We consider three issues concerning unexpected difficulty in the acquisition of motor skills: terminology, diagnosis, and intervention. Our preference for the label Developmental Coordination Disorder (DCD) receives justification. Problems in diagnosis are discussed, especially in relation to the aetiology-dominated medical model. The high degree of overlap between DCD and other childhood disorders appears to militate against its acceptance as a distinct syndrome. In this context, we emphasize the need to determine whether incoordination takes different forms when it occurs alone is combined with general developmental delay or with other specific disorders in children of normal intelligence. Studies of intervention have mostly shown positive effects but do not, as yet, allow adjudication between different sorts of content. We suggest that the study of DCD and its remediation would benefit greatly from the employment of the simple but rich paradigms developed for the experimental analysis of fully formed adult movement skills.
Sheila E. Henderson and Leslie Henderson
David A. Rowe, David McMinn, Leslie Peacock, Arjan W. P. Buis, Rona Sutherland, Emma Henderson and Allan Hewitt
Walking cadence has shown promise for estimating walking intensity in healthy adults. Auditory cues have been shown to improve gait symmetry in populations with movement disorders. We investigated the walking cadence-energy expenditure relationship in unilateral transtibial amputees (TTAs), and the potential of music cues for regulating walking cadence and improving gait symmetry.
Seventeen unilateral TTAs performed 2 5-min treadmill walking trials, followed by 2 5-min overground walking trials (self-regulated “brisk” intensity, and while attempting to match a moderate-tempo digital music cue).
Walking cadence significantly (P < .001) and accurately (R 2 = .55, SEE = 0.50 METs) predicted energy expenditure, and a cadence of 86 steps·min−1 was equivalent to a 3-MET intensity. Although most participants were able to match cadence to prescribed music tempo, gait symmetry was not improved during the music-guided condition, compared with the self-regulated condition.
This is the first study to investigate the utility of walking cadence for monitoring and regulating walking intensity in adults with lower limb prosthesis. Cadence has similar or superior accuracy as an indicator of walking intensity in this population, compared with the general population, and adults with a unilateral TTA are capable of walking at moderate intensity and above for meaningful bouts of time.