The Relationship Between Postural Control and Fundamental Movement Skills in Children With Developmental Coordination Disorder, Mild Cerebral Palsy, and Typical Development.

Abstract

<h4>Importance</h4>Impaired fundamental movement skills are prevalent among children with developmental coordination disorder (DCD) and mild cerebral palsy (CP). Although postural control is a prerequisite for gross motor skills, its role in fundamental movement skills is understudied.<h4>Objective</h4>This study aims to determine the extent to which postural control contributes to fundamental movement skill performance in children with DCD, mild CP, and with typical development (TD).<h4>Design</h4>This was a case-control study.<h4>Participants</h4>Participants were 127 children aged 5.0 to 10.9 years (DCD [N = 48], TD [N = 59)], mild spastic CP [N = 20]). Children with CP were classified as Gross Motor Function Classification System I (N = 11) or II (N = 9), and as having either unilateral (N = 11) or bilateral CP(N = 9).<h4>Main outcomes and measures</h4>The Test of Gross Motor Development-3 (TGMD-3) evaluated fundamental movement skills, and the Kids-Balance Evaluation Systems Test-2 (Kids-BESTest-2) assessed postural control. The domain and total scores of both tests were used for analysis.<h4>Results</h4>Children with TD significantly outperformed those with DCD and mild CP, while DCD and mild CP performed similarly. Across groups the Kids-BESTest-2 and TGMD-3 correlated significantly (r = 0.42-0.77). The total Kids-BESTest-2 score and group (TD-DCD-mild CP) explained 69% of locomotor skill variance but did not significantly explain ball skill performance (R2 = 0.40). Among postural control domains, only anticipatory postural adjustments contributed to fundamental movement skills. Group effects were larger (ηp2 = 0.15-0.31) than the effects of Kids-BESTest-2 scores (ηp2 = 0.01-0.12).<h4>Conclusions and relevance</h4>The findings suggest that postural control plays a role in locomotor performance but that unique group-specific factors influence this relationship. Further research should investigate the impact of postural control task-oriented training on fundamental movement skills, and should examine the influence of additional factors, such as body functions and environmental influences on fundamental movement skill development.