Effectiveness of Body Awareness Training on Motor Skills, Activity Performance, and Participation in Children With Intellectual Disabilities: A Randomized Controlled Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 41
- 试验地点
- 1
- 主要终点
- Motor skills
研究概览
简要总结
We tested whether adding a simple, structured Body Awareness Training (BAT) program to conventional physiotherapy improves motor skills, everyday activity performance, and participation (goal achievement and satisfaction) in children with mild to moderate intellectual disability.41 children aged 8-15 years with mild or moderate intellectual disability completed the study. They were randomly assigned to receive either standard physiotherapy (control) or the same physiotherapy plus Body Awareness Training (intervention).All children received conventional physiotherapy three times per week for six weeks (18 sessions total). The physiotherapy included warm-up, range-of-motion, stretching, strengthening exercises and electrotherapy. The intervention group received an additional 30 minutes per session of Body Awareness Training during the same period. BAT activities were simple, rhythmic, and child-friendly. Both groups improved in some fine motor domains, but improvements were larger in the group that received Body Awareness Training. The BAT group showed additional significant gains in manual dexterity, balance, and running speed/agility that were not observed in the control group. Children in the BAT group reported greater improvements in everyday activity performance and higher satisfaction. The BAT group also achieved better outcomes on individualized functional goals (GAS) for several prioritized activities.
Most improvements were maintained at the 10-week follow-up. Adding short, structured Body Awareness Training to routine physiotherapy may provide extra benefits for motor coordination, balance, and meaningful everyday functioning in children with mild-moderate intellectual disability.
BAT exercises are low-cost, adaptable, and can be integrated into regular therapy sessions; they may help bridge improvements in motor skills to better performance and participation in daily life. Clinicians should individualize intensity and progression according to each child's abilities and stop or adapt activities if pain, excessive fatigue, or breathlessness occurs.
详细描述
This randomized, assessor-blinded controlled trial evaluated a reproducible rehabilitation approach that integrates a standardized Body Awareness Training (BAT) module into conventional pediatric physiotherapy for children with mild-moderate intellectual disability. Grounded in sensorimotor and interoceptive theories of motor learning, the intervention aimed to improve proprioceptive, vestibular and interoceptive processing to support motor control, postural strategies and attentional regulation and thereby enhance activity performance and participation within the ICF framework. The study used a six-week, thrice-weekly dosing schedule (18 sessions); control sessions were 60 minutes of individualized physiotherapy (warm-up, ROM, stretching, strengthening, electrotherapy, cool-down) while the intervention sessions added a 30-minute BAT module delivered one-to-one by a trained physiotherapist. BAT core elements-body scanning, opening/closing and cross-body coordination, rhythmic tactile "catwalk" stimulation, standing alignment tasks, controlled weight-transfer and stability-limits practice, and breathing-wave integration-were delivered in a flexible, modular sequence and progressed in complexity and challenge across weeks according to each child's tolerance and mastery; tempo, repetitions, sensory support and assistance level were adapted individually and documented. Therapists completed standardized fidelity checklists and session logs; a subset of sessions was audited to ensure adherence. Safety procedures included screening exclusions (recent orthopedic surgery, contraindicating comorbidity, severe communication barriers), real-time monitoring for pain, excessive fatigue, dizziness or respiratory distress with immediate modification or cessation as needed, and withdrawal for participants missing >3 sessions. Outcomes spanned impairment to participation (BOT-2 SF, COPM, GAS) assessed at baseline, post-treatment and 10-week follow-up by a blinded assessor. Statistical planning used an a priori power calculation, repeated-measures mixed ANOVA for continuous outcomes and non-parametric analyses with effect sizes for ordinal GAS data; analyses were per-protocol with minimal missing data and no imputation. The intervention is intentionally low-cost and modular to support clinical adaptation, though trial delivery relied on trained, single-therapist, one-to-one sessions; implementers wishing to target strength specifically should add progressive overload components and longer follow-up is recommended to assess durability. De-identified data, the BAT manual and fidelity checklist are available from the corresponding author on reasonable request.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
盲法说明
Outcome assessments were performed at baseline (T0), post-treatment (T1), and 10-week follow-up (T2) by a licensed physiotherapist who was completely blinded to group allocation and had no involvement in delivering the intervention protocols. To maintain the integrity of the blinding, the treating physiotherapist-who was responsible for delivering both the conventional and body awareness interventions-did not participate in any part of the assessment or data entry process. During the data analysis phase, the principal investigators conducted the statistical analysis on de-identified datasets to ensure that the evaluation of results remained independent of the treatment delivery.
入排标准
- 年龄范围
- 8 Years 至 15 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age between 8 and 15 years
- •Mild or moderate intellectual disability with sufficient cognitive and verbal communication ability to understand and follow instructions.
排除标准
- •Receiving any treatment other than conventional physiotherapy within the previous 6 months
- •Having any orthopedic disorder or history of orthopedic surgery
- •Communication problems in parents or caregivers
- •Absence from more than three treatment sessions.
结局指标
主要结局
Motor skills
时间窗: Baseline (T0), immediately post-intervention at 6 weeks (T1), and 10-week follow-up (T2).
Motor skills were evaluated using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition-Short Form (BOT-2 SF). This standardized instrument assesses eight domains: fine motor precision, fine motor integration, manual dexterity, bilateral coordination, balance, running speed and agility, upper-limb coordination, and strength. Total scores are calculated based on subtest performance, where higher scores represents superior motor proficiency and better physical coordination.
Activity performance
时间窗: Baseline (T0), immediately post-intervention at 6 weeks (T1), and 10-week follow-up (T2).
Self-perceived performance and satisfaction in everyday activities were evaluated using the Canadian Occupational Performance Measure (COPM). Through a collaborative clinician-led interview, children and parents identified five priority tasks in the domains of self-care, productivity, or leisure. Each activity was rated on a scale from 1 (lowest) to 10 (highest), where higher scores indicate greater perceived performance and higher satisfaction with the ability to perform meaningful daily routines.
Participation
时间窗: Baseline (T0), immediately post-intervention at 6 weeks (T1), and 10-week follow-up (T2).
Individualized participation goals were collaboratively set by the child, parents, and the evaluating physiotherapist prior to the intervention. Goal achievement was rated on a 5-point scale from -2 (much less than expected) to +2 (much better than expected), with 0 representing the expected level of attainment. GAS provides a standardized method to quantify meaningful, individualized changes in participation and functional goal achievement following the intervention.
次要结局
未报告次要终点
研究者
Mehmet Miçooğulları
Asst. Prof. Dr.
Cyprus International University