043-23 – Can Trip and Slip Recovery Training Reduce the Risk of Falls for Children with Developmental Coordination Disorder: A Proof-of-Principle Study

Children with Developmental Coordination Disorder (DCD) fall more often than typically developing (TD) peers, which causes injuries, low self-esteem and activity avoidance. Children with DCD have difficulties controlling the trajectory of their feet when negotiating obstacles and therefore often experience trips and slips from which they must recover to avoid falls. Further, impairments in balance control and muscle strength may contribute to their frequent falls.
Healthy adults and stroke survivors exposed to repeated disturbances of balance simulating trips or slips showed improvement in their ability to resist the disturbance and recover balance. Hence, balance recovery training might be a valuable intervention to prevent falls but has never been assessed for children. This study aims to understand 1) whether and how children with DCD improve their fall resistance with repeated trip- and slip-like perturbations, and whether this is linked to muscle strength; 2) whether such an intervention can reduce subsequent fall rates.
The stability and balance recovery of 20 DCD and 20 age-matched TD children will be evaluated after exposure to trip- and slip-like perturbations induced whilst walking on an instrumented treadmill. The effect of the intervention on falls risk will be evaluated by comparing self-reported fall events of children with DCD pre- and post-intervention. To understand how these children benefit from this perturbation-based training, we will compare their measured stability and recovery strategy (i.e., step length, force developed etc.) between the first and last perturbation triggered for both trips and slips. Finally, we will investigate the effect of muscle strength, measured over maximal voluntary contractions, on stability.
Insights acquired from this study will establish proof of principle for future balance recovery training and help inform the design of low-cost low-tech fall prevention interventions targeting the needs of children with DCD.