Shirley S.M. Fong

Motor ability and weight status are determinants of out-of-school activity participation for children with developmental coordination disorder

According to the International Classification of Functioning, Disability and Health model endorsed by the World Health Organization, participation in everyday activities is integral to normal child development. However, little is known about the influence of motor ability and weight status on physical activity participation in children with developmental coordination disorder (DCD). This study aimed to (1) compare motor performance, weight status and pattern of out-of-school activity participation between children with DCD and those without; and (2) identify whether motor ability and weight status were determinants of participation patterns among children with DCD. We enrolled 81 children with DCD (boys, n = 63; girls, n = 18; mean age, 8.07 ± 1.5 years) and 67 typically developing children (boys, n = 48; girls, n = 19; mean age, 8.25 ± 1.6 years). Participation patterns (diversity, intensity, companionship, location, and enjoyment) were evaluated with the Children Assessment of Participation and Enjoyment. Motor ability was evaluated with the Movement Assessment Battery for Children, second edition (MABC-2). Other factors that may influence participation such as age, gender, and body weight were also recorded. Analysis of variance was used to compare outcome variables of the two groups, and significant determinants of activity participation were identified by multiple regression analysis. Children with DCD participated in fewer activities (i.e., limited participation diversity) and participated less frequently (i.e., limited participation intensity) than their typically developing peers; however, companionship, location of participation, and enjoyment level did not differ between the two groups. Children in the DCD group demonstrated significantly worse motor ability as assessed by the MABC-2. Further, a greater proportion of children in the DCD group were in the overweight/obese category compared with their typically developing peers. After accounting for the effects of age and gender, motor ability and weight category explained 7.6% and 5.0% of the variance in participation diversity, respectively, for children with DCD. Children with DCD showed less diverse and less intense out-of-school activity participation than typically developing children. Motor impairment and weight status were independently associated with the lower participation diversity. Interventions aiming at improving participation for children with DCD should target weight control and training in motor proficiency. Further study is needed to identify other factors that may hinder participation in this group of children.

Taekwondo training improves sensory organization and balance control in children with developmental coordination disorder: A randomized controlled trial

Children with developmental coordination disorder (DCD) have poorer postural control and are more susceptible to falls and injuries than their healthy counterparts. Sports training may improve sensory organization and balance ability in this population. This study aimed to evaluate the effects of three months of Taekwondo (TKD) training on the sensory organization and standing balance of children with DCD. It is a randomized controlled trial. Forty-four children with DCD (mean age: 7.6±1.3 years) and 18 typically developing children (mean age: 7.2±1.0 years) participated in the study. Twenty-one children with DCD were randomly selected to undergo daily TKD training for three months (1 h per day). Twenty-three children with DCD and 18 typically developing children received no training as controls. Sensory organization and standing balance were evaluated using a sensory organization test (SOT) and unilateral stance test (UST), respectively. Repeated measures MANCOVA showed a significant group by time interaction effect. Post hoc analysis demonstrated that improvements in the vestibular ratio (p=0.003) and UST sway velocity (p=0.007) were significantly greater in the DCD-TKD group than in the DCD-control group. There was no significant difference in the average vestibular ratio or UST sway velocity between the DCD-TKD and normal-control group after three months of TKD training (p>0.05). No change was found in the somatosensory ratio after TKD training (p>0.05). Significant improvements in visual ratios, vestibular ratios, SOT composite scores and UST sway velocities were also observed in the DCD-TKD group after training (p≤0.01). Three months of daily TKD training can improve sensory organization and standing balance for children with DCD. Clinicians can suggest TKD as a therapeutic leisure activity for this population.

Taekwondo training speeds up the development of balance and sensory functions in young adolescents.

OBJECTIVES This study aimed (1) to identify the developmental status of balance and sensory functions in young adolescents as compared to adults and, (2) to explore the effect of Taekwondo (TKD) training on the development of balance and sensory systems in young adolescents. DESIGN Cross-sectional controlled trial. METHODS Sixty-six participants including 42 adolescents (21 TKD practitioners, 21 non-TKD practitioners) and 24 adults were tested. The sway velocity of centre of gravity was recorded during standing on the non-dominant leg on a Smart Equitest ® system. The somatosensory, vestibular and visual ratios were also measured with the machine. RESULTS Adult participants swayed slower than both TKD and non-TKD adolescent groups during single leg stance with eyes open (p=0.007 and p<0.001, respectively). The TKD adolescent group, in turn, swayed slower than the non-TKD adolescent group (p<0.001). Adult participants had better visual ratio than both TKD and non-TKD adolescents (p=0.001 and p<0.001, respectively) while there was no difference between the TKD and non-TKD adolescents (p=0.164). For the vestibular ratio, there was no significant difference between adult participants and TKD adolescents (p=0.432). Adolescents who did not practice TKD showed significantly lower vestibular ratio than TKD adolescents and adults (p=0.003 and p<0.001, respectively). In addition, there was no significant difference in the somatosensory ratio among the 3 participant groups (p=0.711). CONCLUSIONS Participation in TKD appears to speed up the development of postural control and vestibular function in adolescents. Clinicians might advocate TKD exercise as a therapeutic intervention for young people with balance or vestibular dysfunctions.

Altered postural control strategies and sensory organization in children with developmental coordination disorder.

The postural control of children with and without developmental coordination disorder (DCD) was compared under conditions of reduced or conflicting sensory input. Twenty-two children with DCD (16 males, 6 females; mean age 7 years 6 months, SD 1 year 5 months) and 19 children with normal motor development were tested (13 males, 6 females; mean age 6 years 11 months, SD 1 year 1 month). Standing balance, sensory organization and motor control strategy were evaluated using the sensory organization test (SOT). The results revealed that children with DCD had lower composite equilibrium scores (p<.001), visual ratios (p=.005) and vestibular ratios (p=.002) than normal children in the control group. No significant between-group difference in their average somatosensory ratio was observed. Additionally, children with DCD had lower motor strategy scores (swayed more on their hips) than the normal children when forced to depend on vestibular cues alone to balance (p<.05). We conclude that children with DCD had deficits in standing balance control in conditions that included reduced or conflicting sensory signals. The visual and vestibular systems tended to be more involved in contributing to the balance deficits than the somatosensory system. Moreover, children with DCD tended to use hip strategy excessively when forced to rely primarily on vestibular signals to maintain postural stability.

Sensory organization of balance control in children with developmental coordination disorder

This study aimed to (1) compare functional balance performance and sensory organization of postural control between children with and without developmental coordination disorder (DCD) and (2) determine the association between postural control and participation diversity among children with DCD. We recruited 81 children with DCD and 67 typically developing children. Balance was evaluated with the Sensory Organization Test (SOT) and the Movement Assessment Battery for Children-2 (Movement ABC-2). Participation patterns were evaluated using the Children Assessment of Participation and Enjoyment assessment. Analysis of variance was used to compare outcome variables between the two groups. A multiple regression analysis was performed to examine the relationship between participation diversity and balance performance in children with DCD. The DCD group had significantly lower Movement ABC-2 balance scores, SOT-derived equilibrium scores, and sensory ratios than the control group (p<0.05). However, only the Movement ABC-2 balance score was significantly associated with participation diversity in children with DCD. After accounting for the effects of age and gender, Movement ABC-2 balance score remained significantly associated with participation diversity, explaining 10.9% of the variance (F(change1,77) = 9.494, p = 0.003). Children with DCD demonstrate deficits in sensory organization of balance control. This suboptimal balance ability contributes to limited participation in activities.

The associations of sociocultural attitudes towards appearance with body dissatisfaction and eating behaviors in Hong Kong adolescents

OBJECTIVES Western culture has great influences on body dissatisfaction and related eating behaviors in adolescents. This study aimed to assess the sociocultural influences on eating attitudes and motivations among Hong Kong Chinese adolescents. METHODS In 2007, 909 adolescents (mean age = 14.7 years, 55.3% boys) completed a survey with Stunkards Figure Rating Scale (FRS), Motivation for Eating Scale (MFES), Eating Attitudes Test (EAT), Revised Restraint Scale (RRS), and Sociocultural Attitudes Towards Appearance Scale (SATAQ). In addition, their body mass index (BMI) was objectively measured. RESULTS Our results indicated that Hong Kong adolescents, particularly girls exhibited a remarked level of body dissatisfaction, external, emotional, restrained and disordered eating behaviors. Hierarchical regression analyses indicated that age, sex and BMI were the most common contributing factors to individual eating styles. SATAQ significantly accounted for an additional variance of body dissatisfaction (2%), physical eating (2%), external eating (1%), emotional eating (3%), restrained eating (5%), and disordered eating (5%). CONCLUSIONS In Hong Kong, the sociocultural influences on body image and eating disturbance were supported.

Does Taekwondo training improve physical fitness

BACKGROUND Taekwondo (TKD) is a popular sport practiced by people of all ages in more than 180 countries and it is generally considered as being beneficial to health even though the scientific evidence for this is not conclusive. Despite its popularity, there are very few studies on the health benefits of TKD, therefore this article attempts to pull together the existing strands of relevant research. AIM This paper aimed to review the effects of TKD training on physical fitness. METHODS A search of literature on both electronic and printed media was performed and 23 papers with relevance to the topic were included and critically reviewed. The main outcomes examined were anaerobic and aerobic fitness, body composition, muscle strength, endurance, power and flexibility. RESULTS There is no conclusive evidence in the literature that TKD practice can improve anaerobic fitness or muscle strength. However, TKD training may have some benefits in aerobic capacity, body composition (fat loss) and flexibility. CONCLUSION Physiotherapists or fitness instructors may consider recommending TKD to their clients as a beneficial form of exercise to promote aerobic fitness and flexibility.

Slowed muscle force production and sensory organization deficits contribute to altered postural control strategies in children with developmental coordination disorder

This study aimed to (1) compare the postural control strategies, sensory organization of balance control, and lower limb muscle performance of children with and without developmental coordination disorder (DCD) and (2) determine the association between postural control strategies, sensory organization parameters and knee muscle performance indices among children with DCD. Fifty-eight DCD-affected children and 46 typically developing children participated in the study. Postural control strategies and sensory organization were evaluated with the sensory organization test (SOT). Knee muscle strength and time to produce maximum muscle torque (at 180°/s) were assessed using an isokinetic machine. Analysis of variance was used to compare the outcome variables between groups, and multiple regression analysis was used to examine the relationships between postural control strategies, sensory organization parameters, and isokinetic indices in children with DCD. The DCD group had significantly lower strategy scores (SOT conditions 5 and 6), lower visual and vestibular ratios, and took a longer time to reach peak torque in the knee flexor muscles than the control group (p>0.05). After accounting for age, sex, and body mass index, the vestibular ratio explained 35.8% of the variance in the strategy score of SOT condition 5 (p<0.05). Moreover, the visual ratio, vestibular ratio, and time to peak torque of the knee flexors were all significant predictors (p<0.05) of the strategy score during SOT condition 6, accounting for 14, 19.7, and 19.8% of its variance, respectively. The children with DCD demonstrated deficits in postural control strategy, sensory organization and prolonged duration of muscle force development. Slowed knee muscle force production combined with poor visual and vestibular functioning may result in greater use of hip strategy by children with DCD in sensory challenging environments.

Effects of Qigong Exercise on Upper Limb Lymphedema and Blood Flow in Survivors of Breast Cancer: A Pilot Study

Hypothesis. Qigong exercise is a popular method for relieving the side effects of conventional cancer treatments in survivors of breast cancer, yet its effects are not empirically assessed. This study aimed to investigate the effects of qigong exercise on upper limb lymphedema, arterial resistance, and blood flow velocity in survivors with breast cancer and mastectomy. Study Design. This study was conducted as a prospective clinical trial. Methods. Eleven survivors of breast cancer with qigong experience (mean age = 58.3 ± 10.1 years) were assigned to the experimental group and 12 survivors of breast cancer without qigong experience (mean age = 53.8 ± 4.2 years) were assigned to the control group. They all had breast cancer–related lymphedema. All procedures were completed within one session. After baseline measurements were taken, the experimental group performed 18 Forms Tai Chi Internal Qigong for approximately 6 minutes while the control group rested for similar duration in a sitting position. Both groups were then reassessed. All participants were measured on their affected upper limb circumference (by using tape measures), peripheral arterial resistance, and blood flow velocities (using a Doppler ultrasound machine). Results. The between-group differences were not significant for all outcome measures at baseline (P > .05). The circumferences of the affected upper arm, elbow, forearm and wrist decreased after qigong exercise (P < .05). However, no significant difference was found in the circumference measures between the 2 groups posttest (P > .0125). In terms of vascular outcomes, the resistance index decreased and the maximum systolic arterial blood flow velocity (SV) and minimum diastolic arterial blood flow velocity (DV) increased significantly after qigong exercise (P < .05). The between-group difference was close to significant for SV (P = .018) and was significant for DV (P < .001) posttest. Conclusion. Qigong exercise could reduce conventional cancer therapy side effects such as upper limb lymphedema and poor circulatory status in survivors of breast cancer. However, such effects may be temporary, and further studies must be conducted to explore longer term effects.

Differential Effect of Taekwondo Training on Knee Muscle Strength and Reactive and Static Balance Control in Children with Developmental Coordination Disorder: A Randomized Controlled Trial.

This randomized controlled trial aimed to investigate the effect of short-term intensive TKD training on the isokinetic knee muscle strength and reactive and static balance control of children with developmental coordination disorder (DCD). Among the 44 children with DCD (mean age: 7.6 ± 1.3 years) recruited, 21 were randomly assigned to undergo daily TKD training for 1h over three consecutive months, with the remaining 23 children being assigned to the DCD control group. Eighteen typically developing children (mean age: 7.2 ± 1.0 years) received no training as normal controls. Knee extensor and flexor muscle strength and reactive and static balance control were assessed using an isokinetic machine (with low, moderate and high movement velocities), a motor control test (MCT) and a unilateral stance test (UST), respectively. A repeated measures MANCOVA revealed a significant group through time interaction effect in isokinetic outcomes at 180°/s and in the UST outcome. Post hoc analysis demonstrated that DCD-TKD childrens isokinetic knee muscle strength, specifically at 180°/s, was as high as that of the normal control children (p>0.0083) after TKD training. Moreover, UST body sway velocity was slower in the DCD-TKD group than in the DCD control group (p<0.001), and was comparable to that of the normal control group (p>0.05) after TKD training. However, no such improvement in balance was observed in the MCT (p>0.025). The results show that children with DCD who undergo a 3-month program of intensive TKD training experience improvements in isokinetic knee muscle strength at 180°/s and static single-leg standing balance control, but do not benefit from improved reactive balance control.