Effects of Functional Training vs Dual-Task Training in School-Going Children

Motor skill development during childhood plays a vital role in physical fitness, academic participation, and overall functional independence. School-going children require adequate motor competence to perform daily activities, participate in sports, and adapt to increasingly complex physical and cognitive demands. Traditional physical education programs often focus on isolated physical skills, which may not fully address real-life multitasking requirements. Progressive functional training (PFT) emphasizes task-oriented, developmentally appropriate movements that mimic daily activities and progressively increase in difficulty. This approach helps improve fundamental motor skills, balance, coordination, and strength. In contrast, dual-task training (DTT) involves the simultaneous performance of motor and cognitive tasks, thereby enhancing motor performance under divided attention and improving motor-cognitive integration. Although both training methods have shown positive effects on motor skills, limited evidence exists comparing their effectiveness in school-going children. Therefore, this study aims to compare the effects of progressive functional training versus dual-task training on motor skills in school-going children. This study will adopt a randomized clinical design. A total of 66 school-going children aged 6-12 years will be selected based on predefined inclusion and exclusion criteria. Participants will be randomly allocated into two groups: Group A (Progressive Functional Training) and Group B (Dual-Task Training). Baseline assessments of motor skills will be conducted using standardized tools such Bruin inks- as the Ossietzky Test of Motor Proficiency (BOT-2), Pediatric Balance Scale, and Dual-Task Timed Up and Go Test. Group A will undergo progressive functional training focusing on balance, coordination, strength, and functional movement patterns. Group B will receive dual-task training involving motor activities combined with cognitive tasks. Both groups will receive training for 4 weeks, with sessions conducted 3 times per week. Post-intervention assessments will be performed using the same outcome measures. The collected data will be statistically analyzed to compare pre- and post test outcomes within and between groups.

• progressive functional training (Other): This program involves task-oriented exercises such as sit-to-stand, step-ups, reaching, jumping, and obstacle walking, with progressive increases in difficulty, speed, and resistance. It is performed for 30-40 minutes per session, three times per week for six weeks, including a 5-7 minute warm-up, 30 minutes of functional training, and a 5-8 minute cool-down. Training progresses from low-intensity activities in weeks 1-2 (e.g., sit-to-stand, walking, low step-ups, ball activities, and static balance) to moderate intensity in weeks 3-4 (e.g., squats with reach, tandem and obstacle walking, ball tasks, and dynamic balance), and high intensity in weeks 5-6 (e.g., lunges, jumping, agility drills, direction changes, and advanced balance tasks).
• dual task performance (Other): This program combines motor and cognitive tasks, such as walking while counting, balance with memory recall, and ball activities with verbal tasks, with gradually increasing cognitive complexity. It is performed for 30-40 minutes per session, three times per week for six weeks, to improve dual-task performance, attention, and executive function. Each session includes a 5-7 minute warm-up, followed by 30 minutes of dual-task training progressing from simple tasks (e.g., walking while counting forward, naming animals during balance) to moderate (e.g., counting backward, obstacle walking with naming tasks) and then complex activities (e.g., direction-change walking while counting by threes, hopping with verbal tasks, TUG with cognitive tasks). Sessions end with a 5-8 minute cool-down of relaxed walking, stretching, and breathing exercises.

Primary outcomes

• Bruininks-Oseretsky Test of Motor Proficiency [The BOT-2 Short Form was administered at baseline and after the 6-week intervention. Each assessment required approximately 15-20 minutes to complete.]: Bruininks-Oseretsky Test of Motor Proficiency Used for composites and overall proficiency, ranging from a scale of 20 to 80 . Assesses gross and fine motor skills Subtests include: Balance, running, speed and agility, Bilateral coordination, Strength Suitable for children aged 4-21 years, widely used, reliable, and valid for school aged children
• digit span test [Time Frame: Assessed at baseline (Week 1) and after 6 weeks of intervention (Week 6).]: This framework assesses fundamental motor skills in children aged 3-10, including locomotor skills (running, jumping, hopping) and object control skills (throwing, catching, kicking), commonly used in school-based interventions. Cognitive dual-task performance is measured using the Digit Span Test (forward and backward) to assess attention and working memory during concurrent motor tasks, and the Verbal Fluency Test (animal naming) to evaluate executive function and cognitive flexibility, with outcomes based on correct recall sequences and number of words generated in 60 seconds.

Sex: All, ages: 6 Years to 12 Years, accepts healthy volunteers

Inclusion Criteria:

* School going children aged 6-12 years ,
* Both gender ,Ability to understand and follow simple verbal instruction ,
* Typically developing children

Exclusion Criteria:

* Visual or hearing issue ,
* Recent injury or surgeries

• Aung N, Hiengkaew V, Tretriluxana J, Bryant MS, Bovonsunthonchai S. Effectiveness of Motor Imagery Combined with Structured Progressive Circuit Class Training on Functional Mobility in Post-Stroke Individuals: A Randomized Controlled Trial. J Rehabil Med. 2022 Jul 27;54:jrm00297. doi: 10.2340/jrm.v54.1390. PMID 35797065

• Hafsa Aslam, MS-PT, Principal investigator, Riphah International University