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      Children With Developmental Coordination Disorder Exhibit Greater Stepping Error Despite Similar Gaze Patterns and State Anxiety Levels to Their Typically Developing Peers

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          Abstract

          This study examined stepping accuracy, gaze behavior, and state-anxiety in children with ( N = 21, age M = 10.81, SD = 1.89) and without ( N = 18, age M = 11.39, SD = 2.06) developmental coordination disorder (DCD) during an adaptive locomotion task. Participants walked at a self-selected pace along a pathway, placing their foot into a raised rectangular floor-based target box followed by either no obstacles, one obstacle, or two obstacles. Stepping kinematics and accuracy were determined using three-dimensional motion capture, whilst gaze was determined using mobile eye-tracking equipment. The children with DCD displayed greater foot placement error and variability when placing their foot within the target box and were more likely to make contact with its edges than their typically developing (TD) peers. The DCD group also displayed greater variability in the length and width of their steps in the approach to the target box. No differences were observed between groups in any of the gaze variables measured, in mediolateral velocity of the center of mass during the swing phase into the target box, or in the levels of self-reported state-anxiety experienced prior to facing each task. We therefore provide the first quantifiable evidence that deficits to foot placement accuracy and precision may be partially responsible for the increased incidence of trips and falls in DCD, and that these deficits are likely to occur independently from gaze behavior and state-anxiety.

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          Two simple methods for determining gait events during treadmill and overground walking using kinematic data.

          The determination of gait events such as heel strike and toe-off provide the basis for defining stance and swing phases of gait cycles. Two algorithms for determining event times for treadmill and overground walking based solely on kinematic data are presented. Kinematic data from treadmill walking trials lasting 20-45s were collected from three subject populations (healthy young, n=7; multiple sclerosis, n=7; stroke, n=4). Overground walking trials consisted of approximately eight successful passes over two force plates for a healthy subject population (n=5). Time of heel strike and toe-off were determined using the two new computational techniques and compared to events detected using vertical ground reaction force (GRF) as a gold standard. The two algorithms determined 94% of the treadmill events from healthy subjects within one frame (0.0167s) of the GRF events. In the impaired populations, 89% of treadmill events were within two frames (0.0334s) of the GRF events. For overground trials, 98% of events were within two frames. Automatic event detection from the two kinematic-based algorithms will aid researchers by accurately determining gait events during the analysis of treadmill and overground walking.
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            Where we look when we steer.

            Steering a car requires visual information from the changing pattern of the road ahead. There are many theories about what features a driver might use, and recent attempts to engineer self-steering vehicles have sharpened interest in the mechanisms involved. However, there is little direct information linking steering performance to the driver's direction of gaze. We have made simultaneous recordings of steering-wheel angle and drivers' gaze direction during a series of drives along a tortuous road. We found that drivers rely particularly on the 'tangent point' on the inside of each curve, seeking this point 1-2 s before each bend and returning to it throughout the bend. The direction of this point relative to the car's heading predicts the curvature of the road ahead, and we examine the way this information is used.
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              Psychometric properties of the revised Developmental Coordination Disorder Questionnaire.

              The Developmental Coordination Disorder Questionnaire (DCDQ) is a parent-completed measure designed to identify subtle motor problems in children of 8 to 14.6 years of age. The purpose of this study was to extend the lower age range to children aged 5 to 7 years, revise items to ensure clarity, develop new scoring, and evaluate validity of the revised questionnaire. Additional items with improved wording were generated by an expert panel. Analyses of internal consistency, factor loading, and qualitative/quantitative feedback from researchers, clinicians, and parents were used to select 15 items with the strongest psychometric properties. Internal consistency was high (alpha = .94). The expanded questionnaire was completed by the parents of 287 children, aged 5-15 years, who were typically developing. Logistic regression modeling was used to generate separate cutoff scores for three age groups (overall sensitivity = 85%, specificity = 71%). The revised DCDQ was then compared to other standardized measures in a sample of 232 children referred for therapy services. Differences in scores between children with and without DCD (p < .001) provide evidence of construct validity. Correlations between DCDQ scores and Movement Assessment Battery for Children (r = .55) and Test of Visual-Motor Integration (r = .42) scores support concurrent validity. The results provide evidence that the revised DCDQ is a valid clinical screening tool for DCD.
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                Author and article information

                Contributors
                Journal
                Front Hum Neurosci
                Front Hum Neurosci
                Front. Hum. Neurosci.
                Frontiers in Human Neuroscience
                Frontiers Media S.A.
                1662-5161
                28 July 2020
                2020
                : 14
                : 303
                Affiliations
                [1] 1Department of Sport and Exercise Sciences, Research Centre for Musculoskeletal Science and Sports Medicine, Manchester Metropolitan University , Manchester, United Kingdom
                [2] 2Research to Improve Stair Climbing Safety, Faculty of Science, School of Sport and Exercise Sciences, Liverpool John Moores University , Liverpool, United Kingdom
                Author notes

                Edited by: Kate Wilmut, Oxford Brookes University, United Kingdom

                Reviewed by: Frederik J. A. Deconinck, Ghent University, Belgium; Judith Marguerite Gentle, University of Surrey, United Kingdom

                *Correspondence: Johnny V. V. Parr, j.parr@ 123456mmu.ac.uk

                This article was submitted to Motor Neuroscience, a section of the journal Frontiers in Human Neuroscience

                Article
                10.3389/fnhum.2020.00303
                7399056
                32848677
                271779a4-c24d-4696-8da8-57a881d1613b
                Copyright © 2020 Parr, Foster, Wood and Hollands.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 19 May 2020
                : 08 July 2020
                Page count
                Figures: 3, Tables: 2, Equations: 0, References: 77, Pages: 11, Words: 0
                Funding
                Funded by: Waterloo Foundation 10.13039/100012107
                Categories
                Neuroscience
                Original Research

                Neurosciences
                developmental coordination disorder,fall-risk,gaze,kinematics,anxiety
                Neurosciences
                developmental coordination disorder, fall-risk, gaze, kinematics, anxiety

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