Functional Training and Dynamic Play Exercise on Gross Motor Skills, Physical Fitness, and Balance in Healthy Children

Children's motor development progresses through various milestones such as crawling, walking, and refining fine motor skills, influencing their overall growth and well-being. Piaget's theory underscores the role of motor skills in cognitive and social development, emphasizing that children construct understanding through actions. Motor development, a continuous process, involves gross motor skills (involving large muscles) and fine motor skills (involving small muscles), crucial for daily activities and physical play. Physical fitness in childhood is pivotal for long-term health, correlating with reduced body fat and improved cardio-metabolic health. Balance control, integral to motor skills, depends on sensory inputs and neuromuscular responses. Functional Training and dynamic play are approaches to physical activity that impact gross motor skills, fitness, and balance, with implications for enhancing physical capabilities during childhood. This study aims to explore and compare two distinct approaches to physical activity: functional training and dynamic play exercises, focusing on their effects on children's gross motor skills, physical fitness and balance.

A randomized clinical trial will be conducted. The study will be conducted at Primary school of Lahore in a total duration of 10 months. Sample size will be 38. There will be two groups. Non-probability convenient sampling techniques will be used. The sample having the following characteristics will be included; Age 7-10 years, both genders, cognition MMSE score > 25, Class grades 2-5 , BMI between 5th - 85th percentiles, Able to stand and walk independently, PBBS score > 40, TGMD-2 > 13, TUDS > 10 secs.. The population having the following characteristics will be excluded from the study; Pes Planus \& Pes cavus, Scoliosis, Genu valgum, Genu varum, Juvenile Idiopathic Arthritis, Presence of Asthma, Acute orthopedic problem and any history of surgery past 6 months, visual, vestibular, or balance disorders. The tools that will be included in this study are: Pediatrics balance scale, Test for gross motor development (TGMD-2) and Time up and downstairs test (TUDS).

SPSS version 27 will be used for data analyses.

• Functional Training (Other): Each training session includes a preparation phase (warm-up, neuromuscular activation, dynamic stretching, and core activation), followed by two main modules: motor skill development (walking, jumping, crawling, throwing, pushing, catching) and physical fitness (balance, agility, endurance). Sessions conclude with motor skill consolidation and static stretching. Training spans 12 weeks: once weekly during weeks 1-8, and twice weekly during weeks 9-12
• Dynamic Play Exercise (Other): This includes warm-up (for 3-5 mins), rhythmic exercise (5-10 mins), games (7-10 mins) and free play exercises (10-15 mins). This group will receive the lesson once a week during week 1-8 and twice a week during 9-12 weeks

Primary outcomes

• Paediatric Balance Scale [Baseline, 12th week]: The Pediatric Balance Scale (PBS), adapted from the Berg Balance Scale, assesses balance in children through 14 items scored 0-4, with a maximum of 56. It shows excellent test-retest (ICC=0.998) and interrater reliability (ICC=0.997).
• Test for Gross Motor Development (TGMD-2) [Baseline, 12th week]: The Test of Gross Motor Development-2 (TGMD-2) assesses 12 fundamental movement skills-6 locomotor (e.g., running, hopping) and 6 object control (e.g., throwing, catching)-in children aged 3 to 10 years 11 months. It evaluates movement patterns essential for physical activity. The TGMD-2 shows good internal consistency (α = 0.73-0.87), strong inter-rater agreement (≥ 0.92), and high test-retest reliability (locomotor = 0.91, object control = 0.85).

Sex: All, ages: 7 Years to 10 Years, accepts healthy volunteers

Inclusion Criteria:

* Age 7-10 years
* Both genders
* Cognition MMSE score > 25
* Class grades 2-5
* BMI between 5th - 85th percentiles
* Able to stand and walk independently
* PBBS score > 40
* TGMD-2 > 13
* TUDS > 10 secs

Exclusion Criteria:

* Pes Planus \& Pes cavus
* Scoliosis
* Genu valgum
* Genu varum
* Juvenile Idiopathic Arthritis
* Presence of Asthma
* Acute orthopedic problem and any history of surgery past 6 months
* Visual, vestibular, or balance disorders

• Fu T, Zhang D, Wang W, Geng H, Lv Y, Shen R, Bu T. Functional Training Focused on Motor Development Enhances Gross Motor, Physical Fitness, and Sensory Integration in 5-6-Year-Old Healthy Chinese Children. Front Pediatr. 2022 Jul 11;10:936799. doi: 10.3389/fped.2022.936799. eCollection 2022. PMID 35899135

• Zainab Javed, MS-PPT, Principal investigator, Riphah International University