Motor imagery training for children with developmental coordination disorder--study protocol for a randomized controlled trial.

Imke L J Adams,Bert Steenbergen,Bouwien C M Smits-Engelsman,Jessica M Lust

doi:10.1186/s12883-016-0530-6

Abstract

BackgroundPrevious studies have shown that the predictive control of movements is impaired in children with Developmental Coordination Disorder (DCD), most likely due to a deficit in the internal modeling of movements. Motor imagery paradigms have been used to test this internal modeling deficit. The aim of the present study is to examine whether a training focused on the mental imagery of motor skills, can help to improve the motor abilities of children with DCD.Methods/DesignA pre-post design will be used to examine the motor performance, motor imagery and motor planning abilities before and after a training of 9 weeks. Two groups will be included in this study (1) one receiving motor imagery (MI) training focused on the forward modeling of purposive actions, (2) one receiving Cognitive Orientation to daily Occupational Performance (CO-OP) training focused on identifying effective cognitive strategies that will increase motor competence. MI training will be given with the use of instruction videos of the motor skill that will be trained. Both groups will participate in 9 individual sessions of 45 min (once a week) with a paediatric physical or occupational therapist, added with homework sessions. Inclusion criteria are: (1) aged 7–12 years, (2) meeting the DSM-V criteria for DCD (motor performance substantially low (score on the m-ABC ≤ 16th percentile) and motor problems that interfere with daily life (DCDQ, and request for help at a paediatric physical or occupational therapist)). Exclusion criteria are IQ < 70 and other medical conditions causing the motor impairment.DiscussionThe results of this study will help to make treatment protocols for children with DCD more evidence-based. This study will increase our knowledge about the efficacy of both the MI training and CO-OP training, and both children with DCD and therapists will benefit from this knowledge.Trial registrationwww.trialregister.nl/NTR5471.

Highlights

Previous studies have shown that the predictive control of movements is impaired in children with Developmental Coordination Disorder (DCD), most likely due to a deficit in the internal modeling of movements
This study will increase our knowledge about the efficacy of both the motor imagery (MI) training and Cognitive Orientation to daily Occupational Performance (CO-OP) training, and both children with DCD and therapists will benefit from this knowledge
MI training is already described as a possible treatment for children with DCD [9], but it is not recommended yet because there is only one study available [22]

Summary

Introduction

Previous studies have shown that the predictive control of movements is impaired in children with Developmental Coordination Disorder (DCD), most likely due to a deficit in the internal modeling of movements. In two recent systematic reviews [3, 4] this collective evidence was shown to reveal an underlying deficit in motor control and learning, linked to the predictive control of movements This deficit has been described as the ‘internal modeling deficit’ (IMD) [5] and is thought to compromise the motor learning capabilities of children with DCD. We recently showed that children with DCD experience problems with tasks that are thought to rely on an internal model of a movement - motor imagery, action planning and rapid online control of movements [4]. A motor imagery (MI) training, which is focused on the comparison between the predicted consequences of a movement (by using imagery) and the actual consequences of a movement, might help children with DCD to improve the predictive control of movements

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