ANNA MARIA COMBERIATI

PhD Graduate

PhD program:: XXXVIII


supervisor: Prof. Alessandro Lambiase

Thesis title: Efficacia di un training ortottico nei bambini affetti da disturbo della coordinazione motoria: studio randomizzato controllato

Introduction: It is well known that children diagnosed with Developmental Coordination Disorder (DCD) experience multiple difficulties in properly acquiring fine and gross motor skills. These skills are influenced by the individual’s visuoperceptual, visuospatial, attentional, and oculomotor abilities. However, despite the extensive evidence in the literature regarding the crucial role of visual alterations in the genesis of DCD’s characteristic signs, no study has yet demonstrated the benefit of primary treatment of such dysfunctions. Study objective: Implementation of a rehabilitation protocol combining specific training of visual and neuro-visual skills with traditional neuropsychomotor training to assess the possibility of an overall improvement in the psychomotor profile of subjects with DCD. Materials and Methods: The rehabilitation program consists of 10 sessions in which the case group undergoes both visual training and neuropsychomotor training, while the control group receives only neuropsychomotor training. Children with DCD were divided into “cases” and “controls” through randomization performed by the project orthoptist, which remained concealed from patients and the neuropsychomotor therapist. Children with epilepsy, intellectual disabilities, amblyopia, and strabismus were excluded from the sample. The tests used for pre- and post-treatment evaluation were: Movement Assessment Battery for Children (MABC-2), Developmental Test of Visual-Motor Integration (VMI), Neuropsychological Test of Apraxia for Developmental Age (TNA), Developmental Eye Movement (DEM), MP-3 Microperimeter for fixation, near point of convergence, and fusional convergence amplitude. Results: Differences between cases and controls before and after treatment are significant for almost all analyzed variables: manual dexterity, aiming and catching, balance, visuomotor integration, visual perception, motor coordination, imitation of actions with and without objects, imitation of meaningful gestures, improvement in reading times and the amount of horizontally and vertically presented stimuli read, as well as convergence. Conclusions: It is advisable to favor the type of treatment in which orthoptic training is combined with traditional neuropsychomotor therapy to improve visuoperceptual, praxic, and communicative performance in children with DCD.

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