overweight children. METHODS sixty children were stratified into a younger (7-9yr) and an older age group (10-12yr). Participants were also classified as normal-weight (n=22) or overweight (n=38), according to the international BMI cut-off points for children. Postural stability was assessed during quiet bilateral stance in four sensory conditions (eyes open or closed, normal or reduced plantar sensation), using a Kistler force plate to quantify COP dynamics. Coefficients of variation were calculated as well to describe intra-individual variability. FINDINGS removal of vision resulted in systematically higher amounts of postural sway, but no significant BMI group differences were demonstrated across sensory conditions. However, under normal conditions lower plantar cutaneous sensation was associated with higher COP velocities and maximal excursion of the COP in the medial-lateral direction for the overweight group. Regardless of condition, higher variability was shown in the overweight children within the 7-9yr old subgroup for postural sway velocity, and more specifically medial-lateral velocity. INTERPRETATION in spite of these subtle differences, results did not establish any clear underlying sensory organization impairments that may affect standing balance performance in overweight children compared to normal-weight peers. Consequently, it is believed that other factors account for overweight childrens functional balance deficiencies.

Weight Loss and Improved Gross Motor Coordination in Children as a Result of Multidisciplinary Residential Obesity Treatment

This study evaluated the short‐term effectiveness of a multidisciplinary residential obesity treatment program by describing changes in body weight, related measures, and gross motor co‐ordination. Secondarily, it was examined to what extent the amount of relative weight loss achieved by overweight and obese (OW/OB) participants explained the projected improvement in gross motor co‐ordination. Thirty‐six OW/OB children (aged 10.5 ± 1.4 years, 12 girls and 24 boys) were recruited at the Zeepreventorium VZW (De Haan, Belgium), where they followed a specific program consisting of moderate dietary restriction, psychological support, and physical activity. For reference purposes, an additional group of 36 age‐ and gender‐matched healthy‐weight (HW) children was included in the study. Anthropometric measures were recorded and gross motor co‐ordination was assessed using the Körperkoordinationstest für Kinder (KTK) on two occasions with an interval of 4 months. Regardless of the test moment, OW/OB participants displayed significantly poorer KTK performances (P < 0.001). However, treatment was found to be efficacious in decreasing body weight (Δ 17.9 ± 3.1%, P < 0.001) and generating a significant progress in gross motor co‐ordination performance, with a greater increase in KTK score(s) from baseline to re‐test as compared to HW peers (P < 0.01). Within the OW/OB group, the amount of relative weight loss explained 26.9% of the variance in improvement in overall KTK performance. Therefore, multidisciplinary residential treatment and concomitant weight loss can be considered an important means to upgrade OW/OB childrens level of gross motor co‐ordination, which in turn may promote physical activity participation.

Motor competence assessment in children: Convergent and discriminant validity between the BOT-2 Short Form and KTK testing batteries

This study investigated convergent and discriminant validity between two motor competence assessment instruments in 2485 Flemish children: the Bruininks-Oseretsky Test of Motor Proficiency 2 Short Form (BOT-2 Short Form) and the KörperKoördinationsTest für Kinder (KTK). A Pearson correlation assessed the relationship between BOT-2 Short Form total, gross and fine motor composite scores and KTK Motor Quotient in three age cohorts (6-7, 8-9, 10-11 years). Crosstabs were used to measure agreement in classification in children scoring below percentile 5 and 15 and above percentile 85 and 95. Moderately strong positive (r=0.44-0.64) associations between BOT-2 total and gross motor composite scores and KTK Motor Quotient and weak positive correlations between BOT-2 Short Form fine motor composite and KTK Motor Quotient scores (r=0.25-0.37) were found. Levels of agreement were fair to moderate. Therefore, some proof of convergent and discriminant validity between BOT-2 Short Form and KTK was established in this study, underlining the notion that the evaluation of motor competence should not be based upon a single assessment instrument.

Changes in Physical Fitness and Sports Participation Among Children With Different Levels of Motor Competence: A 2-Year Longitudinal Study

The goal of this study was to investigate differences in physical fitness and sports participation over 2 years in children with relatively high, average, and low motor competence. Physical fitness and gross motor coordination of 501 children between 6-10 years were measured at baseline and baseline+2 years. The sample compromised 2 age cohorts: 6.00-7.99 and 8.00-9.99 years. An age and sex-specific motor quotient at baseline testing was used to subdivide these children into low (MQ < P33), average (P33 ≤ MQ < P66) and high (MQ ≥ P66) motor competence groups. Measures of sports participation were obtained through a physical activity questionnaire in 278 of the same children. Repeated Measures MANCOVA and two separate ANOVAs were used to analyze differences in changes in physical fitness and measures of sports participation respectively. Children with high motor competence scored better on physical fitness tests and participated in sports more often. Since physical fitness levels between groups changed similarly over time, low motor competent children might be at risk for being less physically fit throughout their life. Furthermore, since low motor competent children participate less in sports, they have fewer opportunities of developing motor abilities and physical fitness and this may further prevent them from catching up with their peers with an average or high motor competence.

The effects of pediatric obesity on dynamic joint malalignment during gait

BACKGROUND There is a greater prevalence of lower extremity malalignment in obese children during static posture; however, there has been less examination of dynamic joint function in this cohort. Therefore, the purpose of this study was to determine kinematic differences that exist between obese and non-obese children that would support previously reported static joint malalignment. METHODS Forty children were classified as obese (n=20) or non-obese (n=20). Lower extremity joint kinematics were collected during five walking trials at a self-selected pace. Peak joint displacement and amount of joint motion throughout the gait cycle (calculated as the integrated displacement curve) were analyzed for group differences. FINDINGS Non-obese children had greater peak knee and hip extension during gait; however, there were no group differences in the integrated sagittal displacement curve. Obese children had greater peak angular displacement and integrals of angular displacement for peak hip adduction, hip internal rotation, and foot abduction (toe-out) than non-obese children. Obese children also had greater peak knee external rotation than non-obese children. INTERPRETATION Non-obese children showed greater range of motion in the sagittal plane, particularly at the hip and knee. Frontal and transverse plane differences suggest that obese children function in a more genu valgum position than non-obese children. Static measures of genu valgum have been previously associated with pediatric obesity; the findings indicate that there are also dynamic implications of said malalignment in obese children. Genu valgum presents increased risk of osteoarthritis for obese children and should be considered when prescribing weight bearing exercise to this cohort.

The effectiveness of a fundamental motor skill intervention in pre-schoolers with motor problems depends on gender but not environmental context.

This study evaluated the effect of a 10-week fundamental motor skill programme in pre-schoolers with motor problems. Alongside the general effect of the intervention, we also explored possible gender differences and the role of the environmental context (living community, socio-economic status, and recreational space inside/outside the house). The intervention group (n=47; 20 ♂ and 27 ♀) received twenty 60-min motor skill sessions (2 per week) in addition to the regular physical education curriculum for pre-schoolers; the control group (n=46; 21 ♂ and 25 ♀) did not receive additional practice. General motor competence, and locomotor and object control subscales, were assessed before and after the intervention using the Test of Gross Motor Development 2nd edition (TGMD-2). Data regarding environmental factors were gathered through a questionnaire. A Group×Gender×Time ANOVA revealed that the intervention group benefited significantly from the intervention and scored better than the control group at the post-test for general motor competence and both sub-categories (locomotor and object control skill). Moreover, the intervention programme was found to be effective in helping 49% of the intervention group to achieve an average motor skill level, according to the TGMD-2 norms, while a further decline in motor competence was observed in the control group. Interestingly, the effect appeared to be gender-specific, since object control skill improved only in girls of the intervention group. Considering the environmental context, none of the above-mentioned factors was found to have an influence on the effectiveness of the intervention. The present study highlights the need for an early motor skill programme with a gender-specific approach in order to help low skilled boys and girls master a diverse set of motor skills.