Fidgety general movements (Prechtl) are most predictive for later cerebral palsy compared with other spontaneous movements. False positive results are high among all spontaneous movement assessments.

BackgroundChildren with developmental coordination disorder (DCD) experience a range of difficulties that can potentially limit their academic, social and physical ability. Recent research has developed interventions that aim to improve motor outcomes in a variety of paediatric cohorts using video gaming equipment. Therefore, we aimed to systematically review the literature on virtual reality or video game interventions that aim to improve motor outcomes in children with DCD.MethodsSeven databases were searched for studies using the following criteria: a) virtual reality or video game based intervention; b) children with DCD; and c) motor outcomes relating to body structure and function, activity or participation. Data were extracted relating to study design, participant characteristics, details of the intervention, outcome measures, results, and feasibility/adherence.ResultsFifteen articles were included for review, including eight randomised controlled trials. No studies used virtual reality equipment, with all interventions using video games (Nintendo Wii in 12/15 articles). Mixed effects of video game intervention on outcome were found, with conflicting evidence across studies. Studies that reported on feasibility found most children enjoyed and adhered to the video game interventions.ConclusionsThis review found limited evidence for the effectiveness of video game interventions for children with DCD to improve motor outcomes due to limitations in the research including low sample sizes and low to moderate methodological quality. Further research is needed to determine the effect of video game or virtual reality interventions on motor outcomes in children with DCD.Protocol registrationThe protocol for this systematic review can be found on PROSPERO (CRD42017064427).Electronic supplementary materialThe online version of this article (10.1186/s12887-018-1381-7) contains supplementary material, which is available to authorized users.

Children born VP experience significant motor impairment across ICF-CY activity and body structure and function domains at preschool age compared with peers born FT. Evidence investigating participation in VP preschool-age populations relative to children born at term is sparse, requiring further research.

Understanding the developmental precursors of motor impairment in children born before 30 weeks is essential for limiting disruption to skill development, and potential secondary impacts on physical activity, participation, academic achievement, self-esteem and associated outcomes (such as obesity, poor physical fitness and social isolation). An improved understanding of motor skill development will enable targeting of interventions and streamlining of services to children at highest risk of motor impairments.

Child and adolescent conversion disorder has the potential to impart significant burden on health-care services and affect quality of life. Clinically, physiotherapists are involved in conversion disorder management; however, no systematic reviews have examined physiotherapy effectiveness in its management. The aim of this review is to identify the efficacy of physiotherapy management of child and adolescent conversion disorder. A search of multiple databases (Medline, CINAHL, Embase, PsychINFO, PEDro and the Cochrane Library) was completed along with manual searching of relevant reference lists to identify articles including children 0-18 years with a diagnosis of conversion disorder who received physical management. Two independent reviewers screened titles and abstracts using criteria. Data were extracted regarding study characteristics, functional outcome measures, length of stay, physiotherapy service duration and resolution of conversion symptoms. Methodological quality was assessed using a tool designed for observational studies. Twelve observational studies were included. No functional outcome measures were used to assess the effectiveness of the treatment protocols in the case studies. Resolution of symptoms occurred in all but two cases, with conversion symptoms still present at 11 months and at 2 years. Length of stay varied from 3 days to 16 weeks, with similar variation evident in length of physiotherapy service provision (2.5 weeks to 16 weeks). There was limited and poor quality evidence to establish the efficacy of physiotherapy management of child and adolescent conversion disorders. More rigorous study designs with consistent use of reliable, valid and sensitive functional outcome measures are needed in this area.

Objective Children born < 30 weeks’ gestation have more motor impairment than do children born at term (37–42 weeks’ gestation), but reported outcomes have largely focused on cerebral palsy (CP) and Developmental Coordination Disorder (DCD). The aim of this study was to compare muscle strength, motor skills and physical activity of preschool-aged children born < 30 weeks with those born at term. Methods In this cohort study, 123 children born < 30 weeks and 128 born at term were assessed. Children were ≥ 4 years, 0 months and < 6 years, 0 months’ corrected age at the time of the assessment. Outcomes included: grip strength (kg), Movement Assessment Battery for Children 2nd edition (MABC-2), Little Developmental Coordination Disorder Questionnaire (L-DCDQ), accelerometer-measured physical activity (PA), and a parent-completed PA diary. Linear regression and mixed effects models were used to examine differences between children born < 30 weeks and those born at term. Results Children born < 30 weeks had poorer grip strength (preferred hand; mean difference [95% confidence interval] -0.60 kg [−1.04, −0.15], p = 0.008) and poorer motor competence (MABC-2 standard score mean difference − 2.17 [−3.07, −1.27], p < 0.001; L-DCDQ total score mean difference − 5.5 [−9.2, −2.8], p < 0.001) than term-born children. Children born < 30 weeks also completed fewer minutes of accelerometer-measured PA (mean difference − 41 minutes, [−62, −20], p < 0.001), more minutes of accelerometer-measured stationary behavior (mean difference 33 minutes, [12, 54], p = 0.002), and more minutes of parent-reported screen time (mean difference 21 minutes, [10, 32], p < 0.001) per day. Conclusions Preschool-aged children born < 30 weeks had poorer muscle strength, motor skills and physical activity levels than term-born children. These findings suggest that preschool-aged children born < 30 weeks may benefit from enhanced surveillance and PA promotion to improve life-long health outcomes. Impact In our study, children born < 30 weeks had reduced muscle strength, poorer motor skills, participated in less physical activity (PA), and had more stationary and screen behaviour than term-born children. These findings emphasize that awareness of multidomain motor deficits in children born < 30 weeks’ gestation is needed in clinical practice. Given the associations between higher PA and health benefits, and recognition that PA levels can track from early childhood into adulthood, our study highlights the need for assessment and promotion of PA in preschool-aged children born < 30 weeks’ gestation. Lay Summary Children born < 30 weeks had reduced muscle strength, poorer motor skills, participated in less physical activity (PA), and had more stationary and screen behavior than term-born children. Awareness of multidomain motor deficits in children born at < 30 weeks’ gestation is needed in clinical practice. Given the associations between higher PA and health benefits, and in recognition that PA levels can track from early childhood into adulthood, this study highlights the need for assessment and promotion of PA in preschool-aged children born at < 30 weeks’ gestation.

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Developmental co‐ordination disorder is a motor skill disorder that affects an estimated 5–6% of children but lacks recognition and understanding, leading to under‐diagnosis. Essential for diagnosis is a marked impairment in motor co‐ordination that significantly impacts daily living, including education. Although ‘clumsiness’ is often dismissed, the impact of this disorder is significant and extends beyond motor skills into physical and psychological health and educational and vocational success. This is discussed here with regard to the framework of the International Classification of Functioning, Disability and Health. This review also discusses the importance of an accurate, early diagnosis and factors that inhibit this; dual diagnosis with comorbid neurodevelopmental disorders; the multidisciplinary approach to diagnosis and the role of the paediatrician within this; and current evidence regarding the most effective interventions.