The study will be a Randomized Controlled Trial including 22 children aged 6-10 years with deficits in functional mobility and gross motor skills. Participants will be randomly divided into an experimental group (n=11), receiving a seven-stage progressive Maze Balance Board protocol, and a control group (n=11), receiving conventional physical therapy. Both groups will undergo 30-minute sessions, three times per week, for 8 weeks. Eligible participants will be enrolled after guardian consent. Outcomes will be assessed using the Montreal Cognitive Assessment (MoCA) for cognition, Timed Up and Go (TUG) test for functional mobility, and Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) for gross motor skills. Ethical approval will be obtained from Riphah International University, Lahore, and data will be analyzed using SPSS version 27.0.
Children aged 6-10 years
Mild to Moderate Cognitive Impairment (MoCA score =18 to 25)
Gross motor skill delay (10).
Ability to follow verbal instructions
Use of medications that may influence neuromotor functions (e.g., sedatives, antiepileptic's)
Children with visual and hearing impairments
Receiving concurrent therapies
Recent lower limb injuries , surgeries, or musculoskeletal conditions
Parallel
Maze Balance Board traing
Other interventionThe experimental group (n=11) will receive Maze Balance Board Training in a one-on-one setting, conducted three times per week for 8 weeks. A seven-stage progressive protocol will be followed, where participants advance only after successfully completing each stage, with earlier stages revisited to reinforce learning. Stage 1 involves rotating a marble with hands; Stage 2 focuses on manual maze navigation; Stage 3 develops static balance on a board; Stage 4 includes unassisted rotational balance; Stage 5 introduces foot-mediated marble rotation; Stage 6 requires foot-based maze navigation; and Stage 7 combines dynamic balance with precise marble placement as a dual task. Progression will depend on task performance over consecutive days, aiming to improve functional mobility and gross motor skills in children with cognitive impairment.
Conventional Physical Therapy
Other interventionThe control group (n=11) will receive conventional physical therapy as a standard-of-care baseline, conducted to improve postural control and gross motor skills. Sessions will include structured exercises performed regularly throughout the study. Activities include animal walks (bear walk, bunny hops, frog jumps) to enhance core and limb strength; bridging exercises to strengthen glutes and hamstrings; sit-to-stand training to improve lower limb strength and functional movement; tandem walking to challenge balance; standing on varied surfaces (foam/cushions) to improve proprioception; beam/line walking forward and backward for coordination and dynamic balance; and obstacle negotiation involving stepping over or around objects. These exercises will be consistently practiced to enhance mobility and motor performance in children with cognitive impairment.
Functional Mobility
Functional mobility will be assessed using the Timed Up and Go (TUG) test as the primary outcome measure. It evaluates a child's ability to stand up from a chair, walk a short distance, turn, return, and sit down, measuring mobility, balance, and functional movement efficiency.
Gross motor Skills
Gross motor skills will be assessed using the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2) as a primary outcome measure. It evaluates motor abilities including balance, coordination, strength, and agility through standardized tasks, providing a reliable measure of overall gross motor performance in children with cognitive impairment.
Click on the lead sponsor to view all of their trials.
