Impaired postural control in children with developmental coordination disorder is related to less efficient central as well as peripheral control

BACKGROUND: Developmental coordination disorder (DCD) is a neurodevelopmental
impairment that affects approximately 6% of children in primary school age.
Children with DCD are characterized by impaired postural control. It has yet to
be determined what effect peripheral and central neuromuscular control has on
their balance control.
OBJECTIVE: The aim of this study was to investigate the underlying mechanisms to
impaired postural control in children with DCD using the rambling-trembling
decomposition of the center of pressure (CoP).
METHOD: Nine children with DCD (9.0±0.5years, 7 boys, 2 girls) and 10 age- and
gender-matched typically developing children (TD) with normal motor proficiency
(9.1±0.4years, 7 boys and 3 girls) performed 3×30s bipedal standing on a force
plate in six sensory conditions following the sensory organization procedure.
Sway length was measured and rambling-trembling decomposition of CoP was
calculated in medio-lateral (ML) and anterior-posterior (AP) direction.
RESULTS: Both rambling and trembling were larger for the children with DCD in AP
(p=0.031; p=0.050) and ML direction (p=0.025; p=0.007), respectively. ML rambling
trajectories did not differ in any conditions with fixed support surface. In ML
direction children with DCD had a lower relative contribution of rambling to
total sway (p=0.013).
CONCLUSION: This study showed that impaired postural control in children with DCD
is associated with less efficient supraspinal control represented by increased
rambling, but also by reduced spinal feedback control or peripheral control
manifested as increased trembling.