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The effect of a trampoline-based training program on the muscle strength of the inferior limbs and motor proficiency in children with autism spectrum disorders

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The effect of a trampoline-based training program on the muscle strength of the inferior limbs and motor proficiency in children with autism spectrum disorders

Abstract and Figures

Motor proficiency is positively correlated with physical exercise, which is sometimes reduced in children with autism spectrum disorders (ASD). The main goal of this study was to evaluate the effects of a trampoline-based training program, over a period of 32 weeks, on both the muscular strength of inferior limbs and the motor proficiency in children with ASD. Sixteen children diagnosed with ASD (3 girls and 13 boys, 4–10 years-old) were included in this study. The children were randomly assigned to two groups: experimental group (EG, n=8) and control group (CG, n=8). Over the course of the program, children kept their regular school activities. The groups were evaluated before the onset of the program, at week 16 after the beginning of the program and at week 32. Motor proficiency was evaluated using the Bruininks–Oseretsky test for motor proficiency (2ªed.), (BOT2). The strength of inferior limbs was measured using the standing long jump without run-up. The statistical analysis included the multivariate analysis (ANOVA). The trampoline-based program contributed in a significant way to the improvement of both the strength of the inferior limbs (p>0.05) and motor proficiency (p=0.00) in children with ASD.
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Journal of Physical Education and Sport
®
(JPES), 15(3), Art 89, pp..592 - 597, 2015
online ISSN: 2247 - 806X; p-ISSN: 2247 – 8051; ISSN - L = 2247 - 8051 © JPES
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Corresponding Author CARLA LOURENÇO, E-mail: ccvl@ubi.pt
Original Article
The effect of a trampoline-based training program on the muscle strength of the
inferior limbs and motor proficiency in children with autism spectrum disorders
CARLA LOURENÇO1, DULCE ESTEVES1, RUI CORREDEIRA2, ANDRÉ SEABRA2
1Department of Sport Sciences, University of Beira Interior, PORTUGAL
2Faculty of Sport University of Porto, PORTUGAL
Published online: September 28, 2015
(Accepted for publication september 15, 2015)
DOI:10.7752/jpes.2015.03089;
Abstract:
Motor proficiency is positively correlated with physical exercise, which is sometimes reduced in children with
autism spectrum disorders (ASD). The main goal of this study was to evaluate the effects of a trampoline-based
training program, over a period of 32 weeks, on both the muscular strength of inferior limbs and the motor
proficiency in children with ASD. Sixteen children diagnosed with ASD (3 girls and 13 boys, 4–10 years-old)
were included in this study. The children were randomly assigned to two groups: experimental group (EG, n=8)
and control group (CG, n=8). Over the course of the program, children kept their regular school activities. The
groups were evaluated before the onset of the program, at week 16 after the beginning of the program and at
week 32. Motor proficiency was evaluated using the Bruininks–Oseretsky test for motor proficiency (2ªed.),
(BOT2). The strength of inferior limbs was measured using the standing long jump without run-up. The
statistical analysis included the multivariate analysis (ANOVA). The trampoline-based program contributed in a
significant way to the improvement of both the strength of the inferior limbs (p>0.05) and motor proficiency
(p=0.00) in children with ASD.
Keywords: Physical activity; autism spectrum disorders; trampolines; motor proficiency; inferior limbs’
strength.
Introduction
Autism is a neurodevelopmental condition clinically defined by impairments in communication and
social interaction, which is characterized by repetitive and stereotyped restricted patterns of behavior, interests
and activities (American Psychiatric Association, 2000 in Bradley, Caldwell and Underwood (2014). In many
children who have autism spectrum disorders (ASD), motor and sensory difficulties are observed (Baranek,
2002). Several studies have also reported changes in the motor development profile of these children, which
contribute to a lower physical fitness (Loh et al., 2007; Ozonoff et al., 2008; Pan, 2009; Fournier, Hass, Naik,
Loadha, and Cauraugh, 2010).
The strategies for the treatment of ASD focus primarily on cognitive stimulation, social and language
development and also on the elimination of stereotyped movements (Koring et al., 2010; Sowa and
Meulenbroek, 2012). Physical activity plays an important role in the quality of life of these individuals and has
been widely regarded as an important strategy in the promotion of physical fitness (Yilmaz, Yanardag, Birkan,
and Bumin, 2004; Lochbaum and Crews, 2003; Pan, 2011) and the reduction of the maladaptive and stereotyped
behavioral patterns (Lancioni and O'Reilly 1998; Elliott, Dobbin, Rose, and Soper (1994) and Yilmaz et al
(2004), as well as aggressive and antisocial behaviors (Allison, Basile, and Bruce MacDonald (1991);. Pan,
2010). The practice of physical activity is also regarded as having an enormous significance in improving the
nutritional status (Pitetti, Rendoff, Grover, & Beets, 2007), sensory skills (Bass, Duchowny, & Llabre, 2009),
attention, perception and communication (Hameury, et al (2010.), and academic performance (Nicholson, Kehle,
Bray, and Heest 2011; Rosenthal-Malek, and Mitchell, 1997).
Physical activity programs employing trampolines have been used in several areas, as they seem to promote the
improvement of balance, walk, muscle tone and joint flexibility in cases of traumatic spinal cord injury (Citero,
Mederdrut, and Power, 2012) and multiple sclerosis (Garcia, Mederdrut, Veloso & Fontes, 2008), as well as in
balance recovery capacity in the elderly (Aragon, Karamanidis, Vaz, & Arampatzis, 2011) and the postural
control in stroke patients (Miklitsch, Krewer, Freivogel, & Steube, 2013). In addition, the perception of the
temporal and rhythmic space, overcoming fear (Botelho, 1992), the flexibility and resistance of the abdominal
lower limb muscles and the heart rate (Leite et al. 2009) can be improved with this type of training. Notably,
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Ferrarezi and Guedes (2000) reported the existence of progress in the balance and flexibility of adolescents with
cerebral palsy.
There is no study addressing the effects of trampoline-based programs on the physical fitness of
children with ASD. Therefore, in order to fill this gap in the literature, this study seeks to assess the effect of a
trampoline-based training program in the motor proficiency and muscle strength of the lower limbs of children
with ASD.
Methods
Participants
We sampled 16 children (13 boys and 3 girls) diagnosed with ASD. These children were attending pre-
school and schools of the 1
st
cycle of basic education in the district of Viseu. The sample was then divided into
two groups of eight children each: experimental (EG) and the control (CG) groups. Participants were between 4
and 8 years of age (EG: 5:43 ± 1:53 years; CG: 7.60 ± 1.60 years). The EG underwent a 32-week program of
trampoline training in a gym fully equipped with various types of trampolines (1 session per week lasting 45
minutes); during the same period, the GC did not participate in any organized or systematic sport activity.
Instruments
Motor proficiency was assessed using a Bruininks–Oseretsky battery of tests (2nd ed., 2005) in its
reduced form (bot2), as previously used children with ASD (Dewey, Cantell, & Crawford, 2007; Gabriels et al
2012 ; Mattard-Labrecque Ben Love, & Couture, 2013). This battery consists of the following 12 trials: fine
motor precision (two tests: completion of a star and line drawing through a path); fine motor integration (two
tests, drawing two overlapping circles and drawing a diamond as similar as possible to the images presented);
manual dexterity (threading blocks); bilateral coordination (two tests: touching one’s nose with the tip of the
index finger, pivoting index and thumb while keeping the eyes closed); balance (move forward on a line heel-to-
toe); speed and flexibility (one leg walk from one side of a line to the other); coordination of upper limbs (two
tests: catching and throwing a ball with one hand and dribbling the ball alternating hands), and strength
(performing kneeling push-ups). These tests were applied individually to each child, according to the published
protocol (Bruinninks, & Bruininks, 2005), and lasted from 15 to 20 minutes. The strength of the lower limbs was
estimated by a long jump with both feet together (without run up). Each participant had three trials, in which the
goal was to jump as far as possible. For the analysis, the best jump was selected.
Both tests took place in schools attended by students and were made in three stages: before the intervention
program, at week 16 and at the end of the 32 weeks. All participants concluded the trampoline-training program.
Trampoline program
The training program took place in a gym/hall equipped with several trampolines, namely: elastic bed
trampoline, double-mini-trampoline, mini-trampoline, round elastic bed trampoline and trampolines 80 cm in
diameter. All weekly training sessions, which were planned in accordance with the objectives of the
investigation and taking into account the particular limitations of the participant population, lasted 45 minutes.
Each training session was divided into three parts: initial (5 minutes), main (35 minutes) and final (5 minutes)
parts. In the first part, through different running exercises, joint mobilization and different games, the
participants warmed-up for the exercises. In the second and main part, and to improve all the evaluated
components, specific exercises were carried out through the use of trampolines, mats, balls, bows, chairs, tables,
Swedish gymnastic bench, Swedish ladders and ropes. In the last part of the training session, in order to
stimulate social development, children collaborated with the teacher, participating in the arrangement of the
material used in the session. All training sessions were implemented and developed by a physical education
teacher. Parents/guardians attended the training and collaborated if needed.
Statistical Analysis
Descriptive statistics were employed (mean and standard deviation) to characterize the different
distributions of values. All variables followed the normal distribution according to the Kolmogorov–Smirnov
test. Differences in mean basal values of variables from the different groups were assessed using the t-test for
independent measurements. To evaluate the effectiveness of the trampoline program, analysis of variance
(ANOVA) of the repeated measures was used. The level of significance was set at 0.05. Statistical analyses were
performed using SPSS version 21.0 (SPSS Inc., Chicago, IL, USA).
Results
Table 1 presents the results of ANOVA for repeated measures models for the different tests. It can be
observed that before the implementation of the trampoline program the CG showed mean values of leg strength
higher than the EG. Over the course of the training program there was a statistically significant improvement in
leg strength in the EG, contrary to the CG, which did not show significant changes (p> 0.05).
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Table 1. Mean values (standard deviation) of the different variables in the EG and CG at three time points.
Baseline
(A=0)
Intermediate (A=16) Final (A=32) ANOVA results Variables
EG CG EG CG EG CG G T G*T
Lower limbs
strength
26.425
(30.364)
78.900
(26.953)
53.413
(36.393)
75.588
(20.272)
74.013
(35.201)
80.950
(23.103) 0.071 ≤0.001 ≤0.001
Fine Motor
Precision 1
1.25
(0.886)
2.38
(0.518)
1.50
(0.756)
2.38
(0.518)
1.63
(0.518)
2.13
(0.641) 0.009 0.712 0.132
Fine Motor
Precision 2
1.38
(1.506)
4.13
(1.553)
2.63
(2.504)
4.75
(1.753)
2.38
(1.408)
4.00
(1.927) 0.019 0.031 0.259
Fine motor
integration 1
3.38
(2.875)
4.88
(0.641)
3.88
(2.949)
5.13
(0.835)
4.13
(2.167)
5.25
(0.707) 0.181 0.203 0.830
Fine motor
integration 2
0.88
(1.642)
3.63
(1.188)
1.13
(1.642)
2.88
(1.642)
3.38
(1.598)
3.75
(0.886) 0.016 ≤0.001 0.011
Manual
dexterity
1.38
(0.744)
2.88
(1.246)
2.13
(1.126)
3.25
(1.669)
3.13
(1.126)
3.88
(1.356) 0.042 0.001 0.501
Bilateral
Coordination
1
0.63
(0.916)
1.88
(1.553)
1.50
(1.690)
1.38
(1.408)
2.88
(1.458)
1.50
(0.535) 0.880 0.020 0.002
Bilateral
Coordination
2
0.13
(0.354)
1.38
(1.188)
0.25
(0.463)
0.75
(1.035)
1.13
(1.356)
1.50
(0.926) 0.097 0.005 0.143
Balance
0.75
(1.035)
1.88
(1.126)
2.38
(1.408)
2.38
(1.188)
3.88
(0.354)
2.38
(1.408) 0.761 0.000 0.003
Flexibility
and Speed
0.38
(0.518)
1.38
(0.744)
0.75
(0.707)
1.63
(1.061)
1.88
(1.808)
1.75
(1.282) 0.231 0.004 0.075
Upper limb
coordination
1
0.38
(0.744)
0.25
(0.463)
0.75
(1.165)
0.38
(0.744)
0.75
(1.035)
0.88
(1.727) 0.792 0.093 0.532
Upper limb
coordination
2
0.25
(0.707)
0.88
(1.246)
0.50
(0.756)
1.00
(0.926)
1.13
(1.727)
1.50
(1.414) 0.370 0.004 0.845
Strength
0.00
(0.000)
0.38
(1.061)
0.50
(1.069)
0.25
(0.707)
0.50
(0.926)
0.63
(0.916) 0.823 0.184 0.297
BOT-2
Result
10.75
(8.362)
25.88
(8.774)
17.88
(12.495)
26.13
(8.254)
26.50
(12.189)
29.00
(7.635) 0.092 ≤0.001 ≤0.001
EG= Experimental Group; CG= Control Group; G=group; I=intervention.
Concerning motor proficiency, there were obvious changes over the course of the intervention program.
At baseline there is a considerable difference between the experimental and control groups; the former has an
average much lower in all variables, except for the coordination of upper limbs 1. Although both groups showed
improvements in the course of 32 weeks, the change in the experimental group is more significant and there is a
significant interaction between the groups and the training program (P = 0.000). After the training program there
was a significant progress in fine motor integration 2, bilateral coordination 1 and balance (p<0.05). The speed
and agility improved significantly with the training program, with notable changes occurring from the second to
the third evaluation. For the other variables there were clear improvements, but which were not statistically
significant changes.
Discussion
Green et al. (2008) reported that the existence of motor limitations is very common in individuals with
autism spectrum disorders. In this regard, and considering the benefits of performing the trampoline exercises
mentioned before, this study aimed mainly to evaluate the effects of a trampoline training program on the muscle
strength of the lower limbs and motor proficiency of children with ASD. The results obtained shed light on the
impact a 32-week trampoline program has on these variables.
The training program significantly improved the leg strength, contrary to what was found for the
strength of the upper limbs, which showed less obvious improvements. This result can be explained by the
design of the training program that was implemented. In fact, in all training sessions, the exercises and proposed
content comprised various types of jumps and consequently greater demands on the lower limbs. However, it
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should be noted that the arms were also used to keep balance, maintain a correct body posture and perform some
tasks during the jumps (clapping, raising and lowering the arms, launching and receiving a ball). This positive
effect of a trampoline program on physical fitness components has been observed in different studies (Lieberman
et al, 2013;. Citero et al, 2012;. Aragon, et al, 2011; Leite et al, 2009). Although these studies were not
performed on children with ASD, improvements in leg strength, cardiovascular endurance, balance and trunk
stability were found. Moreover, Yilmaz et al (2004) concluded that after 10 weeks of swimming training, there
were improvements in balance and Cheldavi, Shakerian, Shetab Boshehri and Zarghami (2014), after an
intervention program for balance training, found improvements in postural control. In the latter cases presented,
the studied participants had ASD. Although no significant improvements were obtained, there were
improvements in speed and flexibility in the experimental group when compared with the control group.
Contrary to our findings, in a study of adolescents Todd and Reid (2006) found that the training significantly
increased the distance walked or ran by children aged between 6 years and 7 months and 11 years and one
month, and in the participants in the study of Fragala - Pinkham , Haley , and O'Neil (2008 ) it reduced the time
needed to finish the path. Two facts may help explain these differences: compared to our study, in these two
reports the children were older and the training was more frequent (two weekly workouts). In our study, the
variables that make up the fine motor skills and manual dexterity have not changed significantly, except for the
Fine Motor Integration 2 (drawing a diamond as close as possible to the displayed image), which was expected,
since these dimensions were not considered in the training. With regard to the variable that recorded significant
differences, we associate it with the work that was carried out with balls (catching the ball with one hand and
then jump, jumping and throwing the ball to a target).
The two variables of bilateral coordination showed different values. Bilateral coordination 1,
corresponding to the touch display on the nose with the eyes closed, change significantly after the intervention.
In contrast, bilateral coordination 2, the pivoting of the thumb and index finger, showed no significant
improvements. We believe that the exercises described above have positively influenced the bilateral
coordination 1, as well as the more specific exercises of coordination that have been conducted over the
trampolines (spreading and joining legs, performing scissors, raising arms while jumping, clapping while
jumping). However, as the coordination of the upper limbs was not so stimulated, our intervention program did
not lead to significant improvements in the coordination of the upper limbs. Contrary to our study, through an
intervention program conducted with trampoline Mitsiou, Sidiropoulou, Giagkazoglou, and Tsimaras (2011)
improved the neuromuscular coordination of 6–11-year-old children with Developmental Coordination Disorder.
It is important to stress that our experimental group had a mean age of 5.43 years, that is, younger children than
those studied by Mitsiou et al. (2011). To evaluate the coordination of the upper limbs, tasks with a ball are
performed, as already described in the methodology. Papadopoulos et al. (2012) found that the high-functioning
autism group showed more difficulty at the motor level, such as in ball skills and balance exercises, than children
with Asperger syndrome, which may explain the fact that we could not achieve statistically significant results.
As for the total score of the Bruininks–Oseretsky (2nd ed. 2005) battery of tests applied, the reduced form that
evaluates the driving proficiency showed significant improvement (p = 0.000) in contrast to the study of Wuang,
Wang, Huang e Su (2010), in which only autistic children who joined the horseback riding program and attended
the occupational therapy sessions had significant improvements. According to Wrotniak, Epstein, Dorn, Jones
and Kondilis (2006), motor proficiency is positively associated with physical activity and inversely associated
with sedentary activity in children.
Although no specific studies were found in the literature on the effect of trampoline training programs
in children with ASD, some research has been done in particular populations (Apoloni , Lima, and Vieira, 2013;
Ferrarezi and Guedes 2000). The study by Apoloni et al. (2013) consisted of implementing a 12-week program
of trampolines (jumping, playing and running in the trampoline elastic bed) in children with Down syndrome,
and the results have shown a significant improvement in the postural control in these children. After 16 weeks of
intervention, the use of the trampoline has also brought progress in the balance and flexibility of adolescents
with cerebral palsy Ferrarezi et al. (2000). Furthermore, Miklitsch, Krewer, Freivogel and Steube (2013) found
improvements after an intervention using a trampoline-based program in the neuromuscular coordination of
patients who suffered a stroke.
The data of this study should be interpreted and analyzed taking into account some limitations. First,
since the selected sample is very small, it is impossible to generalize the results to the ASD population. Second,
although both groups were similar from the point of view of biological and morphological variables, their
formation in this study was not based on randomization and thus we cannot exclude the presence of some
confounding factors in the results.
Conclusion
Considering the results described in this study, it can be concluded that the trampoline-based training
significantly contributed to the improvement of both the motor proficiency and strength of the inferior limbs.
Taking into account that children with ASD have balance problems, it is urgent and necessary to develop and
implement new strategies and intervention programs designed according to principles of exercise and motor
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learning for children with ASD (Bhat, Landa, & Galloway, 2011). Thus, we recommend the trampoline training,
which is an excellent strategy to address these problems, in addition to having a valuable playful component.
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... Our systematic search produced 15 studies that fulfilled the above-mentioned criteria (Akyol & Pektas, 2018;Ansari et al., 2020;Arzoglou et al., 2013;Cai et al., 2020;El Shemy & El-Sayed, 2018;Huseyin, 2019;Kim et al., 2016;Lourenço et al., 2015aLourenço et al., , 2015bNajafabadi et al., 2018;Pan et al., 2016;Rafie et al., 2017;Sarabzadeh et al., 2019;Wuang et al., 2010;Zamani et al., 2017); and the first and second authors of this paper agreed on the selection of 12 of these 15 studies (80%) with disagreements for three studies. In one of these, the authors reported post-intervention mean scores (and SDs) and compared the intervention group with a control group that did not receive the treatment . ...
... Two studies used trampoline training in their intervention (Lourenço et al., 2015a(Lourenço et al., , 2015b, one study used the Sports, Play, and Active Recreation for the KIDS (SPARK) program (Najafabadi et al., 2018), one used a physical therapy program (El Shemy & El-Sayed, 2018), one used Tai Chi Chuan (Sarabzadeh et al., 2019), one used traditional ...
... For outcome measures, eight of the analyzed studies used Balance/Body Coordination scores from the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP; (Bruininks, 1978;Bruininks & Bruininks, 2005)). More specifically, three studies (Najafabadi et al., 2018;Rafie et al., 2017;Wuang et al., 2010), used the original BOTMP (Bruininks, 1978), while five studies (El Shemy & El-Sayed, 2018;Lourenço et al., 2015aLourenço et al., , 2015bPan et al., 2016;Zamani et al., 2017) used the revised edition of the test (BOTMP-2; (Bruininks & Bruininks, 2005)). The BOTMP and BOTMP-2 are standardized, norm-referenced measures of fine and gross motor skills of children and youth. ...
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... In addition to the sPT, the SSC group received 15-minute SSC exercise sessions, twice weekly, with a total of 24 sessions over 12 successive weeks. The program was adopted from previous reports on the trampoline-based exercise for children with DS or other developmental disorders 21,22 . The participants performed SSC exercises at least 10-15 minutes after the physical therapy sessions. ...
... The main findings of our study were that SSC exercise (15 minutes/ session; twice weekly) in association with the sPT program was more efficient in increasing lower limb muscle strength and enhancing postural control than the sPT program alone in children with DS. Although several studies evaluated the effect of trampoline-based SSC exercises in children with other developmental disabilities and reported favorable effects 17,18,20,21 , the impacts of this therapeutic approach on children with DS remains very interesting to physiotherapist. This may, therefore, highlight the significance of the results demonstrated herein, which expand the evidence on the effectiveness of trampoline-based SSC exercises in children with developmental disabilities. ...
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... (Healy et al., 2018). Examples of locomotor interventions utilized in the meta-analysis were trampoline activities (Lourenço et al., 2015), task variation and constant task methods (Weber & Thorpe, 1989, 1992, and a horse-riding program (Wuang et al., 2010). Skill-related fitness interventions included physical training (Pan et al., 2016), trampoline (Lourenço et al., 2015), and computer activity program (Dickinson & Place, 2014) interventions. ...
... Examples of locomotor interventions utilized in the meta-analysis were trampoline activities (Lourenço et al., 2015), task variation and constant task methods (Weber & Thorpe, 1989, 1992, and a horse-riding program (Wuang et al., 2010). Skill-related fitness interventions included physical training (Pan et al., 2016), trampoline (Lourenço et al., 2015), and computer activity program (Dickinson & Place, 2014) interventions. ...
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... It also reduces their stereotypical behaviour and it has positive effects on socialisation and communication. (Bremer, Crozier, & Lloyd, 2016;Lang, Liu, &Ledbetter-Cho, 2018;Lourenço, Esteves, Corredeira, &Seabra, 2015;Sam, Chow, &Tong, 2015). Deficits in socialisation and communication may negatively impact children with ASD physical activity participation (Clare, Wong, Lo, So, & Chan, (2018 Sutton, Webster, and Westerveld (2018) concluded that initiating and responding to peers could be challenging for children with ASD and physical activity interventions were recommended to motivate children's participation in classroom and promote social interaction Therefore, an innovative dual-task exercise program, called GAMES_4_SOCIALIZATION, was developed and implemented in this study to examine the effectiveness of the program on social and communication skills of children with ASD -. ...
... In all training sessions, the exercises and the proposed content involved different types of static and dynamic balance, which made greater demands of inferior limbs. We should note that the upper limbs were used to maintain balance and the correct body posture, and this is in accordance with Laurenco's results [46]. ...
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One of the characteristics of autism spectrum disorder (ASD) subjects is postural control deficit, which is significant when somatosensory perception is affected. This study analyzed postural stability evolution after physical therapy exercises based on balance training. The study included 28 children with ASD (average age 8 years, average weight 32.18 kg). The rehabilitation program involved performing balance exercises twice a week for three months. Subject assessment was carried out using the RSScan platform. The parameters were the surface of the confidence ellipse (A) and the length of the curve (L) described by the pressure center, which were evaluated before and after the rehabilitation program. Following data processing, we observed a significant decrease in the surface of the confidence ellipse by 92% from EV1 to EV2. Additionally, a decrease of 42% in the curve length was observed from EV1 to EV2. A t test applied to the ellipse surface showed a p = 0.021 and a Cohen’s coefficient of 0.8 (very large effect size). A t test applied to the length L showed p = 0.029 and Cohen’s coefficient of 1.27 mm. Thus, the results show a significant improvement in the two parameters. The application of the program based on physical exercise led to an improvement in the balance of children with autism under complex evaluation conditions.
... Similar positive results were observed in balance of six children with ASD 5-12 years old after their participation in 12 weekly 45-min hippotherapy sessions (Ajzenman et al., 2013). In addition, improvement in balance of children with ASD was found after a highly structured therapeutic skating intervention for 12 weeks (Casey et al., 2015), also, after a program of a 30-minute bicycle workout followed by 30 minutes of training in coordination and especially in balance, thrice-weekly for three weeks (Brand et al., 2015), as well as, after a trampoline-based training program lasting 32 weeks (Lourenco et al., 2015). Rafie et al. (2016) reported balance improvements in adolescents with ASD after a motor activity program. ...
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The purpose of this study was to investigate the effectiveness of a traditional dance program on the balance of primary school students with autism spectrum disorder (ASD). Nineteen primary school students with ASD were randomly assigned into one treatment and the control group. The treatment group consisted of 10 students(11.30±2.26 years old) who took part in a 4-week traditional dance training program (12 sessions), 3 times per week for 45 minutes per lesson, while the control group (9 students, 12±1.41 years old) attended their regular physical education lessons. Prior to and after the intervention, the participants were assessed for dynamic balance (walking forwards on balance beams of the Körperkoordinationstest Für Kinder, KTK test), functional balance (Timed Up and Go test), and static balance (single-leg-stance test). The findings indicated that the treatment group performed significantly better on dynamic balance and Timed Up and Go test. However, there were no significant differences regarding static balance (total excursion of the center of pressure). The results suggest that Greek traditional dances constitute an effective and enjoyable activity for the development of balance in primary school students with ASD.
... Otizmli çocuklarda 16 haftalık cimnastik egzersiz programının motor ve nörofizyolojik beceriler üzerine etkisinin araştırıldığı bir çalışmada, antrenman sonrası elde edilen bulgular karşılaştırıldığında, kontrol grubu ile antrenman grubu arasında antrenman grubu lehine anlamlı bir farklılığın olduğu bulunmuştur (Jam et al., 2018). Otizmli çocuklarda 32 haftalık bir temel trampolin antrenmanının kas kuvveti ve motor yeterlilik üzerine etkilerinin araştırıldığı çalışmada, trampolin temel eğitim programının otizmli çocuklarda kas kuvveti ve motor yeterlilikte anlamlı düzeyde ilerlemelere yol açtığı görülmüştür (Lourenço et al., 2015). ...
Thesis
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This research aimed to examine the effect of gamified physical activity onautism symptoms and basic motor skills of children with autism spectrum disorder.After obtaining the ethics committee permission, the ASD levels of the participants whose Informed Parent-Guardian Consent form was signed were evaluated with GOBDÖ-2-TV, and 30 participants who met the inclusion criteria were randomly assigned to the application and control groups in equal numbers. The research wasdesigned as a pretest-posttest quasi-experimental research with a control group basedon the time series model. The post-test was designed as a quasi-experimental research.A gamified physical activity program (OFA) was applied to 15 boys with a mean ageof 11,2±2,17 years, who were diagnosed with ASD in the practice group, for 14 days,with rest on the 8th day, and 5 hours a day. Autistic disorder levels, social interactionlevels, repetitive behaviour levels and basic motor skills of students with ASD wereevaluated in the measurements made before and after the OFA program. On the 15thand 45th days after the GPA program, the same measurements were repeated, and thestatus of the participants was followed. The data obtained from repeated measurementswere statistically analyzed using the one-way ANOVA test according to the p= 0,05significance level in the IBM SPSS statistical program. According to the findings, it was determined that gamified physical activity had a positive effect on the autistic disorder level, repetitive behaviors and basic motor skills of the children in the application group, but in the follow-up measurements, it was concluded that this effect regressed to the levels measured after the application. According to the data obtained from the follow-up measurements performed after the GPA program applied and, on the 15th, and 45th days, it was concluded that there was no significant difference in the social interaction levels of the students with ASD. It was concluded that the GPA program applied for 14 days had positive effects on the autistic disorder levels, repetitive behaviors and basic motor skills of children with ASD. ------------------------------------- Bu araştırma, oyunlaştırılmış fiziksel aktivitenin otizm spektrum bozukluğu olan çocukların otizm semptomları ve temel motor becerileri üzerindeki etkisini incelemeyi amaçlamıştır. Etik kurul izni alındıktan sonra Bilgilendirilmiş Veli-Vasi Onam formu imzalanan katılımcıların OSB düzeyleri GOBDÖ-2-TV ile değerlendirilmiş çalışmaya dahil edilme kriterlerini karşılayan 30 katılımcı eşit sayıda olacak şekilde uygulama ve kontrol gruplarına rastgele atanmış ve araştırma zaman dizisi modeline dayalı kontrol gruplu ön test-son test yarı deneysel araştırma olarak desenlenmiştir. Uygulama grubunda yer alan OSB tanısı almış ve yaş ortalamaları 11,2±2,17 olan 15 erkek çocuğa, 14 gün boyunca 8. günde dinlenme olmak üzere günde 5 saat oyunlaştırılmış fiziksel aktivite programı (OFA) uygulanmıştır. Uygulama öncesi ve sonrası yapılan ölçümlerde OSB olan öğrencilerin otistik bozukluk düzeyleri, sosyal etkileşim düzeyleri, tekrarlayıcı davranış düzeyleri ve temel motor becerileri değerlendirilmiştir. Uygulama sonrasında 15. ve 45. günlerde ise aynı ölçümler tekrarlanarak katılımcıların durumu takip edilmiştir. Yapılan tekrarlı ölçümlerden elde edilen veriler IBM SPSS istatistik programında p= 0,05 anlamlılık düzeyine göre tek yönlü ANOVA testi kullanılarak istatistiksel analiz yapılmıştır. Elde edilen bulgulara göre oyunlaştırılmış fiziksel aktivitenin uygulama grubunda yer alan çocukların otistik bozukluk düzeyi, tekrarlayıcı davranışları ve temel motor becerilerine olumlu yönde etkisi olduğu saptanmış, ancak gerçekleştirilen takip ölçümlerinde bu etkinin uygulama sonrasında ölçülen seviyelere kadar gerilediği sonucuna ulaşılmıştır. Uygulanan OFA programının sonrasında ve 15. ve 45. günlerde gerçekleştirilen takip ölçümlerinden elde edilen verilere göre OSB olan öğrencilerin sosyal etkileşim düzeylerinde anlamlı bir farklılık yaratmadığı sonucuna ulaşılmıştır. 14 gün boyunca uygulanan OFA programının OSB’li çocukların otistik bozukluk düzeyleri, tekrarlayıcı davranışları ve temel motor becerileri üzerine olumlu etkileri olduğu sonucuna ulaşılmıştır.
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Autism spectrum disorder (ASD) is a complex diagnosis characterized primarily by persistent deficits in social communication/interaction and repetitive behavior patterns, interests, and/or activities. ASD is also characterized by various physiological and/or behavioral features that span sensory, neurological, and neuromotor function. Although problems with lower body coordination and control have been noted, little prior research has examined lower extremity strength and proprioception, a process requiring integration of sensorimotor information to locate body/limbs in space. We designed this study to compare lower limb proprioception and strength in adolescents with ASD and neurotypical controls. Adolescents diagnosed with ASD (n = 17) and matched controls (n = 17) performed ankle plantarflexion/dorsiflexion bilateral proprioception and strength tests on an isokinetic dynamometer. We assessed position-based proprioception using three targeted positions (5 and 20-degrees plantarflexion and 10-degrees dorsiflexion) and speed-based proprioception using two targeted speeds (60 and 120-degrees/second). We assessed strength at 60-degrees/second. Participants with ASD performed 1.3-times more poorly during plantarflexion position and 2-times more poorly during the speed-based proprioception tests compared to controls. Participants with ASD also exhibited a 40% reduction in plantarflexion strength compared to controls. These findings provide insight into mechanisms that underly the reduced coordination, aberrant gait mechanics, and coordination problems often seen in individuals with ASD, and the identification of these mechanisms now permits better targeting of rehabilitative goals in treatment programs.
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Childhood autism is a developmental disorder characterized by difficulties with communication and behaviors. The benefit of physical exercise on behavioral and cognitive functions have been widely recognized. This article aims to explore the effects of exercise intervention on ameliorating symptoms of childhood autism with a meta-analytical approach. The results included five research papers comprising of a total of 282 research subjects aged 3~18-year-old. A random effect model was adopted to test the combined effect size. For children with moderate autism symptoms, the results were: heterogeneity test of Q=94.60, df=11, p<0.05, I2=83.4%, combined effect size of SMD =-1.36, 95% CI (-1.76,-1.12), and Z=6.45. For Children with severe autism symptoms, the results were: heterogeneity test of Q=1.57, df=3, p>0.05, I2=0.1%, combined effect size of SMD =-0.49, 95% CI (-0.5,-0.19), and Z=3.35. The results revealed an overall medium effect, supporting that exercise can significantly ameliorate the symptoms of severe autism in children, especially among those with moderate-level symptoms. However, the effect of exercise on severe autism was on a marginal-to-acceptable level. Further studies were needed to separately analyze the effectiveness of physical exercise on providing benefits for different levels of autism symptoms.
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Investigations have focused on exercise as an intervention with individuals with autism. The purpose of this investigation was to conduct exercise-training programs following standard guidelines with individuals with autism to stimulate future researchers to implement such programs. Aerobic and muscular strength training programs (MST) were con-ducted. Aerobic fitness increased 33%, 50%, and 33% for the 3 participants. For the MST, bench press increased 19% and 28%, low row increased 47% and 21%, and leg press increased 29% and 12% for the 2 participants. Future directions are discussed with regard to using exercise-training programs to not only enhance physical health but also the psychological well-being of individuals with autism.
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Introdução. A lesão medular é uma desordem neurológica frequente, importante causa de morbidade e mortalidade e, que traz consequên­cias graves, às vezes irreversíveis, na vida dos indivíduos acometidos. O trampolim é um recurso fisioterapêutico que pode contribuir para a recuperação de pacientes com acometimento neurológico. Objeti­vo. Verificar os efeitos da intervenção fisioterapêutica (cinesioterapia) utilizando o trampolim no equilíbrio, na marcha, na flexibilidade arti­cular e no tono muscular de uma paciente com trauma raquimedular incompleto, nível C7-T1, imediatamente após o término do trata­mento e após seis meses sem intervenção. Método. Foi realizada ava­liação do equilíbrio (escala de Berg), marcha (escala de Tinetti), tono (escala de Ashworth) e flexibilidade (flexímetro) pré, pós-tratamento e, imediatamente seis meses depois do término do tratamento, sem intervenção. Resultados. Obteve-se melhora do equilíbrio e da mar­cha, houve interferência no tono muscular, na flexibilidade articular ora positiva, ora negativamente dependendo da articulação analisada, depois da intervenção e no follow up. Conclusão. cinesioterapia com trampolim melhorou o equilíbrio e a marcha e, modificou o tono e a flexibilidade articular, porém a manutenção desses efeitos após seis meses sem tratamento foi heterogenia em um caso de lesão medular traumática incompleta.
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Introduction. The spinal cord injury is a common neurologic disorder and an important cause of morbity and mortality in current society. Yours consequences bring severe and either irreversible changes, in individual's life attacked by this injury. The trampoline is more one physiotherapeutic resource that come to contribute for treatment of this and other similar cases. Objective. Check the effect of physiotherapy intervention using the trampoline in the improvement of balance and consequently on the gait as well as verifying the influence in articulation flexibility and in the spasticity of a patient with incomplete spinal cord injury, level C7-T1, immediately after the end of the treatment and after six month. Method. A valuation of balance, gait, spasticity and flexibility was achieved before, after treatment and immediately six month after the finish treatment, using the respective scales. Results. in accordance with the assessment, obtained an improvement of balance, gait, it had an interference in the spasticity, in the articulation flexibility, sometimes positive or negatively subject of articulation analysed, after intervention and on follow up. Conclusion. the trampoline was efficient in the improvement of balance and gait, and influenced spasticity and flexibility, but in a heterogeneous way.
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It is generally agreed that regular physical exercise promotes physical and mental health, but what are the benefits in people with Autism Spectrum Disorders (ASD)? This meta-analysis evaluates 16 behavioural studies reporting on a total of 133 children and adults with various variants of the syndrome who were offered structured physical activities either in an individual or a group context. The effects on social and motor deficiencies, two of the three primary symptom clusters of ASD, were normalized to afford a quantitative evaluation. Results pertaining to communication deficits were insufficient to permit classification. All activity programmes yielded significant progress on the measures assessed, but the individual programmes elicited significantly more improvement than the group interventions in the motor and, more surprisingly, also in the social domain. Although overall sample sizes were small, the combined results do permit the tentative conclusion that in terms of motor performance and social skills children and adults with ASD benefit most from individual exercise interventions. Further research of the impact of individual and group interventions on communication deficits in particular as well as studies gauging the extent to which exercise effects depend on ASD symptom severity are warranted.