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| Efficacy of interventions to improve motor performance in children with developmental coordination disorder: a combined systematic review and meta-analysis [with consumer summary] |
| Smits-Engelsman BCM, Blank R, van der Kaay A-C, Mosterd-van der Meijs R, Vlugt-van den Brand E, Polatajko HJ, Wilson PH |
| Developmental Medicine and Child Neurology 2013 Mar;55(3):229-237 |
| systematic review |
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AIM: The aim of this study was to review systematically evidence about the efficacy of motor interventions for children with developmental coordination disorder (DCD), and to quantify treatment effects using meta-analysis. METHOD: Included were all studies published between 1995 and 2011 that described a systematic review, (randomized) clinical trial, or crossover design about the effect of motor intervention in children with DCD. Studies were compared on four components: design, methodological quality, intervention components, and efficacy. Twenty-six studies met the inclusion criteria for the review. Interventions were coded under four types: (1) task-oriented intervention, (2) traditional physical therapy and occupational therapy, (3) process-oriented therapies, and (4) chemical supplements. For the meta-analysis, effect sizes were available for 20 studies and their magnitude (weighted Cohen's d (dw)) was compared across training types. RESULTS: The overall effect size across all intervention studies was dw = 0.56. A comparison between classes of intervention showed strong effects for task-oriented intervention (dw = 0.89) and physical and occupational therapies (dw = 0.83), whereas that for process-oriented intervention was weak (dw = 0.12). Of the chemical supplements, treatment with methylphenidate was researched in three studies (dw = 0.79) and supplementation of fatty acids plus vitamin E in one study (no effect). The post hoc comparison between treatment types showed that the effect size of the task-oriented approach was significantly higher than the process-oriented intervention (p = 0.01) and comparison (p = 0.006). No significant difference in the magnitude of effect size between traditional physical and occupational therapy approaches and any of the other interventions emerged. INTERPRETATION: In general, intervention is shown to produce benefit for the motor performance of children with DCD, over and above no intervention. However, approaches from a task-oriented perspective yield stronger effects. Process-oriented approaches are not recommended for improving motor performance in DCD, whereas the evidence for chemical supplements for children with DCD is currently insufficient for a recommendation.
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