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Efficacy of Gross Motor Skill Interventions in Young Children

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Efficacy of Gross Motor Skill Interventions in Young Children BMJ Open Sport Exerc Med: first published as 10.1136/bmjsem-2015-000067 on 4 January 2016. Downloaded from Open Access Research Efficacy of gross motor skill interventions in young children: an updated systematic review Sanne L C Veldman,1 Rachel A Jones,1 Anthony D Okely1,2 To cite: Veldman SLC, ABSTRACT What are the new findings Jones RA, Okely AD. Efficacy Objective: The objective of this study was to provide of gross motor skill an update of the evidence on the efficacy of gross ▪ interventions in young The quality of the intervention studies has motor development interventions in young children (0– children: an updated improved, but not the quantity since only seven systematic review. BMJ Open 5 years) from 2007 to 2015. studies have examined gross motor skill inter- Sport Exerc Med 2016;2: Methods: Searches were conducted of six electronic ventions in young children (>5 years) over the e000067. doi:10.1136/ databases: PUBMED, Medline (Ovid), ERIC (Ebsco), past 8 years. bmjsem-2015-000067 Embase, SCOPUS and Psychinfo. Studies included any ▪ Professional development of the educators in the childcare-based, preschool-based, home-based, or area of gross motor skills development should ▸ Prepublication history for community-based intervention targeting the be an important component in future interven- this paper is available online. development of gross motor skills including statistical tions to increase the quality of their practice in To view these files please analysis of gross motor skill competence. Data were early childhood settings. visit the journal online extracted on design, participants, intervention ▪ Parent involvement in interventions is recom- (http://dx.doi.org/10.1136/ components, methodological quality and efficacy. mended given their important role in developing bmjsem-2015-000067). Results: Seven articles were included and all were gross motor skills through role modelling and delivered in early childhood settings. Four studies had providing opportunities, encouragement and by copyright. Accepted 17 November 2015 high methodological quality. Most studies used trained support. staff members/educators to deliver the intervention (86%) and five studies lasted 18 weeks or more. Six studies reported statistically significant intervention conducted a systematic review, which assessed effects. the efficacy of interventions designed to Conclusions: Despite the proven importance of gross increase GMS in young children (<5 years). motor skill development in young children and the Seventeen articles were included, of which recommendations made in the previous review, this most were controlled trials (65%) and imple- review highlights the limited studies evaluated to mented in early childhood settings (65%). improve such key life skills in young children over the More than half of the studies reported http://bmjopensem.bmj.com/ past 8 years. statistically significant improvements (60%). Trial registration number: CRD42015015826. The review highlighted the limited quantity and quality of interventions in young chil- dren and the lack of high-quality evidence in INTRODUCTION this area. Fundamental or gross motor skills (GMS) In recent years, several studies have are the foundation for many sports and phys- reported on the relationship between GMS ical activities. From a health perspective, and other important developmental areas higher levels of GMS are associated with adding evidence to the importance of GMS on September 29, 2021 by guest. Protected lower body mass index1 better cardiorespira- development. Jenni et al13 found positive cor- 1Early Start Research tory fitness2 and physical activity3 as well as relations between motor and intellectual Institute, Faculty of Social enhanced cognitive development45social functions, and Leonard and Hill6 high- Sciences, University of development and language skills.6 Moreover, lighted the significant relationship with the Wollongong, Wollongong, New South Wales, Australia children with poor GMS are more likely to development of social skills and language. As 78 2Illawarra Health and Medical have lower self-esteem and higher levels of this is an area of interest internationally, Research Institute, University anxiety.9 there is a need for a further review which of Wollongong, Wollongong, GMS proficiency in young children is sub- updates the evidence in this area and gives New South Wales, Australia optimal10 11 and given the short-term and directions for further research to promote Correspondence to long-term consequences of poor skills, inter- GMS development. The aim of the current Sanne L Veldman; ventions targeting the improvement of these review was to provide an update of the evi- [email protected] skills are needed. In 2009, Riethmuller et al12 dence on the efficacy of gross motor Veldman SLC, et al. BMJ Open Sport Exerc Med 2016;2:e000067. doi:10.1136/bmjsem-2015-000067 1 BMJ Open Sport Exerc Med: first published as 10.1136/bmjsem-2015-000067 on 4 January 2016. Downloaded from Open Access development interventions in young children (0– discussion followed when there were any disagreements. 5 years) and to provide recommendations for further The full text for the remaining articles was retrieved. research in this area. Data collection process After the study selection process, one author (SLV) METHODS extracted data on methodology, characteristics of partici- This review followed the guidelines in the Preferred pants, interventions programme, GMS measurement Reporting Items for Systematic Review and Meta-analysis and results from the selected studies. These data were (PRISMA) statement.14 checked by another author (RAJ). Eligibility criteria Methodological quality Types of participants Methodological Quality was assessed by using a 10-item Children between the ages of 0 and 5 years (mean age quality assessment scale (see table 1) adapted from pre- >5 years) enrolled in kindergarten, childcare centres, viously used methodological assessments.15 16 Each preschool or community services, but not yet at school. included article was assessed by two authors (ADO/SLV) individually. Any disagreements between the authors Types of intervention were resolved by discussion. An article was classified as Any childcare-based, preschool-based, home-based or high methodological quality when it scored ≥5 for a community-based intervention targeting the develop- controlled trial and ≥6 for a randomised controlled ment of GMS. Targeted skills could include locomotor trial.16 and object control skills. Synthesis of results Types of outcome measures The following data were extracted from the articles: Studies were included if they reported statistical analysis research design and setting, sample size and mean age, of GMS competence with measurements taken pre- and total duration of the intervention in weeks, intervention at least once postintervention and included either groups, intervention content, measurement of motor process (knowledge of performance) or product (knowl- skills and results. by copyright. edge of results) assessments of at least one skill. Types of studies RESULTS Randomised controlled trials (RCTs) with experimental Overview of studies and quasi-experimental designs and single group pretest Study selection is displayed in figure 1. The initial search and post-test designs. Studies were excluded if they: (1) identified 5829 hits. After removing duplicates (n=1336) targeted groups from special populations (eg, children and screening of titles and abstracts (n=4493), 10 articles with cerebral palsy or autism); (2) no full text was avail- remained. The full-texts of these articles were retrieved able; (3) the research was not published in English. and seven articles were included. http://bmjopensem.bmj.com/ Information sources and search Study characteristics Six electronic databases were searched: PUBMED, Table 2 shows characteristics of the studies. Five studies – Medline (Ovid), ERIC (Ebsco), Embase, SCOPUS and were published between 2011 and 2014.17 21 Three Psychinfo with a restriction on the start of the publica- studies were conducted in the USA17 18 22 two studies tion date to 2007 and before given the previous system- were conducted in Australia20 23 and the others were atic review.12 The search was performed in January 2015. conducted in Switzerland19 and Greece.21 Some studies The following search terms were used: toddler OR child- recruited centres based on region19 21 or within an exist- care OR day care OR preschool* OR ‘early childhood’ ing program17 while others worked together with the OR ‘community-based’ AND random* OR trial OR (local) government23 or childcare organisations.18 20 22 on September 29, 2021 by guest. Protected evaluation OR programme OR pilot AND ‘motor skill*’ Two studies involved parents. – OR ‘movement skill*’ OR ‘motor development’. There were six randomised controlled trials17 19 20 22 23 Additional studies were found through scanning refer- and one quasi-experimental study.21 The sample size of ence lists of included articles. the studies varied from 7117 to 835 participants.19 Study selection Implementation After searching the databases, one of the authors (SLV) All interventions took place in early childhood settings – removed all duplicates and two authors (RAJ/SLV) and most were delivered by setting staff.17 19 20 23 screened all titles and abstracts in a non-blinded standar- Professional development sessions were offered prior to dised way. These were screened for inclusion, by dividing the interventions (1–5 sessions). One study
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