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Gait Posture. 2016 Jan;43:60-4. doi: 10.1016/j.gaitpost.2015.10.026. Epub 2015 Nov 10.

Direction-specific impairment of stability limits and falls in children with developmental coordination disorder: Implications for rehabilitation.

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Institute of Human Performance, The University of Hong Kong, Pokfulam, Hong Kong. Electronic address:
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
Department of Health and Physical Education, Hong Kong Institute of Education, Tai Po, Hong Kong, China.
Health, Physical Education and Recreation Department, Emporia State University, USA.
Institute of Human Performance, The University of Hong Kong, Pokfulam, Hong Kong.


Limit of stability (LOS) is an important yet under-examined postural control ability in children with developmental coordination disorder (DCD). This study aimed to (1) compare the LOS and fall frequencies of children with and without DCD, and (2) explore the relationships between LOS parameters and falls in the DCD population. Thirty primary school-aged children with DCD and twenty age- and sex-matched typically-developing children participated in the study. Postural control ability, specifically LOS in standing, was evaluated using the LOS test. Reaction time, movement velocity, maximum excursion, end point excursion, and directional control were then calculated. Self-reported fall incidents in the previous week were also documented. Multivariate analysis of variance results revealed that children with DCD had shorter LOS maximum excursion in the backward direction compared to the control group (p=0.003). This was associated with a higher number of falls in daily life (rho=-0.556, p=0.001). No significant between-groups differences were found in other LOS-derived outcomes (p>0.05). Children with DCD had direction-specific postural control impairment, specifically, diminished LOS in the backward direction. This is related to their falls in daily life. Therefore, improving LOS should be factored into rehabilitation treatment for children with DCD.


Clumsy children; Falls; Limits of stability; Postural control; Rehabilitation

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