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242
Health, Sports & Rehabilitation Medicine
Vol. 22, no. 4, October-December 2021, 242–247
The importance of motor behavior and balance training in
the acquisition of physical activity/sports-related motor skills
among children – review
Dan Alexandru Szabo
Department ME1 – Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy,
Science, and Technology of Targu Mures, Romania
Abstract
Proper motor skill aptitude execution in childhood is critical since it empowers the advancement of other formative
spaces. Besides, motor execution may too be necessary for successful life skills, such as having a physically dynamic way of
life and scholastic accomplishment. Be that as it may, despite its signicance, children’s levels of motor skills execution have
diminished essentially over the past decades.
In the present review, the rst aim was to highlight the importance of motor behavior throughout childhood and beyond.
Secondly, to emphasize the eect of balance-specic training in everything related to acquiring motor skills in close connection
with general motor behavior. Finally, the desire to highlight the process of acquiring physical activity / sports-related motor
skills among children and its importance throughout the ontogenetic period.
Keywords: motor behavior, balance training, motor skills
Copyright © 2010 by “Iuliu Haţieganu” University of Medicine and Pharmacy Publishing
Received: 2021, September 21; Accepted for publication: 2021, September 26
Address for correspondence: George Emil Palade University of Medicine, Pharmacy, Science, and Technology, Târgu Mureş, Gheorghe
Marinescu Str. No. 38, 540139, Romania
E-mail: dan-alexandru.szabo@umfst.ro
Corresponding author: Dan Alexandru Szabo, e-mail: dan-alexandru.szabo@umfst.ro
https://doi.org/10.26659/pm3.2021.22.4.242
Introduction
Infancy is the particularly crucial time of a person’s life
and the fastest period for complete and healthy movement
throughout human existence, as well as cognitive development
(***, 2017); expanded physical action may give sports and
cognitive benets throughout childhood and adolescence
(Riethmuller et al., 2009; Fisher et al., 2011). Therefore,
understanding the potential of physical activity in improving
underage youngsters’ motor skills and knowledge is crucial,
and it can provide pediatricians and additional well-being
professionals with information on its eectivity as an
involvement method. There is some pressing need for
comprehensive RCT studies to determine the impact of sports
and physical activity regarding the level of motor skills and
cognition and determine the dose-response relationship in
the community of preschool youngsters (Zeng et al., 2017).
The early stage of childhood is seen as a critical time
for adopting healthy behaviors (such as physical activity)
(Ward et al., 2010). The physical activity plan provides an
environment for developing motor skills for young children,
and motor skills are the basis for physical activities in the
early and subsequent years (Jones et al., 2011). Today’s
young children show insucient motor skills (Hardy et al.,
2010). Young children’s environments play a signicant
involvement in encouraging physical activity/sports
participation and motor ability improvement because these
environments usually have the resources to implement
physical behavior and motor ability programs (Ward et al.,
2010; Khan & Hillman, 2014; Zeng et al., 2017).
Exercise and language are essential for early
development from one to three years of age. Language is the
best indicator of cognitive function. Fine motor skills are
related to self-help ability. The most typical development
in early life is to form one’s own identity. Through the
period of three years, the youngster may be self-reliant. In
this stage of early childhood, children acquire independent
life skills such as eating behavior, toilet training, and
self-dressing. Early childhood development promotes
the development of questioning skills (Balasundaram &
Avulakunta, 2021) (Fig.1).
Middle and late youth is the period when youngsters
progress from subordinate preschoolers to youthful grown-
ups who inuence their family and local area organizations.
Their reasoning develops more distinctively, their feelings
and practices become more controlled, and their choices
become more unrestricted. The middle and late childhood
periods, which interest us in this article, are when neurons
are answerable for astuteness, language, and social/sports
capacities/skills (Szabo et al., 2020a; Szabo et al., 2020b;
Szabo et al., 2020c; Tulbure et al., 2020) are framed (Mah
& Ford-Jones, 2012) (Fig. 1).
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The importance of motor behavior and balance training
Throughout the life cycle, the advantages of physical
behavior are not limited to physical health, but also extend
to cognitive function, which refers to the mental abilities
involved in the basic process of perception and action. A
recent systematic review and consensus statement positively
correlated children’s physical activity, health, cognition,
and academic performance (Donnelly et al., 2016). In
addition, cross-sectional research has demonstrated that
adolescents and children with higher physical tness or
who regularly participate in physical exercises have better
cognitive functions than adolescents and children with
poor physical tness or sedentary activity (Ballester et al.,
2018; Ballester et al., 2015; Chueh et al., 2017; Pontifex et
al., 2012; Formenti et al., 2021).
Throughout the premature phases of childhood, children
may decide to participate in open or closed skill sports.
Therefore, because of the dierences in open and closed
ability sports requirements, this option may be preferable
and help aect their motor skill acquisition and cognitive
development. Physical skills represent a multi-dimensional
concept, including health-related (cardiovascular health,
BMI, strength and muscle endurance, exibility) and skill-
related components. The latter, also known as sports health,
consists of the capacity to learn and perform motor skills
(reaction time, speed, agility, strength, and in our case,
balance), which may also be related to cognitive performance
in the areas of perceptual speed and executive function (***,
2018; McMorris, 2015; Formenti et al., 2021).
Therefore, the objective of this review article is to
methodically examine the existing evidence to examine
the impact of balance and motor control on the acquisition
of sports-related skills and cognitive improvement in
healthy children. Specically, this review aims to identify,
synthesize, and interpret the best available evidence for
the minimum and optimal physical activity required to
acquire children’s cognitive development and motor
skills development. In addition, this review seeks to assist
academics and health professionals in understanding the
advantages of regular physical exercise and developing
evidence-based physical activity guidelines for children.
The Development of Motor Behavior
Motor development research was previously considered
the icing on the cake of developmental science: the core
of children’s experience, but it has received little attention
(Rosenbaum, 2005; Adolph et al., 2010). The historically
mature methods of motor skills were dominant in the
early 20th century. It was mainly believed that motor
development was carried out through predetermined
biological changes, and there was almost no intervention
from the environment or the cognitive domain (Gonzalez
et al., 2019).
Motor development is often broadly divided into
gross motor and ne motor skills. Gross motor abilities
involve signicant muscular movements, such as sitting
independently, crawling, walking, or sprinting. Fine motor
skills entail using smaller muscles, such as grabbing,
manipulating objects, or sketching (Gonzalez et al., 2019).
Previous research has established a close connection
between sports experience and developments in other
elds. As part of this research topic (Michel et al., 2016)
regarding the evolution of infant hand preferences, it was
found that infants with consistent hand preferences in
the early stages of development also showed advanced
cognitive development. This indicates that infants who
show stable hand preference in the early stage may follow
a dierent developmental path, rather than those who
develop hand preference later and provide evidence for the
inuence of exercise experience on cognitive development
(Libertus & Hauf, 2017).
Motor behavior includes various movements from
unconscious twitches to goal-oriented actions, dierent
components of the physique from head to toe, and
various physical and social environments from playing
alone to group interaction. Motor behavior improvement
happens through the life cycle, beginning with the leading
embryonic motion and ending with the nal breath (Adolph
et al., 2017). Participation in movement education, where
children discover body awareness, space, relationship, and
eort, has historically resulted in learning fundamental
motor skills and their progression to various, complex
movement forms (Castelli, 2019).
According to the formative system, sports behaviors
cannot be comprehended in isolation, and they cannot be
separated from the physical, environmental, and social/
cultural backgrounds in which they occur (Adolph &
Robinson, 2015). Movement is inevitably nested in the
body-environment system. The body and the environment
develop simultaneously. New or strengthened motor skills
enable new parts of the environment to function, thereby
providing new or enhanced opportunities for learning and
doing things. The nursing practice promotes and limits the
Fig. 1 – Child development stages.
244
Dan Alexandru Szabo
development of sports. Therefore, dierences in the way
caregivers construct the environment and interact with
children aect the form of new skills, the age at which they
rst appear, and the shape of their developmental trajectory
(Adolph et al., 2017).
Balance Ability and Balance Training
Balance, especially the balance of the human body,
refers to the body being in a balanced state under stress not
to fall (Pollock et al., 2000). The dierent balance domains
may be under static conditions, where the center of gravity
(CoG) remains the same, or under dynamic conditions,
where the balance must be maintained when moving under
the foundation support (Patton et al., 1999). Balance ability
can determine the performance of extremely concerted
sports (i.e., gymnastics, alpine skiing, gure skating),
but it can also predict the risk of injury, especially in the
lower limbs (Hrysomallis et al., 2011). Physical activity is
universally acknowledged as requiring balance skills (Sopa
& Pomohaci, 2021), and stability workouts are extremely
incorporated into almost all sports training programs.
Although sports static balance and stability are typically
demonstrated to be better than in non-sports practitioners,
little is known about the dierences in balance control
between them, especially in dierent foot positions
(Harmon et al., 2020).
Several original studies have shown the ecacy of
balance training in increasing several components of
children’s and adolescents’ balance performance (Heleno
et al., 2016; Pau et al., 2012; Schedler et al., 2020a), and
these discoveries have been summarized in reviews and
systematic reviews (Gebel et al., 2018; Gebel et al., 2020).
On the contrary, the advice on designing balance training
for dierent load dimensions (for example, training
volume, training intensity) so that it is most eective for
skills acquisition in children and adolescents is rather
unspecic and only comes from review articles (Gebel et
al., 2018; Granacher et al., 2011). For example, reducing
the basis of support/sensory input and tasks involving
unstable surface/cognitive and motor interference has
been proposed as an eective means to increase the task
diculty, thereby improving young people/children
(Granacher et al., 2011). However, although these
recommendations seem reasonable based on the existing
literature, there is still a lack of empirical evidence. In a
systematic review (Gebel et al., 2018), a meta-analysis
was conducted to analyze the impact of balance training
on youth balance performance and the dose-response
relationship. However, this method should be used to
compare dose-response relationships indirectly rather than
directly. In other words, for example, comparing the results
of a study with a short intervention period to the results of
a study with a more extended intervention period but not
comparing the eects of dierent intervention periods in
a single study. In addition, the dose-response relationship
of children’s balance training can only be quantied for
specic training methods (i.e., training time, training
frequency). In summary, the following studies are needed:
directly comparing dierent training methods in a single
study and investigating load dimensions that have not yet
been analyzed (Schedler et al., 2020b).
A published meta-analysis quantied the balance
training dose-response relationship in healthy young
individuals (Lesinski et al., 2015a). These authors
quantied the training frequency, period, and training
volume; however, the intensity was not quantied because
there is no psychometrically reliable measurement method
to describe balanced exercise intensity for children (Farlie
et al., 2013). The meta-analysis results show that the
training method is mainly in the shape of an inverted U,
indicating the best training stimuli below and above the
threshold. We hypothesized that the balance training dose-
response connection in the elderly might show a model-
specic inverted U-shaped transition compared to healthy
young people and children. The dierence in training
status/physical level may require an age-specic balance
training protocol to achieve the best training eect. The
perfect training doctrine of enlightened overload means
that the training method (for example, training frequency,
training volume) should be compared to the current
preparing state of a specic person to avoid overloading of
their respective biological systems (Ackland et al., 2009).
In addition to the training status, advanced age, and related
neuromuscular degeneration processes (e.g., the decrease
in the amount and dimension of type II muscle bers, as
well as the loss of sensory and motor neurons), the time
pattern of the adaptation process after training appears to
have an impact (Pew & Van Hemel, 2004). Based on some
suppositions, there are sucient reasons to ascertain the
phase-particular dose-response relationship after balance
training (Lesinski et al., 2015b).
Acquisition of Physical Activity/Sports-Related
Motor Skills
The discovery about neuroplasticity, that is, the
brain’s ability to reorganize itself by forming new neural
connections in white matter and gray matter, does conrm
that people can learn new things in later life; however, for
the development of fundamental motor skills and physical
awareness, the best time is in early childhood (Dayan &
Cohen, 2011). People would think that children living in
industrialized and economically developed countries have
access to technological innovation, a high standard of living,
and advanced medical screening and treatment. Compared
to children living in substandard human conditions, they
are more eective in mechanical and muscular conditions.
There is an advantage in bones, but this is not the case at
present; genetic and psychological elements have a more
signicant inuence than physical aspects—cultural and
background factors (Baker & Horton, 2004; Castelli, 2019).
Excellent motor skills are supposed to stand crucial for
children’s physical, social, and psychological development
(Gallahue & Ozmun, 2002), and they may even be the
basis for an active lifestyle since numerous studies have
established a link between good motor skills and more
signicant proportions of physical behavior (Lubans
et al., 2010; Williams et al., 2008). As a result, there is
evidence that improving motor abilities has several health
advantages. For example, it has been shown that excellent
motor skills have a benecial impact on cardiorespiratory
tness (Lubans et al., 2010; Okely et al., 2001), body
weight (Lubans et al., 2010; Krombholz, 2013), and sports
245
The importance of motor behavior and balance training
participation (Lubans et al., 2010; Krombholz, 2006); all of
this suggests that the early ability of motor skills may have
signicant health implications and is essential for general
well-being (Viholainen et al., 2014). However, most
available motor performance studies are cross-sectional
and do not give evidence of a probable causal link or only
involve short-term follow-up (Hestbaek et al., 2017).
MSC (motor skill competence) is described as the
development of common core motor skills, especially object
control (e.g., throwing, kicking) and locomotor abilities
(e.g., running, jumping, hopping) (Stodden & Goodway,
2008). Because learning to move is a fundamental skill
underlying future physical activity, the improvement of
motor skill prociency has been postulated as a causal
predictor supporting physical tness, physical activity
behaviors, and health outcomes in infancy (Stodden &
Goodway, 2008; Stodden & Goodway, 2007). Studies have
demonstrated that motor skill growth in adolescence and
childhood is related to improved cardiovascular tness,
muscular endurance, muscular strength, physical activity,
and perceived competence (Barnett et al., 2009; Hands et
al., 2009). Longitudinal studies in youngsters show that
higher motor skill competence is connected to long-term
physical activity levels and health-related physical tness
(Barnett et al., 2008; Gao & Wang, 2019).
Motor learning is a person’s capacity to acquire
motor abilities with a reasonably permanent change in
performance due to practice or experience (Schmidt,
2005). The resulting behavioral outcome is now the
most often utilized approach to measure motor learning
(Schmidt, 2005). In order to enhance motor learning
processes, instructions and additional feedback are key
inuencing variables. Athletes, and in our case, children,
are provided with instructions on the proper movement
pattern or technique in nearly any training setting where
motor skills are taught (Wulf, 2013). Instructional
language impacts both movement performance and motor
learning outcomes (Fraizer & Mitra, 2008). A skill must be
practiced consistently in order to develop prociency and
induce a motor learning adaptation. When determining how
practice should be structured, several elements include the
type of practice and the timetable. Successful procedure
planning should enhance immediate performance impacts
and encourage long-term learning by improving skill
retention and transfer. Furthermore, task-specic or task-
oriented practices relevant to the child should be employed
(Gokeler et al., 2019).
Regarding the methodology of physical education
and sports, rst, Göhner (Göhner, 2013) emphasized the
usefulness of functional sports analysis in segmenting
sports to facilitate the learning of complex motor skills.
In this sense, it is possible to deduce that if and only if
the results are partly meaningful from a functional point
of view, if and only if they reect certain functions, and
these functions are associated with specic functions,
the movement should be split into sub-goals. In addition,
when pursuing the parts method, a question arises, that is,
whether the initial functional state of a particular moving
part can be suciently guaranteed. If this is not the case,
the instructor or coach should be consulted and ensure
that the lost previous function is appropriately supplied
due to the isolation. Finally, while separating movement
portions, the learner may be presented with the learning of
units referring to auxiliary sub-actions, suggesting that the
learner would presumably attempt to achieve a sub-goal
that may subjectively not match the overall movement
objective (Hossner et al., 2015).
Conclusions
1. The current review encourages the use of organized
sports to improve motor performance, by means specic
to balance training and not only in normally growing
youngsters, and oers a foundation for determining whether
involvement in organized sports could be benecial for
children by forming acquisitions of physical activity /
sports-related motor skills.
2. It will be essential to investigate the long-term
impact and sustainability of novel physical activity
programs on various aspects of child development, which
will lead to a better grasp of how dierent approaches can
be used in communities and schools to promote physically
active lifestyles.
3. Longitudinal studies will be required to ascertain
if the link between balance training and the acquisition
of physical activity/sports-related motor abilities in
youngsters changes over time.
4. More research is needed, mainly longitudinal
studies in early life/childhood.
Conicts of interest
Nothing to declare.
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