Smits-Engelsman Bouwien, Denysschen Marisja, Lust Jessica, Coetzee Dané, Valtr Ludvík, Schoemaker Marina, Verbecque Evi
Physical Activity, Sport and Recreation(PhASRec), Focus Area, Faculty Health Sciences, North-West University, Potchefstroom, South Africa; Department of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Physical Activity, Sport and Recreation(PhASRec), Focus Area, Faculty Health Sciences, North-West University, Potchefstroom, South Africa.
Biomed J. 2024 Jul 18;48(2):100768. doi: 10.1016/j.bj.2024.100768.
Purpose of this study was to determine what key aspects of function should be incorporated to make up a pre-intervention assessment profile of a child with Developmental Coordination Disorder (DCD); more specifically, what aspects of functioning are implicated in DCD and what is their relative impact?
A systematic review and meta-analysis were conducted, for which Pubmed, Web of Science, Scopus and Proquest were searched (last update: April 2023, PROSPERO: CRD42023461619). Case-control studies were included to determine point estimates for performances on field-based tests in different domains of functioning. The risk of bias was assessed, and the level of evidence was estimated. Random-effect meta-analyses were performed to calculate the pooled standardized mean differences for domains of functioning and subgrouping was done for clinically relevant subdomains. Heterogeneity was determined with I.
121 papers were included for analyses. Data of 5923 children with DCD were included (59.8% boys) and 23 619 Typically Developing (TD) children (45.8% boys). The mean (SD) age of the DCD group was 10.3y (1.2) and 9.3y (1.3) for the TD children. Moderate evidence was found for motor performance, executive functions, sensory processing and perceptions, cognitive functions and sports and leisure activities to be affected in children with DCD.
Differences between the two groups varied per domain of functioning. This emphasizes the diversity present within children with DCD and provides a rationale for explaining the heterogeneity in this patient group. Yet, results highlight the potential involvement of all these domains and call for clinicians to be alert not only to examine motor skill difficulties but also other aspects of function. Results indicate the need to develop an individualized pre-intervention multi-dimensional assessment profile for each child with DCD. It also supports the important role that clinicians play in an interdisciplinary team to tackle the difficulties encountered by children with DCD.
本研究的目的是确定功能的哪些关键方面应纳入发育协调障碍(DCD)儿童的干预前评估概况;更具体地说,哪些功能方面与DCD有关,以及它们的相对影响是什么?
进行了一项系统评价和荟萃分析,检索了PubMed、科学网、Scopus和ProQuest(最后更新时间:2023年4月,PROSPERO:CRD42023461619)。纳入病例对照研究以确定不同功能领域基于现场测试的表现的点估计值。评估了偏倚风险,并估计了证据水平。进行随机效应荟萃分析以计算功能领域的合并标准化平均差异,并对临床相关子领域进行亚组分析。用I统计量确定异质性。
纳入121篇论文进行分析。纳入了5923名DCD儿童的数据(59.8%为男孩)和23619名发育正常(TD)儿童的数据(45.8%为男孩)。DCD组的平均(标准差)年龄为10.3岁(1.2),TD儿童为9.3岁(1.3)。有中等证据表明,DCD儿童在运动表现、执行功能、感觉处理与感知、认知功能以及体育和休闲活动方面受到影响。
两组之间的差异因功能领域而异。这强调了DCD儿童中存在的多样性,并为解释该患者群体的异质性提供了理论依据。然而,结果突出了所有这些领域的潜在参与,并呼吁临床医生不仅要警惕检查运动技能困难,还要关注功能的其他方面。结果表明,需要为每个DCD儿童制定个性化的干预前多维评估概况。它还支持临床医生在跨学科团队中发挥重要作用,以解决DCD儿童遇到的困难。