Motor-Cognitive Integrated Intervention for Children With Developmental Coordination Disorder

A School-based Motor-cognitive Integrated Training Programme Improves Executive Function and Motor Competence in Children With Developmental Coordination Disorder

The goal of this clinical trial is to evaluate the efficacy of an Action Observation and Motor Imagery (AOMI) combined with Fundamental Movement Skills (FMS) intervention for children aged 7 to 11 years with Developmental Coordination Disorder (DCD). The main questions it aims to answer are:

Does the AOMI combined with FMS intervention improve basic motor proficiency and posture control in children with DCD?

Does this integrated motor-cognitive intervention enhance executive functions, specifically cognitive flexibility, inhibitory control, and spatial working memory?

Researchers will compare an experimental group (receiving 30 minutes of AOMI and 30 minutes of FMS per session) to a control group (receiving 30 minutes of FMS and 30 minutes of non-specific activities) to see if the combined approach yields superior outcomes.

A total of 20 strictly screened children with DCD will participate. Both groups will attend 60-minute intervention sessions, 3 times a week, for a total of 10 weeks, while maintaining their normal daily school activities.

Study Overview

• Status: Completed
• Conditions: Developmental Coordination Disorder
• Intervention / Treatment: Behavioral: Action Observation and Motor Imagery (AOMI) Training; Behavioral: Fundamental Movement Skills (FMS) Training; Behavioral: General Physical Activities

Detailed Description

This study employs a single-blind, randomized controlled trial (RCT) with a 2 (Time: pre-test, post-test) × 2 (Group: experimental, control) mixed design framework to investigate the empirical effects of a motor-cognitive integrated intervention for children with Developmental Coordination Disorder (DCD).

Following a comprehensive screening process to identify eligible participants, children are randomly assigned to either the experimental group or the active control group.

During the 10-week intervention period, participants in both groups attend sessions three times per week. The experimental group receives a structured motor-cognitive integrated training program that uniquely combines Action Observation and Motor Imagery (AOMI) with physical Fundamental Movement Skills (FMS) training. The control group participates in standard FMS training matched for duration and frequency, alongside general physical activities without the specialized cognitive training elements.

To evaluate the overall efficacy of the integrated approach, comprehensive assessments evaluating motor proficiency, postural control, and executive functions are conducted by blinded assessors before the intervention begins (baseline) and immediately after the 10-week intervention concludes.

All study procedures adhere strictly to ethical guidelines, and informed consent is obtained from the legal guardians of all participating children prior to the commencement of the research.

• Study Type: Interventional
• Enrollment (Actual): 20
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Shanghai Municipality
    • Shanghai, Shanghai Municipality, China, 200438
      • Shanghai University of Sport

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

Aged 7 to 11 years, currently enrolled as a primary school student.

Meets the diagnostic characteristics of Developmental Coordination Disorder (DCD) according to the DSM-5 criteria, confirmed via standardized screening tools.

Total percentile score ≤ 16, or any subtest percentile score ≤ 5 on the Movement Assessment Battery for Children-2 (MABC-2).

Score on the Developmental Coordination Disorder Questionnaire (DCD-Q) meets the screening cut-off for the corresponding age group.

Parent/guardian reports that motor coordination issues have existed since early development.

Possesses basic comprehension skills to understand researchers' instructions and complete motor training and cognitive tasks.

Able to participate independently in daily school activities without severe motor functional limitations.

Capable of completing the majority of the intervention sessions and the entire testing protocol.

Exclusion Criteria:

Currently receiving systematic specialized sports training or competitive athletic training.

Recent surgery or acute injury that significantly impairs motor capacity.

Severe neurological diseases or other health conditions that may affect motor performance.

Co-morbidity with severe intellectual disability, Autism Spectrum Disorder (ASD), or other developmental disorders that significantly affect the ability to participate in the experiment.

Currently receiving rehabilitation treatments or other systematic motor intervention programs (e.g., physical therapy, occupational therapy, or psychomotor training).

Inability to complete the behavioral tests or cooperate with the research procedures.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: AOMI Combined with FMS Intervention Group; Participants will receive a 10-week motor-cognitive integrated training program, consisting of 60-minute sessions conducted 3 times per week.	Behavioral: Action Observation and Motor Imagery (AOMI) Training; A computerized "observe-imagine-execute" cognitive training framework aimed at enhancing internal motor representations via visual observation and mental imagery. This component lasts for 30 minutes per session.; Behavioral: Fundamental Movement Skills (FMS) Training; Physical training progressively focusing on core locomotor and object control skills (e.g., running, jumping, kicking, throwing, catching). This component lasts for 30 minutes per session.
Active Comparator: Standard FMS Intervention Group; Participants will receive a 10-week pure motor intervention, consisting of 60-minute sessions conducted 3 times per week.	Behavioral: Fundamental Movement Skills (FMS) Training; Physical training progressively focusing on core locomotor and object control skills (e.g., running, jumping, kicking, throwing, catching). This component lasts for 30 minutes per session.; Behavioral: General Physical Activities; Non-specific physical activities lacking specialized cognitive training elements, serving as a time-matched control condition. This component lasts for 30 minutes per session.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Inhibitory Control Assessed by the Stroop Task	A computerized task evaluating automated response inhibition under conflict. Stimuli are four Chinese color words presented in congruent or incongruent font colors (1:1 ratio). Participants must ignore the meaning and respond only to the font color. The task consists of 68 trials. Performance is assessed via RT and accuracy.	Baseline (pre-intervention) and post-intervention (10 weeks).
Change in Cognitive Flexibility Assessed by the More-Odd Shifting	A computerized task evaluating rule-switching ability. Stimuli (digits 1-9, excluding 5) require magnitude, parity, or color-cued judgments. Task 1 and 2 are single-rule blocks (58 trials each). Task 3 is a mixed-rule block (59 trials) producing switch and non-switch conditions. Performance is evaluated via Reaction Time (RT) and accuracy.	Baseline (pre-intervention) and post-intervention (10 weeks).
Change in Spatial Working Memory Assessed by the 16-Grid Paradigm	A computerized task assessing spatial information retention and updating in a 4x4 grid. 4 black squares are presented (1000ms), followed by a blank screen (1000ms), and a target stimulus. Participants judge whether the target is the original pattern rotated by 90°. The task consists of 90 trials divided into 4 blocks.	Baseline (pre-intervention) and post-intervention (10 weeks).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Dynamic Postural Control Assessed by the Y-Balance	Measures maximum controlled reach distance in three directions while maintaining a single-leg stance.	Baseline (pre-intervention) and post-intervention (10 weeks).
Change in Static Postural Control Assessed by the Single-Leg Stance Test with Eyes Closed	Participants stand on one leg with their eyes closed. The duration (in seconds) they can successfully maintain balance is recorded to evaluate static postural control and proprioceptive integration capacity.	Baseline (pre-intervention) and post-intervention 10weeks
Change in Lower Limb Coordination Assessed by the Side Hop Test	Participants perform continuous lateral jumps back and forth over a set distance within a limited time. The total number of successful jumps is recorded to reflect lower limb coordination and rapid posture adjustment ability.	Baseline (pre-intervention) and post-intervention 10 weeks
Change in Sprinting Speed Assessed by the 50-Meter Dash	The time taken (in seconds) to complete a 50-meter sprint is recorded to evaluate physical speed and acceleration capabilities.	Baseline (pre-intervention) and post-intervention (10 weeks).
Change in Coordination and Cardiopulmonary Endurance Assessed by the 1-Minute Jump Rope Test	The number of valid jumps completed within one minute is recorded to reflect whole-body coordination and cardiopulmonary endurance levels.	Baseline (pre-intervention) and post-intervention (10 weeks).
Change in Lower Limb Explosive Power Assessed by the Standing Long Jump	The maximum valid horizontal jump distance (in centimeters) is recorded to evaluate the explosive power of the lower limbs.	Baseline (pre-intervention) and post-intervention (10 weeks).
Change in Core Muscle Endurance Assessed by the 1-Minute Sit-Up Test	The number of correctly performed sit-ups completed in one minute is recorded to evaluate trunk and core muscle endurance.	Baseline (pre-intervention) and post-intervention (10 weeks).
Change in Flexibility Assessed by the Sit-and-Reach Test	The maximum forward reach distance (in centimeters) is recorded to evaluate the flexibility of the lower back and hamstring muscles.	Baseline (pre-intervention) and post-intervention (10 weeks).
Change in Gross Motor Skills Assessed by the BOT-2	The Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) evaluates gross motor skills, including balance, bilateral coordination, and running speed. The Total Motor Composite standard score will be reported. The standard score ranges from a minimum of 20 to a maximum of 80. Higher scores indicate better gross motor proficiency and coordination.	Baseline (pre-intervention) and post-intervention (10 weeks).
Change in Gross Motor Development Assessed by the TGMD-3	The Test of Gross Motor Development - Third Edition (TGMD-3) evaluates fundamental locomotor and object control skills. The total score is calculated based on the performance criteria of the skills. The total score ranges from a minimum of 0 to a maximum of 100. Higher scores indicate better overall gross motor development.	Baseline (pre-intervention) and post-intervention (10 weeks).

Collaborators and Investigators

• Sponsor: Shanghai University of Sport
• Investigators: Principal Investigator: Kun Zhu, Ph.D., Shanghai University of Sport; Study Chair: bin Zhang, Ph.D., Shanghai University of Sport

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2025
• Primary Completion (Actual): June 30, 2025
• Study Completion (Actual): June 30, 2025

Study Registration Dates

• First Submitted: March 16, 2026
• First Submitted That Met QC Criteria: March 16, 2026
• First Posted (Actual): March 23, 2026

Study Record Updates

• Last Update Posted (Actual): March 25, 2026
• Last Update Submitted That Met QC Criteria: March 21, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Neurodevelopmental Disorders; Motor Skills Disorders
• Other Study ID Numbers: 102772024RT188

Drug and device information, study documents

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