Maze Balance Board Training Effects on Mobility and Motor Skills in Cognitively Impaired Children

Effects of Maze Balance Board Training on Functional Mobility and Gross Motor Skills in Children With Cognitive Impairment

The study will be a Randomized Controlled Trial including 22 children aged 6-10 years with deficits in functional mobility and gross motor skills. Participants will be randomly divided into an experimental group (n=11), receiving a seven-stage progressive Maze Balance Board protocol, and a control group (n=11), receiving conventional physical therapy. Both groups will undergo 30-minute sessions, three times per week, for 8 weeks. Eligible participants will be enrolled after guardian consent. Outcomes will be assessed using the Montreal Cognitive Assessment (MoCA) for cognition, Timed Up and Go (TUG) test for functional mobility, and Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) for gross motor skills. Ethical approval will be obtained from Riphah International University, Lahore, and data will be analyzed using SPSS version 27.0.

Study Overview

• Status: Recruiting
• Conditions: Cognitive Impairment
• Intervention / Treatment: Other: Maze Balance Board traing; Other: Conventional Physical Therapy

Detailed Description

Difficulties with Functional Mobility, Gross and fine motor skills are common in children with Cognitive Impairment, significantly impacting their ability to perform everyday activities and acquire new motor skills. These difficulties often arise from impaired integration of sensory information and deficits in motor planning, resulting in poor functional mobility and increased risk of instability. As a result, affected children may struggle with maintaining upright positions, transitioning between movements, and executing coordinated actions, all of which are essential for functional mobility and participation in age-appropriate activities. To address these concerns, this study will assess the effects of Maze Balance Board Training on Functional Mobility and Gross Motor Skills in Children with Cognitive Impairment.

The study design will be a Randomized Controlled Trial. The study will recruit 22 children aged 6-10 years with identified deficits in Functional Mobility and Gross motor skills.

Participants will be randomly assigned to either the experimental group (n=11) which will follow a seven-stage progressive Maze Balance board protocol, and a control group (n=11) receiving standard Conventional physical therapy exercises. These interventions will be performed for 30 mins, thrice a week over 8 weeks. All the referred participants will be assessed on the basis of eligibility criteria. Guardians of participants fulfilling the eligibility criteria will be asked to sign the consent forms before entering them to study. This study will utilize three standardized assessment tools to objectively measure Cognition level, Functional Mobility and gross motor skills in children with Cognitive Impairment: Montreal Cognitive Assessment (MoCA) to measure cognition, Time Up and Go (TUG) Test for the functional mobility, While the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) for Gross Motor Skills. The synopsis will be presented to the Research Ethical Committee of Riphah International University, Lahore, for ethical approval to conduct this study. Data will be analyzed through SPSS version 27.0.

• Study Type: Interventional
• Enrollment (Estimated): 22
• Phase: Not Applicable

Contacts and Locations

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

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 05450
      • Recruiting
      • Imran Amjad, PhD
      • Contact: IMRAN AMJAD, PhD; Phone Number: 9233224390125; Email: imran.amjad@riphah.edu.pk
      • Contact: Muhammad Asif Javed, MS-PT; Phone Number: 923224209422; Email: a.javed@riphah.edu.pk
      • Principal Investigator: Maryam Shafique, MS-PT

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Children aged 6-10 years
• Mild to Moderate Cognitive Impairment (MoCA score =18 to 25)
• Gross motor skill delay (10).
• Ability to follow verbal instructions
• Parents are willing to make sure their child's participation

Exclusion Criteria:

• Use of medications that may influence neuromotor functions (e.g., sedatives, antiepileptic's)
• Children with visual and hearing impairments
• Receiving concurrent therapies
• Recent lower limb injuries , surgeries, or musculoskeletal conditions

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Maze Balance Board Training; The experimental group (n=11) will receive Maze Balance Board Training in a one-on-one setting, conducted three times per week for 8 weeks. A seven-stage progressive protocol will be followed, where participants advance only after successfully completing each stage, with earlier stages revisited to reinforce learning. Stage 1 involves rotating a marble with hands; Stage 2 focuses on manual maze navigation; Stage 3 develops static balance on a board; Stage 4 includes unassisted rotational balance; Stage 5 introduces foot-mediated marble rotation; Stage 6 requires foot-based maze navigation; and Stage 7 combines dynamic balance with precise marble placement as a dual task. Progression will depend on task performance over consecutive days, aiming to improve functional mobility and gross motor skills in children with cognitive impairment.	Other: Maze Balance Board traing; The experimental group (n=11) will receive Maze Balance Board Training in a one-on-one setting, conducted three times per week for 8 weeks. A seven-stage progressive protocol will be followed, where participants advance only after successfully completing each stage, with earlier stages revisited to reinforce learning. Stage 1 involves rotating a marble with hands; Stage 2 focuses on manual maze navigation; Stage 3 develops static balance on a board; Stage 4 includes unassisted rotational balance; Stage 5 introduces foot-mediated marble rotation; Stage 6 requires foot-based maze navigation; and Stage 7 combines dynamic balance with precise marble placement as a dual task. Progression will depend on task performance over consecutive days, aiming to improve functional mobility and gross motor skills in children with cognitive impairment.
Other: Conventional Physical Therapy; The control group (n=11) will receive conventional physical therapy as a standard-of-care baseline, conducted to improve postural control and gross motor skills. Sessions will include structured exercises performed regularly throughout the study. Activities include animal walks (bear walk, bunny hops, frog jumps) to enhance core and limb strength; bridging exercises to strengthen glutes and hamstrings; sit-to-stand training to improve lower limb strength and functional movement; tandem walking to challenge balance; standing on varied surfaces (foam/cushions) to improve proprioception; beam/line walking forward and backward for coordination and dynamic balance; and obstacle negotiation involving stepping over or around objects. These exercises will be consistently practiced to enhance mobility and motor performance in children with cognitive impairment.	Other: Conventional Physical Therapy; The control group (n=11) will receive conventional physical therapy as a standard-of-care baseline, conducted to improve postural control and gross motor skills. Sessions will include structured exercises performed regularly throughout the study. Activities include animal walks (bear walk, bunny hops, frog jumps) to enhance core and limb strength; bridging exercises to strengthen glutes and hamstrings; sit-to-stand training to improve lower limb strength and functional movement; tandem walking to challenge balance; standing on varied surfaces (foam/cushions) to improve proprioception; beam/line walking forward and backward for coordination and dynamic balance; and obstacle negotiation involving stepping over or around objects. These exercises will be consistently practiced to enhance mobility and motor performance in children with cognitive impairment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional Mobility	Functional mobility will be assessed using the Timed Up and Go (TUG) test as the primary outcome measure. It evaluates a child's ability to stand up from a chair, walk a short distance, turn, return, and sit down, measuring mobility, balance, and functional movement efficiency.	Baseline, 8 weeks
Gross motor Skills	Gross motor skills will be assessed using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) as a primary outcome measure. It evaluates motor abilities including balance, coordination, strength, and agility through standardized tasks, providing a reliable measure of overall gross motor performance in children with cognitive impairment.	Baseline, 8 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Maryam Shafique, MS-PT, Riphah International University Lahore

Publications and helpful links

General Publications

• Karnad SD, Narayan A, Kamath N, Rao BK, Sharma M, K VK. A protocol to evaluate the effect of Modified Scooter Board Therapy on Trunk Control and Hip muscles Activation in children with Cerebral Palsy. MethodsX. 2025 Apr 5;14:103301. doi: 10.1016/j.mex.2025.103301. eCollection 2025 Jun.

Study record dates

Study Major Dates

• Study Start (Actual): October 28, 2025
• Primary Completion (Estimated): May 5, 2026
• Study Completion (Estimated): June 15, 2026

Study Registration Dates

• First Submitted: May 5, 2026
• First Submitted That Met QC Criteria: May 5, 2026
• First Posted (Actual): May 11, 2026

Study Record Updates

• Last Update Posted (Actual): May 11, 2026
• Last Update Submitted That Met QC Criteria: May 5, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Cognitive impairment; Functional mobility; Gross motor skills; Maze balance board
• Additional Relevant MeSH Terms: Mental Disorders; Neurocognitive Disorders; Cognition Disorders; Cognitive Dysfunction
• Other Study ID Numbers: REC/RCR&AHS/24/Maryam Shafique

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