Video-Assisted Core Stabilization Exercises in Children With Developmental Coordination Disorder

This single-center, single-blind, prospective randomized controlled trial aims to investigate the effects of a video-assisted core stabilization exercise program (Fun-Core) on motor competence, balance, and gait in children with DCD. Children who meet the eligibility criteria will be randomly assigned to either the intervention group or the control group. The intervention group will participate in a video-assisted, story-based, child-friendly Fun-Core exercise program delivered through a web-based platform, whereas the control group will receive the same core stabilization exercises as a home-based program provided in an illustrated brochure format. In both groups, the intervention will last 8 weeks, with exercises performed 3 days per week for approximately 30 minutes per session. The exercise program will consist of two progressive levels, with Level 1 performed during weeks 1-4 and Level 2 during weeks 5-8. Progression to Level 2 will depend on correct and pain-free performance of the exercises, completion of at least 75% of the planned sessions, and absence of exercise-related adverse events.

The primary outcome will be motor competence, assessed using the Movement Assessment Battery for Children-Third Edition (MABC-3). The MABC-3 evaluates motor performance across three domains: Manual Dexterity, Aiming and Catching, and Balance. Raw performance scores are converted into age-adjusted standard scores and percentile ranks, with higher scores indicating better motor performance.

Secondary outcomes will include balance, functional mobility, participation, health-related quality of life, and static and dynamic pedobarographic parameters. Balance will be evaluated using the Pediatric Balance Scale (PBS), a 14-item scale scored from 0 to 56, with higher scores representing better balance performance. Functional mobility will be evaluated using the Modified Timed Up and Go Test (M-TUG) by recording the time required to stand from a chair, complete the specified mobility task, return, and sit down; shorter completion times indicate better functional mobility. Participation and environmental factors will be evaluated using the Participation and Environment Measure for Children and Youth (PEM-CY), a parent-reported measure assessing participation across home, school, and community settings. Health-related quality of life will be assessed using the Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0), including physical, emotional, social, and school functioning domains, using child self-report and parent proxy-report forms. Scores are transformed to a 0-100 scale, with higher scores indicating better health-related quality of life.

Gait and plantar loading characteristics will additionally be evaluated using static and dynamic pedobarographic assessment with a pressure platform integrated with FreeStep 2.0 software. Static assessment will include plantar pressure distribution, right-to-left load distribution, forefoot-to-rearfoot load distribution, and center of pressure (CoP) parameters. Dynamic assessment during walking at a self-selected natural speed will include plantar pressure distribution, maximum plantar pressure, load transfer patterns, and gait-line parameters.

All outcome assessments will be performed by an investigator blinded to group allocation at baseline (Week 0), immediately after the 8-week intervention (Week 8). During the intervention period, participants will be contacted weekly to monitor exercise adherence, general health status, and possible adverse events.

Eligible participants will be children aged 5-14 years who meet the DSM-5 diagnostic criteria for DCD and have an MABC-3 Total Standard Score corresponding to the 16th percentile or below. Exclusion criteria will include treatment for motor problems within the previous 6 months; a neurological disorder that primarily explains the motor difficulties; intellectual disability that substantially interferes with participation in assessments or exercises; moderate-to-severe autism spectrum disorder or attention-deficit/hyperactivity disorder, or behavioral problems that interfere with participation; orthopedic deformities preventing exercise; previous lumbar or lower-extremity surgery; moderate-to-severe visual or hearing impairment; and epilepsy or another uncontrolled neurological condition.