Examining the Effects of Group Versus Individual-Based Exercise Programs on Balance and Coordination in Children With Autism: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 16
- 试验地点
- 1
- 主要终点
- Pediatric Balance Scale (PBS)
研究概览
简要总结
This study compared the effects of group-based versus individual-based exercise programs on balance and coordination in children aged 3-12 years who were diagnosed with Autism Spectrum Disorder (ASD) Level 1. A total of 16 children were recruited and randomly allocated into two groups (n=8 each): Group A (individual-based) and Group B (group-based). Both groups received 40-minute exercise sessions, 3 days per week, for 6 weeks. Outcomes were assessed at baseline and after 6 weeks using the Pediatric Balance Scale (PBS) and neurological coordination tests (Finger-to-Nose, Heel-to-Shin, Past-Pointing).
详细描述
Background: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition affecting motor function, including balance and coordination. Physical activity interventions showed promise in improving motor outcomes, but comparative evidence between group-based and individual-based formats was limited.
Study Design: Randomized Controlled Trial with parallel assignment. Participants: 16 children (aged 3-12 years) with ASD Level 1 severity were recruited from rehabilitation centers and special education institutions in Islamabad, Pakistan, using purposive sampling and random allocation via lottery method.
Interventions: Group A (Individual-Based): Each child received a personalized 40-minute physiotherapy exercise session including warm-up (movement to music, trampoline jumping, stair climbing), balance and coordination exercises (single-leg stance, animal walks, wobble board, ball games, tug of war, obstacle course), and cool-down (bubble blowing, block building). Sessions were delivered 3 times per week for 6 weeks. Group B (Group-Based): The same exercise protocol was delivered in group, incorporating peer interaction, social modeling, and group dynamics.
Outcome Measures: Pediatric Balance Scale (PBS; score 0-56) and neurological coordination tests (Finger-to-Nose, Heel-to-Shin, Past-Pointing) were administered pre- and post-intervention.
Data Analysis: Data were analyzed using SPSS v21. Normality was assessed and tests were applied accordingly.
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
- None
入排标准
- 年龄范围
- 3 Years 至 12 Years（Child）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Inclusion Criteria:
- •Diagnosed with Autism Spectrum Disorder (level one severity).
- •Age 3-12 years.
- •Ability to understand simple instructions.
- •No participation in previous physiotherapy balance programs.
排除标准
- •Co-existing intellectual disability or ADHD.
- •Visual impairments.
- •Chronic medical disorders affecting mobility or postural control.
- •Inability to participate consistently in sessions.
研究组 & 干预措施
Group B - Group-Based Exercise Program
Group-Based Physiotherapy Exercise Program (40 min/session, 3×/week, 6 weeks): Same protocol as Group A but delivered in group, incorporating peer interaction and social modeling.
干预措施: Group Based Exercise (Other)
Group A - Individual-Based Exercise Program
Individual-Based Physiotherapy Exercise Program (40 min/session, 3×/week, 6 weeks): Warm-up, balance and coordination exercises (single-leg stance, animal walks, wobble board, ball games, obstacle course), cool-down activities.
干预措施: Individual based (Other)
结局指标
主要结局
Pediatric Balance Scale (PBS)
时间窗: Assessed at Baseline (Week 0) and Post-intervention (Week 6).
It is a comprehensive and effective scale evaluating the balance in the following three dimensions: static balance, anticipatory balance, and functional movement transitions. The scale comprises 14 items including sitting balance, standing balance, sitting to standing/standing to sitting, transfers, stepping, reaching forward with outstretched arm, reaching the floor, turning, and placing foot on stool items. Each item ranked from 0 to 4. 0 shows inability to perform the instruction, while 4 shows the ability to perform without any difficulty. Maximum total score is 56. The intraobserver agreement of the PBS total score was high, perfectly (ICC=0.927).(15, 16) PBS can be considered a simple, valid scale for examining functional balance capacity in children with neurological disorders.
Finger-to-Nose Test
时间窗: Assessed at Baseline and Week 6
A widely used neurological test for evaluating cerebellar function and upper limb coordination, the finger-to-nose test involves the patient alternately touching the examiner's finger and their nose in a smooth, controlled manner. Its reliability is generally moderate to good. Its validity is thought to be good for detecting gross cerebellar dysfunction, coordination, intention tremor, and dysmetria. Sensitivity roughly 60-85% and specificity around 70-90, while its reliability is usually moderate to good, with inter-rater reliability coefficients (ICC or kappa) commonly reported in the range of 0.60-0.85.
Heel-to-Shin Test
时间窗: Assessed at Baseline and Week 6
The heel-to-shin test is a neurological examination used to evaluate lower-limb coordination and cerebellar function. The patient is asked to place the heel of one foot on the opposite knee and smoothly slide it down the shin to the ankle. Normal performance is smooth and accurate; abnormal findings, such as irregular movement, side-to-side wavering, inability to maintain contact, or intention tremor, suggest cerebellar dysfunction, sensory ataxia. Studies report sensitivity ranging approximately from 65-90% and specificity around 70-95% for detecting significant cerebellar dysfunction, depending on standardization and patient population, while its reliability is generally moderate to good, with reported inter-rater and intra-rater reliability coefficients (ICC or kappa) typically between 0.60 and 0.85.
Past-Pointing Test
时间窗: Assessed at Baseline and Week 6
When a person consistently overshoots or undershoots a target during voluntary, goal-directed movements, it is a sign of impaired cerebellar coordination. It reflects defective error correction and timing of agonist-antagonist muscle activity normally regulated by the cerebellum, leading to dysmetria. It becomes more pronounced when visual guidance is removed, which worsens primarily with eyes closed, multiple sclerosis, and autism. Sensitivity (\~60-80%) and good specificity (\~70-90%).
次要结局
未报告次要终点