Background Research suggests that children identified with impaired motor skills can respond well to intensive therapeutic interventions delivered via occupational and physical therapy services. There is, however, a need to explore alternative approaches to delivering interventions outside traditional referral‐based clinic settings because limited resources mean such health services often struggle to meet demand. This review sets out to systematically assess the evidence for and against school‐based interventions targeted at improving the motor skills of children aged between 3 and 12 years old. Method Five electronic databases were searched systematically (AMED, CINAHL, Cochrane, Medline, and PsycINFO) for peer‐reviewed articles published between January 2012 and July 2018. Studies were eligible if they implemented a school‐based motor skill intervention with a randomized or case‐controlled trial design that objectively measured motor skills as an outcome, which were not specific to an athletic or sporting skill. Participants had to be aged between 3 and 12 years old and free from neurological disorders known to affect muscle function. Risk of bias was assessed using the Cochrane risk of bias tool. Results Twenty‐three studies met the inclusion criteria. These studies encompassed interventions targeted at training: fundamental movement skills, handwriting, fine, and global motor skills. The majority of these studies reported beneficial impact on motor function specifically, but some interventions also assessed subsequent impacts on activity and participation (but not well‐being). A number of the studies had methodological shortcomings that means these results need to be interpreted with caution. Conclusions Schools appear to be an effective setting for motor skill interventions, but the extent of benefit likely depends on the type of intervention. Moreover, confirmation is needed as to whether benefits extend beyond motor function into everyday activities, participation, and well‐being. Future research should include follow‐up measures to assess the longer term efficacy of school‐based interventions.
Research has shown that adults can engage in cognitive offloading, whereby internal processes are offloaded onto the environment to help task performance. Here, we investigate an application of this approach with children, in particular children with poor working memory. Participants were required to remember and recall sequences of colors by placing colored blocks in the correct serial order. In one condition the blocks were arranged to facilitate cognitive offloading (i.e., grouped by color), whereas in the other condition they were arranged randomly. Across two experiments (total N = 166) the ordered condition improved task performance for children with low working memory ability. In addition, participants in Experiment 2 rated the difficulty of the two arrangements and performed a further condition in which they were given an opportunity to freely arrange the blocks before completing the task. Despite performing better in the ordered condition, children with low working memory ability did not rate the ordered arrangement as easier, nor did they choose an ordered arrangement when given the opportunity to do so. This research shows that cognitive offloading can also be a useful process in populations other than typical adults, and the implications of this work for supporting children with poor working memory are discussed.
Electroencephalography-based brain-computer interfaces (BCI) that allow the control of robotic devices to support stroke patients during upper limb rehabilitation are increasingly popular. Hand rehabilitation is focused on improving dexterity and fine motor control and is a core approach for helping stroke survivors regain activities of daily living. This systematic review examines recent developments in BCI-robotic systems for hand rehabilitation and identifies evidence-based clinical studies on stroke patients. A search for January 2010-October 2019 articles using Ovid MEDLINE, Embase, PEDro, PsycINFO, IEEE Xplore and Cochrane Library databases was performed. The selection criteria included BCI-hand robotic systems for rehabilitation in various development stages involving tests on healthy human subjects or stroke survivors. Data fields include those related to study design, participant characteristics, technical specifications of the system, and clinical outcome measures. 30 studies were identified as eligible for qualitative review and among these, 11 studies involved testing a BCI-hand robot on chronic and subacute stroke patients. Statistically significant improvements in motor assessment scores relative to controls were observed for two BCI-hand robot interventions. The degree of robot control for the majority of studies was limited to triggering the device to perform grasping or pinching movements using motor imagery. Most employed a combination of kinaesthetic and visual response via the robotic device and display screen, respectively, to match feedback to motor imagery. Most studies on BCI-robotic systems for hand rehabilitation report systems at prototype or pre-clinical stages of development. Some studies report statistically significant improvements in functional recovery after stroke, but there is a need to develop a standard protocol for assessing technical and clinical outcomes so that the necessary evidence base on efficiency and efficacy can be developed.
Background Evidence suggests that significant numbers of school children fail to acquire age-appropriate fundamental movement skills (FMS), despite the importance of FMS in facilitating participation in physical activities. This has led to calls for an increase in routine screening of children’s FMS in school settings. However, there is limited research exploring teachers’ knowledge of FMS, and the capacity of schools to conduct such assessments. This project therefore aimed to explore primary school teachers’ knowledge of FMS, and investigated what factors might influence the acceptability of FMS assessments in primary schools. Methods Primary school staff working in roles that directly impact the learning of children were invited to take a brief (10–15 minutes) online questionnaire developed using the COM-B Behaviour Change Model. Results Primary school staff (n = 851) from 32 countries (UK: n = 746, 88%) completed the questionnaire. A majority reported that knowledge of their pupils’ FMS ability would be beneficial (65.3%), and 71.8% said they would assess FMS if appropriate support was provided. Identified barriers to school-based FMS assessments included: Capability – few (15%) possessed knowledge of FMS; Opportunity – teachers reported that 30–60 minutes would be acceptable for assessing the FMS of a whole class, a substantially shorter period than current assessments require; Motivation – 57.2% stated FMS assessments would increase workload stress and 48% of teachers would be influenced by their peers. Solutions to these issues are discussed using the COM-B theoretical framework. Conclusions Current FMS assessment tools are not acceptable, or feasible for use in schools. There is a need for existing measures to be modified, or new tools to be developed, underpinned by the considerations outlined in this paper, if FMS screening in schools is to become a reality.
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