Awareness about developmental coordination disorder.

The present paper is designed to promote awareness of DCD outside the academic world. With a prevalence of 5-6% it is one of the most common disorders of child development. It is therefore surprising that so little is known about it among professionals in child healthcare and education. Parents have expressed frustration about this lack of awareness, including the general public. The general aim of this paper was to describe those critical aspects of DCD that will promote awareness.

Intensive training programme improves handwriting in a community cohort of people with Parkinson's disease.

BACKGROUND: People with Parkinson's disease (PwP) often report problems with their handwriting before they receive a formal diagnosis. Many PwP suffer from deteriorating handwriting throughout their illness, which has detrimental effects on many aspects of their quality of life. AIMS: To assess a 6-week online training programme aimed at improving handwriting of PwP. METHODS: Handwriting samples from a community-based cohort of PwP (n = 48) were analysed using systematic detection of writing problems (SOS-PD) by two independent raters, before and after a 6-week remotely monitored physiotherapy-led training programme. Inter-rater variability on multiple measures of handwriting quality was analysed. The handwriting data was analysed using pre-/post-design in the same individuals. Multiple aspects of the handwriting samples were assessed, including writing fluency, transitions between letters, regularity in letter size, word spacing, and straightness of lines. RESULTS: Analysis of inter-rater reliability showed high agreement for total handwriting scores and letter size, as well as speed and legibility scores, whereas there were mixed levels of inter-rater reliability for other handwriting measures. Overall handwriting quality (p = 0.001) and legibility (p = 0.009) significantly improved, while letter size (p = 0.012), fluency (p = 0.001), regularity of letter size (p = 0.009), and straightness of lines (p = 0.036) were also enhanced. CONCLUSIONS: The results of this study show that this 6-week intensive remotely-monitored physiotherapy-led handwriting programme improved handwriting in PwP. This is the first study of its kind to use this tool remotely, and it demonstrated that the SOS-PD is reliable for measuring handwriting in PwP.

Insights on action observation and imitation abilities in children with Developmental Coordination Disorder and typically developing children.

BACKGROUND: Children with Developmental Coordination Disorder (DCD) face difficulties in motor learning. Action observation and imitation are strategies frequently used to teach motor skills. AIMS: (1) To study action observation and imitation abilities in children with DCD compared with typically developing peers with a new protocol. (2) To gain insights in the relation between action observation, imitation, motor performance and activities of daily living (ADL). METHOD: Twenty-one children with DCD (mean age 7 years 9 months, range 6-10 years) and 20 age-matched controls (mean age 7 years 8 months, range 6-10 years) were included. A newly developed protocol was used for testing action observation and imitation proficiency. Motor performance were evaluated with the Movement Assessment Battery for Children-2. ADL were investigated with DCD Questionnaire'07. RESULTS: Children with DCD presented significantly lower action observation (p = .037) and imitation abilities (p < .001) than peers. Worse action observation and imitation abilities were related to lower motor performance and ADL skills and a younger age. Non-meaningful gestures imitation proficiency had predictive value for global motor performance (p = .009), manual dexterity (p = .02) and ADL (p = .004). CONCLUSIONS: The new protocol for action observation and imitation abilities can be helpful for detecting motor learning difficulties and for delineating new opportunities for motor teaching approaches in children with DCD.

Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study.

BACKGROUND: Task-oriented approaches are recommended for children with developmental coordination disorder (DCD) to address deficits in motor performance and reduce activity limitations. Although this approach is used in several settings, the efficacy of these approaches in children with in dual-diagnosis of specific learning disabilities (SLD) and DCD is less widely known. This study aims to determine the effect of a group-based intervention based on neuromotor task training (NTT) principles on the motor performance of children aged 6-10 years with SLD/DCD. METHODS: A pre-post-test controlled study design was conducted in children with a primary diagnosis of specific learning disabilities (SLD). DCD status was confirmed based on clinical assessment. Children scoring ≤16th percentile on the Motor Assessment Battery for Children 2nd Edition (MABC-2), who also presented with a functional motor problem, according to the MABC checklist were considered as having DCD. Children were allocated to the NTT intervention group based on teachers' perceived notion of need and received two 45-60 min training sessions per week for nine weeks. Children allocated to the usual care (UC) group, received their planned occupational therapy and physical education. The MABC-2 was used to assess changes in motor performance. OUTCOME AND RESULTS: Our numbers confirm that it is crucial to identify the presence of motor coordination difficulties in children who have been diagnosed with SLD. A task-oriented training program based on NTT principles, presented in small groups, has a positive effect on the motor performance in learners with neurodevelopmental disorders and this effect was larger than in the usual care group. CONCLUSION AND IMPLICATIONS: Although using a small group format in children with multiple neurodevelopmental disorders may be challenging for the therapists, it may be a way of delivering services to children in schools for special education. WHAT THIS PAPER ADDS: Children with DCD plus LSD show improvement in their motor skills by performing group-based NTT in the school environment. Group-based NTT shows a significant improvement in the TSS score of the MABC-2 compared to usual care. Children with DCD plus SLD show equal effect sizes after NTT intervention as DCD without SLD.

Injuries in Physical Education Teacher Students: Differences between Sex, Curriculum Year, Setting, and Sports.

Background: Injury risk is high in Physical Education Teacher Education (PETE) students. Insights into specific injury locations per sex, setting, sports, and curriculum year are needed to develop preventive measures. Purpose: To compare injury distributions by body locations in PETE students and how these distributions differ by sex, type, onset, curriculum year, settings, or sports. Methods: In a historical cohort study over 14 years, data from 2899 students (male 76.2%, n = 1947) enlisted in the first three years of a PETE curriculum were analysed. Injuries reported at the institution's medical facility were categorised per sex, body location, onset, type, setting, sports, and curriculum year. Results: Forty-three percent (n = 1247) of all students (female 54.9%, n = 523, male 37.2%, and n = 429) reported a total of 2129 injuries (freshmen 56.4%; 2nd year 28.2%; 3rd year 15.5%). The most prevalent sudden onset injury locations (63.4% of all injuries) were the ankle (32.5%) and knee (16.6). The most prevalent gradual onset injuries were the lower leg (27.8%) and knee (25.2%). Joint/ligament injuries (45.8%) and muscle/tendon injuries (23.4%) were the most prevalent injury types. Proportions for injury locations and injury types differed significantly between curriculum years. Injury prevalence per setting and sport differed significantly between the sexes. Injury locations differed significantly between sports and between the sexes per sport. Conclusion: A differential approach per injury location, onset, type, sex, setting, sports, and curriculum year is needed to develop adequate preventive measures in PETE studies. The engagement of precurricular, intracurricular, and extracurricular stakeholders is needed in the development of these measures.

The effects of a visuo-motor and cognitive dual task on walking adaptability in children with and without Developmental Coordination Disorder.

BACKGROUND: Children with Developmental Coordination Disorder (DCD-C) have motor coordination deficits which lead to difficulties in sports and play activities that require adaptations of the walking pattern. Sports and play often involve performing dual tasks, which affects performance in DCD-C more than in typically developing children (TD-C). So far, testing the impact of dual tasking on walking adaptability in DCD-C has received little scientific attention. RESEARCH QUESTION: We tested the hypothesis that 6-12 year old DCD-C will show lower levels of walking adaptability than TD-C, and that due to problems with automatization this difference will increase when they are forced to divide their attention between tasks when a concurrent visuo-motor or cognitive task is added. METHODS: Twenty-six DCD-C and sixty-nine TD-C were included in this cross-sectional study. They performed a challenging walking adaptability (WA) task on a treadmill as a single, a visuo-motor dual and a cognitive dual task at a pace of 3.5 km/h. Repeated measures ANCOVAs were performed with condition (single/dual task) as within-subjects factor, group (TD/DCD) as between-subjects factor, and age as covariate. RESULTS: DCD-C performed poorer on the WA task than TD-C. The group differences increased when a concurrent visuo-motor task was added, but not when adding a concurrent cognitive task. A significant effect of age was found with younger children performing worse on all tasks. SIGNIFICANCE: The results highlight the problems DCD-C have with walking adaptability and dual tasks, which capacities are essential for full participation in sports and play activities. Future research should investigate whether DCD-C may benefit from task-specific walking adaptability training.

Reliability and construct validity of the Walking Adaptability Ladder Test for Kids (WAL-K): a new clinical test for measuring walking adaptability in children.

PURPOSE: Walking adaptability is essential for children to participate in daily life, but no objective measurement tools exist. We determined psychometric properties of the Walking Adaptability Ladder test for Kids (WAL-K) in 6-12 year old children. MATERIALS AND METHODS: In total, 122 typically developing (TD) children and 26 children with Developmental Coordination Disorder (DCD) completed the single and double run conditions of the WAL-K. Intra-rater, inter-rater and test-retest reliability were determined by ICCs and Smallest Detectable Change (SDC) in 53 TD children. Construct validity was determined by comparing WAL-K scores between 69 TD and all DCD children and correlating these scores with age and MABC-2 scores. RESULTS: ICCs for reliability varied between 0.76 and 0.99. Compared to the first test performance, WAL-K scores were lower (i.e., better) at retest. SDCs for test-retest reliability varied between 20.8 and 26.1% of the mean scores. WAL-K scores were significantly higher (i.e., worse) in DCD children compared to TD children (p < 0.001). Significant negative correlations were found with MABC-2 (-0.52 and -0.60) and age (-0.61 and -0.68). CONCLUSIONS: The WAL-K shows to be a valid, reliable and easy-to-use tool for measuring walking adaptability in children. Adding an extra practice trial may reduce the observed learning effect.Implications for rehabilitationWalking adaptability is an essential skill for children to participate in daily life, but no objective measurement tools are available.The Walking Adaptability Ladder test for Kids (WAL-K) is a new measurement tool for evaluating walking adaptability in children.The WAL-K shows to be a reliable and valid measurement tool for evaluating walking adaptability in 6-12 year old children.

Walking adaptability improves after treadmill training in children with Developmental Coordination Disorder: A proof-of-concept study.

BACKGROUND: Children with Developmental Coordination Disorder (DCD) have motor coordination deficits leading to difficulties in sports and play that require adaptations of the walking pattern. Children with DCD indeed demonstrate poorer walking adaptability (WA) compared to typically developing children, but it remains elusive whether WA can be improved by training. RESEARCH QUESTION: Does augmented-reality treadmill training lead to improvements in WA in children with DCD? METHODS: Seventeen children with DCD were included in this proof-of-concept intervention study. They received a six-session training on the C-mill, a treadmill on which gait adjustments can be evoked by projected visual context. The effect of the training was evaluated before (M1), directly after training (M2) and after 6 months follow-up (M3) using the WAL-K (single and double run) and WA-tasks on the C-mill (as a single and with concurrent visuo-motor and cognitive task). In addition, parents completed a questionnaire on their perception of the training. Linear Mixed Model analyses were performed to assess the differences in WAL-K scores and success rates on the WA-tasks between M1-M2 and M1-M3. RESULTS: Children significantly improved on the WAL-K double run and on all three WA-tasks between M1-M2 and M1-M3. Children did not improve on the WAL-K single run. Parents found the training useful and fun for their child and indicated that their child fell less frequently. SIGNIFICANCE: The results show that C-mill training had positive and task-specific effects on WA in children with DCD, which effects generalized to an overground task and were retained at 6 months follow-up. This may help children with DCD to better participate in daily activities. Future research should include a control group to examine the effectiveness of the training program compared to receiving no training and may also examine the effect of the training on participation in daily life.

Children with Poor Motor Skills Have Lower Health-Related Fitness Compared to Typically Developing Children.

Most of the current empirical evidence regarding the relationship between health-related fitness and level of motor performance is based on children from high-income countries. Yet, children from low-resource areas may have fewer opportunities to develop their fitness skills. The aim of the study was to determine if South African children from both low- and middle-income areas scoring below the 16th percentile on the Movement Assessment Battery for Children-2 (probable-Developmental Coordination Disorder (p-DCD)) have lower health-related fitness levels than typically developing (TD) children. We hypothesized that children with p-DCD would have lower overall health-related fitness than TD children. A sample of 146 participants aged 10 to 11 (10.05 years (SD = 0.41)) was collected from schools in the North West Province of South Africa, on the basis of their poverty classification. Children were tested for anaerobic capacity and strength using the Bruininks-Oseretsky test of motor proficiency second edition (BOT-2) and aerobic capacity using the Progressive Aerobic Cardiovascular Endurance Run (PACER). Body composition was evaluated using body mass index corrected for age and sex (BMI-z), body fat (BF), and waist circumference. The data was analyzed using Spearman correlations and chi-squared tests. Statistically significant differences (p < 0.05) were found between groups for running and agility, strength, and aerobic capacity. No significant differences were found between p-DCD and TD groups in terms of body mass (36.1 kg vs. 33.3 kg), waist circumference (62.2 cm vs. 59.8 cm), BMI-z (19.7 vs. 17.6), and fat percentage (20.2 vs. 18.1%). Overweight and obesity prevalence was 15% in those with low socio-economic status (SES) and 27% in high SES. In conclusion, children with p-DCD had lower muscular strength, aerobic capacity, and endurance than TD children. Although it has been reported that children with p-DCD have a higher risk for overweight/obesity than TD children, this is not (yet) the case in 10-11-year-old children living in rural areas in South Africa (North West Province).

Ecological validity of the PERF-FIT: correlates of active play, motor performance and motor skill-related physical fitness.

BACKGROUND: Active games are important health enhancing physical activities in children with and without developmental disorders and will help children to develop fundamental motor skills, while inactivity exacerbates coordination difficulties and increases the risk of obesity. Regular engagement in active play promotes physical, social and cognitive development. It is therefore important to know if children have the capabilities for healthy behavior. Motor skills and muscular fitness are both important components to participate in play, sport and leisure. The Performance and Fitness (PERF-FIT) test battery integrates motor skills (running, jumping, hopping, catching, bouncing, throwing, balance) and muscular fitness (explosive power and muscular endurance) needed in many forms of active play. AIM: To test the ecological validity of the PERF-FIT test battery; a field-based test integrating motor skill proficiency and muscular fitness. METHODS: Seventy-five children were assessed on the PERF-FIT, Movement Assessment Battery for Children (MABC)-2 and performance in 6 active games was scored. Of these children, 52 children scored in the normal range and 23 (or 30.3%) below the 16th percentile of the MABC-2. Association between the outcomes of the two tests and the 6 games was calculated. RESULTS: High to moderate associations were found between game scores and PERF-FIT items; moderate to low associations between game scores and MABC-2 items. Principle axes factor analysis with oblique rotation revealed communalities between the explosive power and agility items of the PERF-FIT and the running and ball catching games but not between the games and the balance items. CONCLUSIONS AND IMPLICATIONS: Scores on the PERF-FIT are significantly related to performance in active play. The tool is able to measure aspects of motor skills, muscle endurance and explosive power needed in children's active games and could be used as an additional tool to measure requirements for participation in everyday physical activity in children with and without developmental disorders .

Inter-rater reliability and test-retest reliability of the Performance and Fitness (PERF-FIT) test battery for children: a test for motor skill related fitness.

BACKGROUND: The Performance and Fitness (PERF-FIT) test battery for children is a recently developed, valid assessment tool for measuring motor skill-related physical fitness in 5 to 12-year-old children living in low-income settings. The aim of this study was to determine: (1) inter-rater reliability and (2) test-retest reliability of the PERF-FIT in children from 3 different countries (Ghana, South Africa and the Netherlands). METHOD: For inter-rater reliability 29 children, (16 boys and 13 girls, 6-10 years) were scored by 2 raters simultaneously. For test-retest reliability 72 children, (33 boys and 39 girls, 5-12 years) performed the test twice, minimally 1 week and maximally 2 weeks apart. Relative and absolute reliability indices were calculated. ANOVA was used to examine differences between the three assessor teams in the three countries. RESULTS: The PERF-FIT demonstrated excellent inter-rater reliability (ICC, 0.99) and good test-retest reliability (ICC, ≥ 0.80) for 11 of the 12 tasks, with a poor ICC for the Jumping item, due to low spread in values. A significant difference between first and second test occasion was present on half of the items, but the differences were small (Cohen's d 0.01-0.17), except for Stepping, Side jump and Bouncing and Catching (Cohen's d 0.34, 0.41 and 0.33, respectively). Overall, measurement error, Limits of Agreement and Coefficient of Variation had acceptable levels to support clinical use. No systematic dissimilarities in error were found between first and second measurement between the three countries but for one item (Overhead throw). CONCLUSIONS: The PERF-FIT can reliably measure motor skill related fitness in 5 to 12-year-old children in different settings and help clinicians monitor levels of fundamental motor skills (throwing, bouncing, catching, jumping, hopping and balance), power and agility.

Feasibility and content validity of the PERF-FIT test battery to assess movement skills, agility and power among children in low-resource settings.

BACKGROUND: Numerous movement skills and physical fitness tests have been developed for children in high-income countries. However, adaptation of these tests to low-resource settings has been slow and norms are still unavailable for children living in low-income communities. The aim of this paper was to describe the development and validation of the Performance and Fitness (PERF-FIT) test battery, a new test to assess motor skill-related physical fitness in children in low-resource settings. METHOD: The PERF-FIT test was developed in a stepwise manner. This involved defining the relevant domains of the construct of interest and selecting and evaluating test items. The Content Validity Index (CVI) was used to estimate content validity. Following development of the PERF-FIT test, a preliminary study was performed to validate items and to examine the feasibility of implementing the test in a low-resource community. Structural validity was also determined based on data from eighty (n = 80) children (aged 7-12 years) using principal component analysis. RESULTS: The CVI for the throw and catch item was 0.86 and 1.00 for the other nine items, leading to a total CVI score of 0.99. The hierarchical sequence of the item series was demonstrated by highly significant (p < 0.001) linear trends, confirming the increase in difficulty of subsequent items. Principal component analysis revealed three factors; the first component is represented by locomotor skills that require static and dynamic balance, the second component by throwing and catching items and the third component by agility and power items. These findings suggest that it is feasible to implement the PERF-FIT in low-resource settings. CONCLUSION: The PERF-FIT test battery is easy to administer and may be suitable for measuring skill-related physical fitness in in low-resource settings. It has excellent content validity and good structural validity. After minor adaptions, further studies should be conducted to establish normative values, evaluate reliability, and document criterion and cross-cultural validity of this test.

Anthropometric, physiological characteristics and rugby-specific game skills of schoolboy players of different age categories and playing standards.

BACKGROUND: Rugby is increasingly gaining popularity among school-aged male junior players in countries hardly known for dominating international rugby, such as Zimbabwe. Given rugby combativeness, participating adolescents should possess qualities or skills commensurate with the physical demands of the sport for effective participation. This study investigated the independent and interactive effects of age category and playing standard on anthropometric, physiological characteristics and rugby-specific game skills among Zimbabwean athletes. METHODS: Two hundred and eight elite, sub-elite and non-rugby players competing at Under 16 and Under 19 age categories were assessed using the School Clinical Rugby Measure (SCRuM) test battery. Participants underwent height, sitting height, mass, skinfolds, speed, agility, upper-and-lower muscular strength and power, prolonged high-intensity intermittent running ability, tackling, passing and catching assessments in a cross-sectional experimental design. RESULTS: Age categories had significant main effect on all SCRuM test items except sum of seven skinfolds (p = 0.45, η2p = 0.003). Playing standard had significant main effects for all variables except height (p = 0.40, η2p = 0.01) and sum of seven skinfolds (p = 0.11, η2p = 0.02). Specifically, upper-and-lower muscular strength and power, prolonged high-intensity intermittent running ability, tackling, passing and catching improved with increasing playing standards. However, two-way analysis of variance only demonstrated significant interactions between the effects of age category and playing standards for vertical jump height (VJ) test, 2-kg medicine ball chest throw (2-kg MBCT) test, Yo-Yo intermittent recovery test level 1 (Yo-Yo IRT L1), and tackling and catching tests. Yo-Yo IRT L1, VJ, tackling and catching tests demonstrated greater discriminative ability among Under 16 s, whereas the 2-kg MBCT test showed better ability in Under 19 s. CONCLUSION: All SCRuM variables except skinfolds improved with age, highlighting relative sensitivity in differentiating older from younger athletes. However, the discriminative ability by playing standards for VJ, 2-kg MBCT, Yo-Yo IRT L1, tackling and catching ability tests was age-dependent. These findings informs on general attribute development in junior rugby players with age and on specific players attributes in need of monitoring for attainment of elite status at U16 or U19 level.

Anthropometric, physiological characteristics and rugby-specific game skills discriminating Zimbabwean under-16 male adolescent rugby players by level of competition.

OBJECTIVES: Despite growing popularity of adolescent rugby in Zimbabwean schools, little is known about qualities or skills of schoolboy rugby players and how they differ by competitive level. Therefore, the aim of the current study was to identify anthropometric, physiological characteristics and rugby-specific game skills capable of discriminating under-16 (U16) RU players across three proficiency levels. METHODS: Following development of School Clinical Rugby Measure test battery, elite rugby players (n=41), subelite rugby players (n=30) and non-rugby players (n=29) were enrolled and tested for height, sitting height, body mass, skinfolds, speed, agility, upper and lower muscular strength and power, prolonged high-intensity intermittent running ability, tackling, passing and catching in a cross-sectional study. RESULTS: Elite rugby players displayed significantly better scores for all physiological tests and game skills compared with either subelite or non-rugby players, except for Sit-and-Reach, 20 m speed and L-run tests. However, only vertical jump (VJ) and Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IRT L1) significantly improved with increasing competitive level. In addition, elite rugby players showed significantly better scores for tackling (p<0.001) and catching (p<0.001) compared with subelites. No statistical differences were observed across competitive levels for height (p=0.43), sum of seven skinfolds (p=0.26) and passing (p=0.27). CONCLUSION: Since VJ and Yo-Yo IRT L1 improved with increasing playing standard, these findings possibly highlight physiological attributes important in elite schoolboy rugby in Zimbabwe. Additionally, development and training of tackling and catching skills in U16 schoolboy rugby is important since they are linked to higher playing standard.

Children's Repetitive and Intermittent Sprinting Performance (CRISP) Test: A new field-based test for assessing anaerobic power and repeated sprint performance in children with developmental coordination disorder.

BACKGROUND: Evidence on anaerobic power and sprinting performance of children with Developmental Coordination Disorder (DCD) is limited. AIMS: The primary aim of this study was to investigate if the Children's Repetitive and Intermittent Sprinting Performance (CRISP) test could induce fatigue among participants. Secondly, the study examined the construct validity of the test in children with probable DCD (p-DCD) and typically developing (TD) peers. METHODS AND PROCEDURES: The study was carried out in two phases. In phase 1, we compared performance of 25 children (7-12 years) on the CRISP test to their performance on the Muscle Power Sprint test (MPST). For phase 2, forty-six (n = 46) participants with p-DCD were matched with TD children (n = 46) on age, weight and sex. Anaerobic performance of participants was assessed using the CRISP test, 10 × 5 m sprints straight and slalom tests, side jumps, stepping on platform task and the ladder agility test. OUTCOMES AND RESULTS: Phase 1: The increase in running time on the CRISP test was greater than on the MPST, indicating that the CRISP test was more fatiguing than the MPST. Phase 2: Children with p-DCD had poorer anaerobic capacity (muscle power, muscle endurance) compared to their TD peers. However, fatigue was comparable between the two groups. The differences in performance between p-DCD and TD children were found to be greater for tests with more agility elements. CONCLUSIONS AND IMPLICATIONS: The findings showed that CRISP test could induce fatigue in children. The CRISP test was also found to have positive construct (i.e. known-group) validity. The differences in muscle power and endurance between children with p-DCD and TD peers tend to widen when assessments are performed with tests having high agility components.

Logical validation and evaluation of practical feasibility for the SCRuM (School Clinical Rugby Measure) test battery developed for young adolescent rugby players in a resource-constrained environment.

There is a growing impetus towards usage of test batteries in talent identification (TID) programmes in rugby. Consequently, there are many test batteries in existence profiling anthropometric, physiological characteristics and rugby-specific skills. There is no consensus in the literature on the constituent variables and corresponding tests required to inform TID programs. Following development of a new test battery called the SCRuM (School Clinical Rugby Measure), this study aimed at establishing face, logical validity and practical feasibility of included tests. The test battery, initially comprised of 23 items, had its face and logical validity evaluated by five (5) adolescent rugby coaches and 20 rugby experts, respectively. Logical validation was conducted in two questionnaire-based rounds with Content Validity Index (I-CVI) calculated for each variable. Subsequently, a cross-sectional study targeting 30 local rugby coaches was conducted to determine the perceived practical feasibility of each test item. The results showed excellent I-CVI (>0.78) for 17 variables (speed, weight, height and skin fold measures, repeated high-intensity exercise performance ability, prolonged high-intensity intermittent running ability, change of direction speed, anaerobic capacity, lower-and upper body muscular power and strength, muscular flexibility, reactive agility, passing for accuracy, tackling proficiency, and catching). However, three tests, namely, Reactive Agility, One Repetition Maximum Back Squat and One Repetition Maximum Bench Press had low test-feasibility indices (T-FI< 35) suggesting practicality concerns with implementation in the Zimbabwean context. Thus, these findings suggest the need for substitution or development of new practically feasible tests for upper-and lower body muscular strength and reactive agility.

Training for Micrographia Alters Neural Connectivity in Parkinson's Disease.

Despite recent advances in clarifying the neural networks underlying rehabilitation in Parkinson's disease (PD), the impact of prolonged motor learning interventions on brain connectivity in people with PD is currently unknown. Therefore, the objective of this study was to compare cortical network changes after 6 weeks of visually cued handwriting training (= experimental) with a placebo intervention to address micrographia, a common problem in PD. Twenty seven early Parkinson's patients on dopaminergic medication performed a pre-writing task in both the presence and absence of visual cues during behavioral tests and during fMRI. Subsequently, patients were randomized to the experimental (N = 13) or placebo intervention (N = 14) both lasting 6 weeks, after which they underwent the same testing procedure. We used dynamic causal modeling to compare the neural network dynamics in both groups before and after training. Most importantly, intensive writing training propagated connectivity via the left hemispheric visuomotor stream to an increased coupling with the supplementary motor area, not witnessed in the placebo group. Training enhanced communication in the left visuomotor integration system in line with the learned visually steered training. Notably, this pattern was apparent irrespective of the presence of cues, suggesting transfer from cued to uncued handwriting. We conclude that in early PD intensive motor skill learning, which led to clinical improvement, alters cortical network functioning. We showed for the first time in a placebo-controlled design that it remains possible to enhance the drive to the supplementary motor area through motor learning.

Improved Learning a Coincident Timing Task With a Predictable Resisting Force.

The present study analyzes the learning in a coincident timing task with force perturbation. We aimed to verify whether a predictable load (constant spring) applied to hand movements could facilitate learning and, thus, performance improvement with respect to movements without any external load and an unpredictable load to perform a coincident timing task with a few number of repetitions (n = 28) under acquisition and transfer phases. The results showed that the group with a predictable load had a significant better performance with lower percentage of errors and smaller time variance in the acquisition and transfer phase. The groups with no load and unpredictable load had a similar performance in the transfer phase. It can be concluded that adding a predictable force to the coincident timing task results in performance improvement. Therefore, learning to reach a target at a correct time could be improved with the application of predictable external loads.

Manual therapy compared with physical therapy in patients with non-specific neck pain: a randomized controlled trial.

BACKGROUND: Manual therapy according to the School of Manual Therapy Utrecht (MTU) is a specific type of passive manual joint mobilization. MTU has not yet been systematically compared to other manual therapies and physical therapy. In this study the effectiveness of MTU is compared to physical therapy, particularly active exercise therapy (PT) in patients with non-specific neck pain. METHODS: Patients neck pain, aged between 18-70 years, were included in a pragmatic randomized controlled trial with a one-year follow-up. Primary outcome measures were global perceived effect and functioning (Neck Disability Index), the secondary outcome was pain intensity (Numeric Rating Scale for Pain). Outcomes were measured at 3, 7, 13, 26 and 52 weeks. Multilevel analyses (intention-to-treat) were the primary analyses for overall between-group differences. Additional to the primary and secondary outcomes the number of treatment sessions of the MTU group and PT group was analyzed. Data were collected from September 2008 to February 2011. RESULTS: A total of 181 patients were included. Multilevel analyses showed no statistically significant overall differences at one year between the MTU and PT groups on any of the primary and secondary outcomes. The MTU group showed significantly lower treatment sessions compared to the PT group (respectively 3.1 vs. 5.9 after 7 weeks; 6.1 vs. 10.0 after 52 weeks). CONCLUSIONS: Patients with neck pain improved in both groups without statistical significantly or clinically relevant differences between the MTU and PT groups during one-year follow-up. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT00713843.

How reliable and valid is the teacher version of the Strengths and Difficulties Questionnaire in primary school children?

INTRODUCTION: The Strengths and Difficulties Questionnaire (SDQ) is validated for parents, but not yet for teachers in a broad age range of children. We conducted a cross-sectional study with 4-10 years old school children to investigate if the SDQ-T can be used instead of the validated but lengthy Teacher's Report Form (TRF) to acquire information about emotional and behavioral problems in the school community. METHODS: Teachers of 453 children from primary schools were approached. Teachers of 394 children (response rate 86.9%) with a mean age of 7.1 years filled in the SDQ-T (n = 387), the TRF (n = 349) or both (n = 342). We assessed reliability by calculating internal consistency and concurrent validity (using correlation coefficients, sensitivity, specificity) of the SDQ-T compared with the TRF. RESULTS: Internal consistency of the SDQ-T Total Difficulties Score (SDQ-T TDS; Cronbach α = 0.80), hyperactivity/ inattention- (α = 0.86) and prosocial behavior (α = 0.81) was very good. Concurrent validity demonstrated a strong correlation of all subscales of the SDQ-T with the corresponding scale on the TRF (range 0.54-0.73), except for peer problems (0.46). Using a SDQ-T TDS cut-off score > 14, the SDQ-T had a good sensitivity (90%) and specificity (94%). DISCUSSION: The good reliability, validity and brevity of the SDQ-T make it an easily applicable questionnaire for obtaining information about emotional and behavioral problems from teachers in primary school children.