Efficacy of Bimanual Training With Lower-Limb Activities on Attention, Coordination, and Concentration in Children
Dipti D Kadam1, Mandar Malawade1
1Department of Pediatric Neurosciences Physiotherapy, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.
Abstract:
Introduction Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder in children, marked by inattention, hyperactivity, impulsivity, and impaired motor coordination. While pharmacological and behavioral interventions remain the primary management strategies, growing evidence highlights the influence of motor-based interventions on cognitive and attentional functions. Physiotherapy approaches incorporating bimanual and whole-body movements may enhance sensory integration, bilateral coordination, and executive control. However, limited research exists on structured play-based bimanual training combined with lower-limb activities in children with ADHD. Method An experimental pre-post interventional study was conducted at the Department of Pediatric Physiotherapy, Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth (KVV), Karad, and Chaitanya Bal Rugnalaya, Karad. Eighteen children aged 6-12 years with mild to moderate ADHD were recruited through convenience sampling. Participants underwent a 12-week play-based bimanual training program with lower-limb activities using hopscotch mats, sensory boards, balance trainers, Swiss balls, and sorting tasks. Motor proficiency and behavioral outcomes were assessed pre- and post-intervention using the Bruininks-Oseretsky Test of Motor Proficiency-2, Second Edition (BOT-2) (Short Form) and Conners' Parent Rating Scale-Revised (CPRS-R). Result Results showed statistically significant improvement in motor coordination, attention, and concentration following the 12-week intervention. BOT-2 scores improved significantly from 32.17 ± 3.35 to 41.11 ± 3.08, while CPRS-R scores reduced from 160.61 ± 25.39 to 105.56 ± 14.42, indicating decreased ADHD symptom severity and enhanced behavioral performance. Conclusion Bimanual training with lower-limb assistance is an effective, engaging physiotherapy intervention for children with ADHD. It simultaneously addresses motor coordination deficits and cognitive-behavioral deficits, making it a valuable adjunct to existing ADHD management strategies. Future large-scale randomized controlled trials are recommended to further establish its clinical efficacy.
