Effect of Pressure-Biofeedback on Manual Dexterity in Children with Developmental Coordination Disorder

Developmental Coordination Disorder (DCD) is a neurodevelopmental condition affecting manual dexterity (MD) and fine motor skills (FMS). Pressure biofeedback (PB), a noninvasive tool providing real-time feedback, may enhance motor learning. This study examined the effects of PB combined with occupational therapy (OT) on MD and FMS in children with DCD. In this single-blinded, randomized controlled trial, 40 children aged 5-10 years with DCD were assigned to an intervention group (PB + OT) or a control group (OT alone). The Developmental Coordination Disorder Questionnaire (DCD-Q) provided a subjective evaluation of motor coordination, including FMS and proprioception. MD was objectively measured by the manual dexterity subtest of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2). Pressure biofeedback (PB) pattern tracking quantified fine motor precision and proprioceptive regulation using Root Mean Square Error (RMSE) and visual-motor integration using the Correlation Coefficient (CC). Post-intervention, the intervention group showed significantly more improvements than controls in DCD-Q, BOT-2, RMSE, and CC scores. DCD-Q and BOT-2 scores increased (p < 0.05), indicating enhanced manual dexterity, including proprioception and fine motor skills. RMSE decreased (p < 0.001), reflecting improved fine motor precision and proprioceptive regulation. CC scores improved post-intervention (p = 0.011) and remained higher at follow-up (p < 0.001), demonstrating sustained visuomotor coordination gains. Repeated measures ANOVA confirmed significant time and group effects (p < 0.05), supporting lasting motor improvements. PB is a practical, quantitative intervention for enhancing MD and FMS in children with DCD. Integrating PB with OT led to significant and sustained improvements in motor coordination, visuomotor integration, proprioceptive function, and handwriting performance. These findings support biofeedback as a non-invasive and engaging approach for pediatric neurorehabilitation, aligning with family-centered, non-pharmacological care models.