Adapted Frenkle Exercises Versus Dynamic Balance Training in School Going Children (DBT)

Comparison of Adapted Frenkel Exercises and Dynamic Balance Training on Balance, Gait, Mobility, and Motor Coordination in School-Going Children

A randomized clinical trial will be conducted at Realm Educational School. Children aged 6-12 years will be randomly assigned to either the AFE or DBT group using convenient sampling. Participants must be physically active and free from neurological, orthopedic, or cognitive impairments, while those with sensory impairments or recent musculoskeletal injuries will be excluded. Outcome measures will include the Pediatric Balance Scale (PBS), Y-Balance Test, Observational Gait Scale (OGS), Timed Up and Go (TUG) test, and BOT-2. Pre- and post-intervention assessments will evaluate the effectiveness of both interventions on balance, gait, mobility, and motor coordination.

Study Overview

• Status: Not yet recruiting
• Conditions: Healthy Children
• Intervention / Treatment: Behavioral: Adapted Frenkle Exercises; Behavioral: Dynamic Balance Training

Detailed Description

Balance, gait, mobility, and motor coordination are essential for the physical and functional development of school-going children and influence their participation in academic, recreational, and daily activities. The ages of 6-12 years represent a critical period for neuromuscular and postural maturation, making early motor interventions particularly effective. Deficits in these skills may result in reduced physical activity, poor posture, and social withdrawal. This study compares Adapted Frenkel Exercises (AFE), which focus on slow, visually guided, and controlled movements to enhance coordination and proprioception, with Dynamic Balance Training (DBT), which uses functional, task-specific activities such as balance beam walking, multidirectional stepping, and hopping to improve stability during movement. A randomized clinical trial will be conducted at Realm Educational School over 10 weeks (2 sessions per week). Each session will be of 40 minutes. Children aged 6-12 years will be randomly assigned to either the AFE or DBT group using convenient sampling. Participants must be physically active and free from neurological, orthopedic, or cognitive impairments, while those with sensory impairments or recent musculoskeletal injuries will be excluded. Outcome measures will include the Pediatric Balance Scale (PBS), Y-Balance Test, Observational Gait Scale (OGS), Timed Up and Go (TUG) test, and BOT-2. Pre- and post-intervention assessments will evaluate the effectiveness of both interventions on balance, gait, mobility, and motor coordination.

• Study Type: Interventional
• Enrollment (Estimated): 36
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Imran Amjad Phd; Phone Number: 03324390125; Email: imran.amjad@riphah.edu.pk
• Study Contact Backup: Name: Khadija Liaquat MS-NMPT; Email: khadijaliaquat90@gmail.com

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 54000
      • Riphah Rehabilitation Center, Riphah International University
      • Contact: Imran Amjad Phd; Phone Number: 03324390125; Email: imran.amjad@riphah.edu.pk
      • Contact: Khadija Liaquat MS-NMPT; Phone Number: 03334956854; Email: khadijaliaquat90@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. Healthy school-going children aged 8-10 years
2. Both male and female participants
3. No history of neurological, orthopedic, or developmental disorders
4. Informed parental consent and child assent obtained
5. MMSE score ≥ 24
6. TUG score < 20 seconds
7. Pediatric Berg Balance Scale score ≥ 40

Exclusion Criteria:

1. History of diagnosed balance or coordination issues.
2. Children with orthopedic and motor impairments.
3. Behavior or attention disorders limiting participation.
4. Neuromuscular conditions, Visual and mental disorders

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Adapted Frenkle Exercises; For 10 weeks, 40 minutes session, twice a week. Frenkle Exercises will be perform from simple to complex ones. These are coordinated exercises that improve motor function, proprioception and balance.	Behavioral: Adapted Frenkle Exercises; Participants will receive adapted Frenkel exercises progressing from simple to complex movements, focusing on controlled, precise lower-limb movements to improve coordination and balance. Sitting: Controlled leg movements (side leg placement to floor markers, drawing shapes with toes, slow leg lifts). Standing: Marching in place, side leg lifts, and controlled weight shifting. Walking drills: Straight-line walking with visual cues, step-and-stop walking, and figure-8 walking to negotiate obstacles.
Experimental: Dynamic Balance Training; For 10 weeks, dynamic balance training will be performed for 40 minutes in each session. These activities involve the sensory system and require muscle power and coordination.	Behavioral: Dynamic Balance Training; Participants will receive dynamic balance training emphasizing postural control, coordination, strength, and functional balance through varied movement tasks. Mat-based balance exercises Rope activities (e.g., jumping) Balance equipment and ground-based balance tasks Paired movements, rhythm and coordination activities, stepping stones, and non-dominant limb tasks

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pediatric Balance Scale	Assesses functional balance in children through 14 task-based items. Scale Range: 0-56 Interpretation: Higher scores indicate better balance performance.	10 weeks
Y Balance Test - Pediatric version	The Y Balance Test is a dynamic balance assessment that measures a child's ability to maintain single-leg stance while reaching in three directions: anterior, posteromedial, and posterolateral. Scale Range: Reach distance measured in centimeters (%) normalized to limb length. Interpretation: Higher reach distances indicate better dynamic balance and postural control.	10 weeks
Observational Gait Scale	Evaluates gait parameters, including stance, swing, and foot placement during walking. Scale Range: 0-22 Interpretation: Higher scores indicate better gait performance.	10 weeks
Timed Up and Go Test	Measures functional mobility and dynamic balance during sit-to-stand, walking, turning, and sitting. Scale Range: Measured in seconds (no fixed minimum or maximum score). Interpretation: Lower completion times indicate better functional mobility and balance performance.	10 weeks
Bruininks-Oseretsky Test of Motor Proficiency (BOT-2) - Selected subtests	Assesses gross motor coordination, bilateral coordination, and balance in children.	10 weeks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Mehwish Javed, MS-PPT, Riphah International University

Publications and helpful links

General Publications

• Mani H, Miyagishima S, Kozuka N, Inoue T, Hasegawa N, Asaka T. Development of the Relationships Among Dynamic Balance Control, Inter-limb Coordination, and Torso Coordination During Gait in Children Aged 3-10 Years. Front Hum Neurosci. 2021 Oct 28;15:740509. doi: 10.3389/fnhum.2021.740509. eCollection 2021.

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): July 1, 2026
• Study Completion (Estimated): August 1, 2026

Study Registration Dates

• First Submitted: December 14, 2025
• First Submitted That Met QC Criteria: June 1, 2026
• First Posted (Actual): June 2, 2026

Study Record Updates

• Last Update Posted (Actual): June 2, 2026
• Last Update Submitted That Met QC Criteria: June 1, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Balance, Motor coordination, Gait, Frenkel Exercises
• Other Study ID Numbers: RiphahIU- Mehwish

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