Article

The aim of this study was to review systematically evidence about the
efficacy of motor interventions for children with developmental coordination
disorder (DCD), and to quantify treatment effects using meta-analysis. Method
Included were all studies published between 1995 and 2011 that described a
systematic review, (randomized) clinical trial, or crossover design about the
effect of motor intervention in children with DCD. Studies were compared on four
components: design, methodological quality, intervention components, and
efficacy. Twenty-six studies met the inclusion criteria for the review.
Interventions were coded under four types: (1) task-oriented intervention, (2)
traditional physical therapy and occupational therapy, (3) process-oriented
therapies, and (4) chemical supplements. For the meta-analysis, effect sizes were
available for 20 studies and their magnitude (weighted Cohen's d [d(w) ]) was
compared across training types. Results The overall effect size across all
intervention studies was d(w) =0.56. A comparison between classes of intervention
showed strong effects for task-oriented intervention (d(w) =0.89) and physical
and occupational therapies (d(w) =0.83), whereas that for process-oriented
intervention was weak (d(w) =0.12). Of the chemical supplements, treatment with
methylphenidate was researched in three studies (d(w) =0.79) and supplementation
of fatty acids plus vitamin E in one study (no effect). The post hoc comparison
between treatment types showed that the effect size of the task-oriented approach
was significantly higher than the process-oriented intervention (p=0.01) and
comparison (p=0.006). No significant difference in the magnitude of effect size
between traditional physical and occupational therapy approaches and any of the
other interventions emerged. Interpretation In general, intervention is shown to
produce benefit for the motor performance of children with DCD, over and above no
intervention. However, approaches from a task-oriented perspective yield stronger
effects. Process-oriented approaches are not recommended for improving motor
performance in DCD, whereas the evidence for chemical supplements for children
with DCD is currently insufficient for a recommendation.
CI - (c) The Authors. Developmental Medicine & Child Neurology (c) 2012 Mac Keith
Press.

Langue : ANGLAIS