Correlation of Gross Motor Movement, and Balance With Screen Time in Healthy Children

Gross motor function involves large muscle control for activities like walking, running, and sports, and is essential for balance and coordination. Excessive screen time may hinder gross motor development by reducing physical activity, affecting strength and coordination. Structured activities like free play and exercise are key to minimizing these effects. A cross-sectional study will be conducted over 10 months in public and private schools in Lahore. Children aged 7-10 will be included. Screen time will be assessed through demographic data, and gross motor skills evaluated using the TGMD-2. Exclusion criteria: PBS < 20, TGMD-2 < 30, recent orthopedic surgery, and MMSE < 26. Data will be analyzed in SPSS v25 using descriptive statistics and correlation. This study explores the impact of screen time on children's physical development, particularly gross motor skills and balance

Study Overview

• Status: Not yet recruiting
• Conditions: Healthy Children

Detailed Description

This study aims to examine the impact of screen time on gross motor development in school-aged children. Gross motor function, which involves large muscle control for activities such as walking, running, and sports, plays a vital role in developing balance, coordination, and overall physical health. With increased screen use among children, physical activity levels may decrease, potentially affecting their motor development.

A cross-sectional study will be conducted over 10 months in public and private schools across Lahore. The target population includes children aged 7 to 10 years. Screen time exposure will be recorded through demographic questionnaires, and gross motor skills will be assessed using the Test of Gross Motor Development-Second Edition (TGMD-2). Children will be excluded if they have a Pediatric Balance Scale (PBS) score below 20, a TGMD-2 score below 30, recent orthopedic surgery, or a Mini-Mental State Examination (MMSE) score below 26. Data will be analyzed using SPSS version 25 with descriptive statistics and correlation tests. This study seeks to identify how screen time may influence key aspects of children's physical development, particularly focusing on gross motor skills and balance

• Study Type: Observational
• Enrollment (Estimated): 429

Contacts and Locations

• Study Contact: Name: IMRAN AMJAD, PhD; Phone Number: 9233224390125; Email: imran.amjad@riphah.edu.pk
• Study Contact Backup: Name: Muhammad Asif Javed, MS-PT; Phone Number: 923224209422; Email: a.javed@riphah.edu.pk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of children aged 7 to 10 years enrolled in public and private schools in Lahore. Participants must be able to follow basic instructions and engage in physical tasks required for assessment. Children with a Pediatric Balance Scale (PBS) score below 20, TGMD-2 score below 30, a history of orthopedic surgery within the past 6 months, or a Mini-Mental State Examination (MMSE) score below 26 will be excluded. The sample will represent typically developing school-aged children with varying levels of screen time exposure

Description

Inclusion Criteria:

• Children between ages 7 to 10 years
• Children with screen time exposure of more than 2 hours per day on a weekday (30,
• Screen time exposure through television, smartphones, tablets, laptops or computers.
• Children with exposure of screen time more than 3 hours on a weekend

Exclusion Criteria:

• Children with Pediatric balance score: below 45.
• Children with TGMD-2 Score: below 30 (less than 10" percentile).
• Children who have had orthopedic surgery within the previous 6 months.
• Cognition Score below 26 on MMSE (Mini-Mental State Examination).

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
healthy children; The healthy children group will include school-aged children between 7 to 10 years with no known neurological, musculoskeletal, or developmental disorders. All participants will have normal cognitive function (MMSE ≥ 26) and PBS scores above 20, indicating mild or no motor difficulties.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PBS (Pediatric Berg Balance Scale)	The Pediatric Balance Scale (PBS) is a modified version of Berg's Balance Scale, designed for school-aged children with mild to moderate motor difficulties. In a study by Bal et al., 20 children (ages 5-15) with balance disorders were tested twice by the same examiner. Additionally, 10 pediatric physical therapists, unaware of the study hypotheses, rated 10 randomly chosen sessions. The PBS showed excellent reliability, with high test-retest (ICC = 0.998) and interrater (ICC = 0.997) consistency, confirming its effectiveness as a reliable balance assessment tool for this population	baseline
Screen Time Questionnaire	The Pediatric Balance Scale (PBS), a modified Berg's Balance Scale, is for school-aged children with mild to moderate motor difficulties. In a study by Bal et al., 20 children (ages 5-15) were tested twice by the same examiner, and 10 pediatric physical therapists rated 10 randomly chosen sessions. PBS showed high test-retest (ICC = 0.998) and interrater reliability (ICC = 0.997), confirming its effectiveness as a reliable balance assessment tool	baseline
TGMD-2 (Test of Gross Motor Development-2)	The Test of Gross Motor Development-Second Edition (TGMD-2) evaluates children's motor skills. A study assessed the Portuguese version for clarity, validity, and reliability. Two trials per child were video recorded for analysis. The motor tasks were found clear and reflective of motor development. The test showed good validity (Chi-square/df = 3.38; GFI = 0.95; AGFI = 0.92; TLI = 0.83) and strong reliability (locomotor: r = 0.82; object control: r = 0.88).	baseline
kinovea software	Kinovea is a non-invasive, cost-effective tool for assessing thoracic kyphosis and lumbar lordosis. In a study with 18 participants, its measurements were compared to Cobb's method. Inter- and intra-rater reliability showed moderate to perfect agreement (ICC < 0.001). Validity for thoracic kyphosis was moderate and dependent on evaluator expertise, while lumbar lordosis showed weaker correlation. Kinovea proves useful for clinical and research-based postural assessments	baseline

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Mahrukh Fatima, MS-PPT, Riphah International University

Publications and helpful links

General Publications

• Yuan R, Zhang J, Song P, Qin L. The relationship between screen time and gross motor movement: A cross-sectional study of pre-school aged left-behind children in China. PLoS One. 2024 Apr 5;19(4):e0296862. doi: 10.1371/journal.pone.0296862. eCollection 2024.

Study record dates

Study Major Dates

• Study Start (Estimated): April 16, 2025
• Primary Completion (Estimated): July 16, 2025
• Study Completion (Estimated): July 16, 2025

Study Registration Dates

• First Submitted: April 17, 2025
• First Submitted That Met QC Criteria: April 17, 2025
• First Posted (Actual): April 24, 2025

Study Record Updates

• Last Update Posted (Actual): April 24, 2025
• Last Update Submitted That Met QC Criteria: April 17, 2025
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Keywords: balance; screen time; school-aged children; Gross motor movement
• Other Study ID Numbers: REC/RCR/AHS/24/0730

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No