Postural Control In Children Research Articles

Effect of Visual Information on Postural Control in Children with Autism Spectrum Disorder.

Visual information is crucial for postural control. Visual processing in children with autism spectrum disorder (ASD) was hypothesized to be less efficient and thus they would display a less stable standing posture than typically developing children. The present study compared the static standing responses and attentional demands of 15 children with ASD and 18 control participants in conditions of eyes open and eyes closed. The results showed that postural responses and attention invested in standing were similar between the participant groups in the two visual conditions. Both groups displayed a more stable posture when their eyes were open in comparison to eyes closed. The finding suggests that normal postural control development could occur in children with ASD.

Do the type of walking surface and the horse speed during hippotherapy modify the dynamics of sitting postural control in children with cerebral palsy?

BackgroundHippotherapy is described as a rehabilitation method for postural control in children with cerebral palsy. Horse's movements can be manipulated during hippotherapy's sessions with horse walking on different surfaces and at different speeds. The purpose of this study was to assess if dynamic sitting postural control in children with cerebral palsy in hippotherapy is modified when surfaces (sand or asphalt) and horse's walking speed (slow or faster) are changed. MethodsSixteen children participated in this crossover study. Eight bilateral spastic cerebral palsy children, age range (6–12 years), with Gross Motor Function Classification System levels III to IV, practicing hippotherapy and eight children with typical development (reference group), matched for age and sex. All children were evaluated during riding a horse on sand and asphalt surfaces and at slow (self-selected) and faster (30%) horse's walking speed. Center of pressure parameters were determined by a portable pressure measurement system positioned on the saddle. FindingsMediolateral displacement amplitude of the center of pressure was larger when the horse was on sand. Mediolateral and anteroposterior displacements amplitude and velocities of the center of pressure increased at horse's faster walking speed. InterpretationOur study test empirical procedures used in clinical practice and with a population widely reached by hippotherapy. In order to increase the demand for sitting postural control in children with cerebral palsy during horse riding, faster horse speed or riding on sand should be used.

The cross-sectional relationships between age, standing static balance, and standing dynamic balance reactions in typically developing children

BackgroundStatic balance performance is a common metric for evaluating the development of postural control in children. Less is known about the potentially independent development of dynamic balance performance. Research questionHow does age relate to static (i.e. postural sway) and dynamic (i.e. stepping thresholds) standing balance performance, and what is the relationship between postural sway and stepping thresholds? MethodsTwenty-six typically developing children (12 males, 14 females; 5–12 years of age) were recruited for this cross-sectional study. Static balance performance was quantified as the total path length during a postural sway assessment using a force platform with conditions of eyes open and eyes closed. Dynamic balance performance was quantified using a single-stepping threshold assessment, whereby participants attempted to prevent a step in response to treadmill-induced perturbations in the anterior and posterior directions. Relationships between age and body-size scaled measures of static and dynamic balance performance were assessed using Spearman rank correlations. ResultsThere was a weak correlation between age and postural sway (|rs| < 0.10, p > 0.68), but a moderate-to-strong correlation between age and single-stepping thresholds (rs > 0.68, p < 0.001). A weak correlation was found between postural sway and single-stepping thresholds (|rs| < 0.20, p > 0.39). SignificanceDynamic, but not static standing balance performance, may improve with typical development between the ages of 5 and 12 years. Static and dynamic balance should be considered as unique constructs when assessed in children.

Effect of tDCS on Postural Control of Children With DCD

Effect of tDCS on Postural Control of Children With DCD

Trunk and pelvic alignment in relation to postural control in children with cerebral palsy.

Trunk-pelvic mal-alignment and postural control deficit are common problems facing children with cerebral palsy (CP). The aim of this study was to investigate the relation of trunk and pelvic alignment with postural control in children with diplegic CP. Seventy seven children with spastic diplegic CP, aged from 6 to 8 years with level II on Gross Motor Function Classification System, participated in this study. Trunk imbalance, lateral deviation of the spine and pelvic tilt were evaluated by using Formetric instrumentation system while postural control was assessed by using Pediatric Balance Scale. The results showed that there was a moderate negative correlation of trunk imbalance, lateral deviation of the spine and pelvic tilt with postural control (-0.44, -0.59 and -0.57, respectively). Increased trunk imbalance, lateral deviation of the spine and pelvic tilt may be associated with decreased postural control ability in children with diplegic CP.

Influence of age, sex, and visual information on postural control in children

Abstract Aim: This study aims to evaluate and identify the influence of age, sex, and visual information on postural control in children. Methods: Participants were 62 children (30 boys and 32 girls) divided into the following age groups (G): G1, aged 5-6 years (n = 23); G2, aged 7-8 years (n = 21); and G3, aged 9-10 years (n = 18). The analyzed variables were the center of pressure (COP) and anteroposterior (AP) and mid-lateral (ML) oscillation velocity (OV) obtained in the biped posture force platform with their open eyes (OE) and closed eyes (CE). Results: G3 COP, OV_AP, and OV_ML are smaller than those in G1 and G2 in OE (p < 0.00) and CE (p < 0.05). Girls demonstrated worse postural control than boys for COP, OV_AP, and OV_ML (p < 0.00) in G1. Conclusion: Age was the most influential factor of COP (21%), OV_AP (24%), and OV_ML (39%). Older children perform better, because of the positive contribution of visual information. Girls initially had worse postural control responses, but at age 7-8, they tend to outgrow boys. Advanced age provides more influence on postural control than visual information and sex.

Postural deficiency in children with spinal stenosis

Introduction. Stenosis of the spinal canal can be accompanied by abnormalities of gait and body balance. At the same time, changes occurring in the postural control in children with spinal stenosis remain unexplored.&#x0D; Aim. To study postural stability in children with spinal stenosis and assess the imbalance of the body depending on the level of stenosis localization.&#x0D; Material and methods. This study investigated 14 patients, aged 10–17 years, with stenosis of the spinal canal. The first group consisted of seven patients with spinal stenosis due to congenital deformity of the thoracic spine with spinal cord compression at the stenosis level. The second group consisted of seven patients with spondylolisthesis of the L5 vertebra body of grades 3–4, accompanied with spinal cord root compression. The control group consisted of seven healthy children of the same age. We used stabilometry, and statistical study included correlation-regression analysis.&#x0D; Results. A significant deviation of the stabilometric parameters was noted only in the first group of patients (p &lt; 0.05). In the same group, a strong correlation was found between the parameters of statokinesiogram: area S, length L, amplitude A, and mean power level of the spectrum of f 60%, which were much higher than those of healthy children, which may indicate a pathologically high synchronization of the vertical balance control system of the body. Other changes were revealed, such as a strong relationship between L/S and A at normal stabilometric parameters and a moderate force between L/A and f 60%, indicating postural deficiency in the group of patients with stenosis at the level of the lumbosacral spine.&#x0D; Correlation-regression analysis for assessing the postural balance in both groups of patients showed a correlation between parameters L, S, A, and f 60%, which were significantly higher than those in healthy children and most pronounced in the thoracic localization of stenosis.&#x0D; Conclusion. The system of maintaining vertical balance of the body in children with stenosis of the spinal canal at the level of the thoracic spine has a more pronounced deficiency than that in patients with stenosis of the canal at the lumbosacral level. To reveal hidden violations of the postural balance, the relationship between length, area, amplitude, and mean power of the statokinesiogram must be evaluated.

Analysis of the weight of school backpack with double strapson the postural control of children

To investigate the influence of the weight of school backpacks on postural control of children. Cross-sectional study in healthy children aged eight years old. The postural control was evaluated on the force plate (FP) and the Timed Up and Go test (TUG) in three distinct conditions: without backpack (WB), and the backpack adjusted with 5% (.5) and 10% (. 10) of body mass. 90 children were evaluated, and 80% of them used backpacks with two shoulder straps, and 16% of the children carried over 10% of their body mass in the backpacks. Regarding the postural control with load on school backpack, there was increase in the sway area of the center of pressure (A-COP.WB = 6.92 cm²; A-COP.5 = 8.39 cm²; A-COP.10 = 7.96 cm²) and time, in seconds, the performance of the TUG (TUG.WB = 4.75 s; TUG.5 = 4.99 s; TUG.10 = 5.06 s), with statistically significant difference between the loads (p = 0.0001; p = 0.0005), respectively. The anteroposterior (VELAP.SM = 2.41cm s-1; VELAP.5 = 2.30 cm s-1; VELAP.10 = 2.22 cm s-1; p = 0.0001) and mediolateral velocity (VELML.WB = 2.38 cm s-1; VELML.5 = 2.28 cm s-1; VELML.10 = 2.20 cm s-1; p = 0.0001) had a decrease in the median values with statistically significant difference in different conditions. School backpack load increased the COP area, the time of the TUG and modified the response mechanisms. Therefore, loads up to 5% of body mass imposed on school backpack have negatively influenced the postural control.

Effect of Optic Flow on Postural Control in Children and Adults with Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) have been associated with sensorimotor difficulties, commonly presented by poor postural control. Postural control is necessary for all motor behaviors. However, findings concerning the effect of visual motion on postural control and the age progression of postural control in individuals with ASD are inconsistent. The aims of the present study were to examine postural responses to optic flow in children and adults with and without ASD, postural responses to optic flow in the central and peripheral visual fields, and the changes in postural responses between the child and adult groups. Thirty-three children (8–12 years old) and 33 adults (18–50 years old) with and without ASD were assessed on quiet standing for 60 seconds under conditions of varying optic flow illusions, consisting of different combinations of optic flow directions and visual field display. The results showed that postural responses to most optic flow conditions were comparable between children with and without ASD and between adults with and without ASD. However, adults with ASD appeared more responsive to forward-moving optic flow in the peripheral visual field compared with typically developed adults. The findings suggest that children and adults with ASD may not display maladaptive postural responses all the time. In addition, adults in the ASD group may have difficulties prioritizing visual information in the central visual field over visual information in the peripheral visual field when in unfamiliar environments, which may have implications in understanding their motor behaviors in new surroundings.

Characterizing postural oscillation in children and adolescents with hereditary sensorimotor neuropathy.

Charcot Marie Tooth disease (CMT) has negative functional impact on postural control of children; however, it has not been widely studied. Stabilometry can provide insights about postural control and guide preventive interventions in immature perceptual and musculoskeletal systems as those seen in children with CMT. This cross-sectional study aimed to identify and interpret stabilometric variables that reflect the postural control of children with CMT. 53 subjects (age 6–17) were assigned to one of the two groups: CMT (15 males and 14 females with CMT) or Control (13 males and 11 females healthy). Quiet standing was tested in different conditions: with open and closed eyes on regular surface (open-regular, closed-regular) and foam surface (open-foam, closed-foam) using a force platform. The minimum of 2 and maximum of 3 trials of 30 seconds for each test condition provided the classical stabilometric variables and Romberg Quotient (RQv). CMT group showed increase of confidence ellipse area, mean velocity, mediolateral and anteroposterior velocities associated with decreased mean body oscillation frequency, as the complexity of tasks increased. CMT postural deficit was identified by greater and faster sway associated with these lower frequencies, when compared to Control.

The severity of chewing disorders is related to gross motor function and trunk control in children with cerebral palsy

Purpose: The frequency of chewing disorders increases with decreasing level of gross motor function in children with cerebral palsy (CP). Besides its frequency, the severity of chewing disorders is also important. The aim of this study was to determine the relationship between chewing performance level and gross motor function, and trunk postural control in children with CP.Materials and methods: The study included 119 children with CP (age 2–10 years). Chewing performance level was determined by the Karaduman Chewing Performance Scale (KCPS). The Gross Motor Function Classification System (GMFCS) was used to determine the level of gross motor function. Segmental Assessment of Trunk Control (SATCo) was used to measure trunk control.Results: Children with spastic CP with a median age of 4 years were evaluated, of which 50.4% were male. The percentages of patients classified to GMFCS levels I to V were 43.7%, 6.7%, 9.2%, 5.0%, and 35.3%, respectively. The median KCPS score was 3 (min = 0, max = 4). A good correlation was found between KCPS and GMFCS (p < .001, r = 0.70). Negative, excellent correlations between KCPS and SATCo static, SATCo active, and SATCo reactive postural controls were found (p < .001, r = –0.75, r = –0.77, r = –0.79; respectively).Conclusions: The severity of chewing disorders is related to the level of gross motor function and trunk postural control in children with CP.Clinical trial number: NCT03241160

The Effects of a 5-Day Virtual-Reality Based Exercise Program on Kinematics and Postural Muscle Activity in Youth with Cerebral Palsy

Aims: To determine the effects of a 5-day virtual reality (VR)-based intervention on anticipatory and reactive mechanisms of postural control in children and adolescents with cerebral palsy (CP). Methods: Eleven youth with CP (GMFCS levels I and II), ages 7–17, were allocated to intervention (N = 5) and control (N = 6) groups. Both groups attended balance assessment sessions 1 week apart. Participants in the intervention group received 1-hour one-on-one physiotherapist-supervised VR balance games for 5 consecutive days between assessments. For balance assessments, participants stood erect with eyes open on a movable platform that translated progressively through four speeds in the anterior/posterior direction. Participants performed two trials each of experimenter-triggered and self-triggered perturbations. Postural muscle activity and kinematics were recorded. The Anchoring Index and body segment cross-correlations were calculated as an indication of body stabilization, and the number of steps taken to regain balance/avoid falling were counted. Mann–Whitney U tests for between group differences in change scores were undertaken with an accepted significance level of 0.01. Results: No consistent differences in change scores were identified between groups. Conclusions: There was no effect of a 5-day VR-based intervention on postural control mechanisms used in response to oscillating platform perturbations. Subsequent studies will further tailor VR interventions to patients’ functional balance needs.

Brain network connectivity associated with anticipatory postural control in children and adults

Internal models provide a coherent framework for understanding motor behavior. Examples for the use of internal models include anticipatory postural adjustments (APAs), where the individual anticipates and cancels out the destabilizing effect of movement on body posture. Yet little is known about the functional changes in the brain supporting the development of APAs. Here, we addressed this issue by relating individual differences in APAs as assessed during bimanual load lifting to interindividual variation in brain network interactions at rest. We showed that the strength of the connectivity between three main canonical brain networks, namely the cingulo-opercular, the fronto-parietal and the somatosensory-motor networks, is an index of the ability to implement APAs from late childhood (9- to 11-year-old children). We also found an effect of age on the relationship between APAs and coupling strength between these networks, consistent with the notion that APAs are near but not yet fully mature in children. We discuss the implications of these findings for our understanding of learning disorders with impairment in predictive motor control.

Changes of spatial and temporal characteristics of dynamic postural control in children with typical neurodevelopment with age: Results of a multicenter pediatric study

BackgroundThe aim of this multicenter study is to investigate the effect of chronological age and gender in postural control. MethodsTo approach an ecological model, we used a multicenter posturography assessment. We analyzed postural control with surface, mean velocity of center of pressure [CoP] and temporal analysis, with Postural Instability Index [PII] being a more sensitive parameter in postural evaluation. A large sample of 156 age- and gender-matched healthy children recruited in several pediatrics hospitals, participated. ResultsOur current results showed a significant decrease of all postural parameters (surface, mean velocity of CoP and PII) with age, and only on stable support condition. Our study additionally described a gender effect in conditions where all sensory inputs are most challenged with a mean velocity of CoP being significantly smaller in girls with respect to boys. ConclusionWe concluded that postural control improves with age linked with maturation process. Moreover, this maturation process seems not yet achieved at 16.08 years and still ongoing beyond. Interestingly, our result reported specificities linked with gender effect. Indeed, girls and boys do not proceed in the same way to maintain their postural control. We could make hypothesis that more children maintain their postural control efficiently; with a low energy cost, the more they could allocate attention to learning during childhood.

Peripheral sensory information and postural control in children with strabismus

BackgroundSensory feedback from the visual system along with the vestibular and somatosensory systems is essential for the regulation of normal postural control. Children with strabismus and, therefore, with abnormal binocular vision, may have an altered perception of space and use different sets of cues to determine depth perception when compared with children without strabismus. ObjectiveTo explore the postural control of children with and without strabismus, when the three sensory systems are challenged. MethodForty-six children (21 with strabismus and 25 age-matched controls) aged between 5 and 10 years completed ophthalmic screening and then underwent assessment for postural control, which included Paediatric Balance Scale (PBS) and six conditions of the Sensory Organization Test (SOT). Four primary outcome measures were: PBS summary score, Equilibrium Score (ES), Strategy Score (SS) and Sensory Analysis Score of the SOT. ResultsA significant difference (P < 0.05) was observed between the strabismus and non-strabismus group in the PBS and, ES and SS of SOT condition 1. The Sensory Analysis scores were significantly different (P = 0.03) between the groups for ‘Somatosensory’. Simple linear regression analysis suggested that the strabismus condition was significantly (P ≤ 0.02) associated with the PBS and, the ES and SS of condition 1, with a variance of 14.6%, 16.1% and 12.8%, respectively. Subgroup analysis suggested that age was a significant (P ≤ 0.001) correlate for balance scores in non-strabismus group (R2 ranged from 32% to 58.4%), but not for the strabismus group. SignificancePostural control in children with strabismus is not equivalent to that of children without strabismus, when their somatosensory system is challenged. Additionally, the functional balance performance of children with strabismus is lower than their counterparts without strabismus. Collectively, the results suggest that the usual improvement in balance performance with increasing age is observed in children without strabismus but not in children with strabismus.

Discriminant ability and criterion validity of the Trunk Impairment Scale for cerebral palsy

Aims: To compare the performance of children with mild and moderate-to-severe cerebral palsy (CP) on the Trunk Impairment Scale (TIS), Gross Motor Function Measure (GMFM), and on center-of-pressure variables; to establish the discriminant ability of these tools to predict severity of motor impairment in CP; and to investigate the criterion validity of the TIS.Methods: Children with mild (n = 18, 11 males, 7 females, mean age = 9.5 ± 2.9 years, Gross Motor Function Classification System I–II) and moderate-to-severe (n = 18, 11 males, 7 females, mean age = 9.2 ± 229, Gross Motor Function Classification System III–IV) CP were tested using the TIS and the GMFM, and during static sitting on force-plate.Results: Children with mild CP showed better trunk (median; 95% confidence interval = 22.5; 21.29–22.59 vs. 13; 11.97–14.8; p < 0.001) and gross motor (60; 57.73–59.3 vs. 40; 38.96–46.25; p < 0.001) scores, and better postural control (lower center of pressure (CoP) displacement [anterior–posterior: (0.42; 0.32–1.11 vs. 0.89; 0.70–1.65; p = 0.022); medial–lateral: (0.42; 0.31–1.08 vs. 0.91; 0.65–1.17; p = 0.044)], and lower area of sway, (0.05; −0.15–0.97 vs. 0.44; 0.23–0.90; p = 0.008) than the moderate-to-severe group. Trunk control and gross motor function explained 81.5% of the variance in the severity of motor condition. Correlations between the TIS and the GMFM were excellent (ρ = 0.944, p < 0.001); correlations between the TIS and CoP variables were low (anterior–posterior displacement: ρ = −0.411, p < 0.05; medial–lateral displacement: ρ = −0.327, p < 0.05); area of sway: ρ = −0.430, p < 0.05; velocity of sway: ρ = −0.308, p < 0.05).Conclusions: The TIS is able to differentiate levels of trunk control across various levels of motor impairments in CP. It is a valid tool to assess trunk control, showing very high concurrent validity with the GMFM sitting dimension.Implications for RehabilitationTrunk Impairment Scale (TIS) can be used by rehabilitation professionals to differentiate levels of trunk control across levels of motor impairment.TIS showed concurrent validity with Gross Motor Function Measure and should be used to assess trunk control in children with cerebral palsy (CP) in clinical settings.The use of TIS allows a reliable assessment of postural control in children with CP in clinical settings.

Mu-oscillation changes related to the development of anticipatory postural control in children and adolescents.

Anticipatory postural adjustments (APAs) cancel the destabilizing effects of movement on posture. Across development, the maturation of APAs is characterized by an accurate adjustment of the timing parameters of electromyographic (EMG) response. The study aimed at investigating the maturation of cortical oscillations involved in the improvement of APAs efficiency. Thirty-six healthy participants (8-16 yr) performed the bimanual load-lifting task in which subjects are instructed to lift a load, placed on the left forearm, with the right hand. EMG data were acquired over the biceps brachii on the postural arm to the determine EMG response onset. Electroencephalographic signals were analyzed in the time-frequency domain by convolution with complex Gaussian Morlet wavelets. Electrophysiological signature of APAs in children and adolescents consisted of a mu-rhythm desynchronization over the sensorimotor cortex contralateral to the postural arm. Across development, the mu-rhythm desynchronization was characterized by a progressive shift forward of the onset of the desynchronization, lower amplitude, and velocity. These changes occurred along with an alteration of the timing of the EMG response, as shown by an earlier onset of the flexor inhibition with increasing age. The maturational changes in the Mu-oscillations might sustain the development of APAs. A possible role of the Mu-oscillation in the generation of postural command is discussed. NEW & NOTEWORTHY Across development, our study showed a progressive shift forward of the parameters of the mu-rhythm desynchronization. These changes occurred along with an alteration of the timing parameters of the electromyographic response, as shown by an earlier onset of the flexor inhibition with increasing age. The progressive development of APAs during childhood and adolescence might therefore be sustained by maturational electrophysiological changes that include mu-rhythm oscillation modifications in the postural sensorimotor cortex.

Proprioception and vestibular alterations affect postural control in children with mild autism: A pilot study

Background: Individuals diagnosed with Autism Spectrum Disorder (ASD) exhibit some type of motor control impairment, for instance, motor apraxia and history of gross motor delay that could lead to increased risk of fall. This pilot research was designed to assess and characterize static postural stability and create a starting point to better understand and describe postural control in children with mild autism. Method: We measured static postural control with center of pressure (COP) displacement in 10 children with mild autism during eight sensory conditions that challenge and cancel the visual, proprioceptive and vestibular systems. Results: Our results showed that children with autism demonstrated increased postural sway in response to challenges to the proprioceptive and vestibular systems. Conclusion: Therefore, under appropriate, challenging conditions, static postural control instability can be detected in children with mild autism.

Evaluation of postural control in children and adolescents with down syndrome aged eight to twelve years old

Introduction: Down Syndrome is a genetic disorder caused by the presence of the third copy of chromosome 21 (total or partial). The syndrome occurs in approximately one out of every 700 – 1000 newborns per year. Objective:To analyze postural control (PC) of children and adolescents with Down Syndrome (DS) and to compare differences regarding age, sex, nutritional status, and physical activity (PA) levels. Methods: In this cross-sectional study, a convenience sample composed of 21 children and adolescents (9 girls) was categorized according to age: G1 (8 to 9 years old; n = 8), G2 (10 years old; n = 7), and G3 (11 to 12 years old; n = 6), Score-Z: eutrophic (n = 9) and overweight (n = 12), and PA level: practitioners (n = 7) and non-practitioners (n = 14). PC was assessed in the force platform (FP), in the standing position, with feet together during 30 seconds. The variables analyzed were the center of pressure area (COP) and the mean velocities of anteroposterior and mediolateral oscillation (VEL-AP and VEL-ML). Shapiro-Wilk test was used to test the normality of data. Kruskal-Wallis, Dunn’s, and Mann Whitney tests were performed to analyze associations with PC. Statistical significance was set at p&lt;0.05. Results: The median COP, VEL-AP and VEL-ML were 3.55 [2.13 – 6.82] , 2.81 [2.32 – 3.16], and 2.98 [2.42 – 3.43], respectively. There were no differences in PC regarding sex, body mass index and PA level. The adolescents in G3 presented lower values of VEL-AP (G1=2,88 [2,82 – 3,21]; G2= 2,94 [2,35 – 3,39]; G3= 2,27 [2 – 2,3]) and VEL-ML (G1= 3,22 [3,14 – 3,68]; G2= 2,91 [2,52 – 3,63]; G3= 2,34 [2,1 – 2,39]). Conclusion: Sex, nutritional status, and PA level did not affect COP area and AP-VEL and ML-VEL. However, strategies were affected by age, as observed by differences in velocity, but did not affect the COP area.

Neuromuscular Processes in the Control of Posture in Children with Developmental Coordination Disorder: Current Evidence and Future Research Directions

The ability to control body position in space is fundamental to all daily activities. This review article summarizes the neurological and muscular deficits that are associated with poor postural control in children with developmental coordination disorder (DCD) and includes suggestions for future research work. The atypical neuromuscular processes in the control of posture in children with DCD include abnormal structures and functions of the central nervous system, sensory organization disorders, abnormal recruitment of postural muscles, slow muscle contraction, and lower maximum muscle strength of the legs. Inattention can further compromise neuromuscular processes and postural control performance in these children. Atypical neuromuscular processes in static, reactive, and anticipatory postural control have been reported in children with DCD. These include atypical structures and functions of the central nervous system, sensory organization disorders, abnormal recruitment pattern of postural muscles, slow muscle contraction speed, and lower maximum muscle strength of the legs. Functional movement-power training is a recommended treatment strategy as it can address both the neuromuscular deficits (lower peak force and longer time to reach peak force in the knee muscles) and atypical standing balance responses of children with DCD. Future studies could explore the neuromuscular processes associated with adaptive postural control, an under-examined area, and effective rehabilitation interventions to improve functional balance control and the associated impairments in children with DCD.