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Initiation of movement and energy expenditure in children with developmental delay: a case-control study
Chiao-Nan Joyce Chen1, Ai-Wen Hwang2, Shang-Ying Lin3
1C-N. Chen, PT, PhD, Department of Physical Therapy, College of Medicine, Chang Gung University, Tao-Yuan, Taiwan.
Insights
Children with developmental delay (DD) do not expend more energy walking but show delays in initiating goal-directed movement. Therapists should assess movement initiation in young children with DD.
Area of Science:
- Pediatric Physical Therapy
- Developmental Pediatrics
- Movement Science
Background:
- Children with developmental delay (DD) are often presumed to have higher energy costs for physical activity.
- Evidence is lacking to confirm if children with DD expend more energy during daily activities like walking.
Purpose of the Study:
- To compare the energy costs of walking and movement initiation times in children with DD versus typically developing (TD) children.
- To investigate potential differences in goal-directed walking initiation between these groups.
Main Methods:
- A case-control study involving 3- and 5-year-old children with DD (n=12) and TD (n=12).
- Measurements included lower extremity range of motion, physiological walking costs, and movement initiation times using a 'go play with the toy' task.
- Reaction times for goal-directed walking were assessed.
Main Results:
- Physiological costs of walking were comparable between children with DD and TD.
- Children with DD walked at a significantly lower speed compared to TD children.
- Children with DD demonstrated longer times to initiate goal-directed walking.
Conclusions:
- Movement initiation delays in young children with DD may not solely stem from motor impairments.
- Findings suggest evaluating movement initiation is crucial for intervention planning in 3- to 5-year-old children with DD.
- Study limitations restrict causal inferences due to design.
Background:
Lower levels of physical activity in children with developmental delay (DD) usually are attributed to higher energy costs. However, there is no evidence that children with DD spend more energy on daily physical activities, such as walking.
Objective:
The aim of this study was to compare energy costs during walking and movement initiation times in children with DD and children with typical development (TD) and matched for age.
Design:
This was a case-control study.
Methods:
Children who were 3 and 5 years old and had DD (n=12) or TD (n=12) participated in the study. Measurements included ranges of motion in the lower extremities, physiological costs of walking, and movement initiation times. A task designed to evaluate the initiation of movement (the "go play with the toy" task) was used to examine the reaction times for children's goal-directed walking.
Results:
The physiological costs of walking were similar in the 2 groups; however, children with DD walked at a lower speed than children with TD. Importantly, children with DD took more time to initiate goal-directed walking.
Limitations:
The nature of the study design limited causal inference from the results.
Conclusions:
Children who were 3 to 5 years old and had DD had delays in goal-directed movement that may not have been attributable to motor impairments. The findings suggest that therapists should evaluate the movement initiation ability of 3- to 5-year-old children with DD as part of the design of an overall intervention plan.
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