Autism
Conditions
Brief summary
This study compared the effects of group-based versus individual-based exercise programs on balance and coordination in children aged 3-12 years who were diagnosed with Autism Spectrum Disorder (ASD) Level 1. A total of 16 children were recruited and randomly allocated into two groups (n=8 each): Group A (individual-based) and Group B (group-based). Both groups received 40-minute exercise sessions, 3 days per week, for 6 weeks. Outcomes were assessed at baseline and after 6 weeks using the Pediatric Balance Scale (PBS) and neurological coordination tests (Finger-to-Nose, Heel-to-Shin, Past-Pointing).
Detailed description
Background: Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition affecting motor function, including balance and coordination. Physical activity interventions showed promise in improving motor outcomes, but comparative evidence between group-based and individual-based formats was limited. Study Design: Randomized Controlled Trial with parallel assignment. Participants: 16 children (aged 3-12 years) with ASD Level 1 severity were recruited from rehabilitation centers and special education institutions in Islamabad, Pakistan, using purposive sampling and random allocation via lottery method. Interventions: Group A (Individual-Based): Each child received a personalized 40-minute physiotherapy exercise session including warm-up (movement to music, trampoline jumping, stair climbing), balance and coordination exercises (single-leg stance, animal walks, wobble board, ball games, tug of war, obstacle course), and cool-down (bubble blowing, block building). Sessions were delivered 3 times per week for 6 weeks. Group B (Group-Based): The same exercise protocol was delivered in group, incorporating peer interaction, social modeling, and group dynamics. Outcome Measures: Pediatric Balance Scale (PBS; score 0-56) and neurological coordination tests (Finger-to-Nose, Heel-to-Shin, Past-Pointing) were administered pre- and post-intervention. Data Analysis: Data were analyzed using SPSS v21. Normality was assessed and tests were applied accordingly.
Interventions
OTHERIndividual based
Individual-Based Physiotherapy Exercise Program (40 min/session, 3×/week, 6 weeks): Warm-up, balance and coordination exercises (single-leg stance, animal walks, wobble board, ball games, obstacle course), cool-down activities.
OTHERGroup Based Exercise
Group-Based Physiotherapy Exercise Program (40 min/session, 3×/week, 6 weeks): Same protocol as Group A but delivered in group, incorporating peer interaction and social modeling.
Sponsors
Ibadat International University, Islamabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
3 Years to 12 Years
Healthy volunteers
No
Inclusion criteria
Diagnosed with Autism Spectrum Disorder (level one severity). Age 3-12 years. Ability to understand simple instructions. No participation in previous physiotherapy balance programs.
Exclusion criteria
Co-existing intellectual disability or ADHD. Visual impairments. Chronic medical disorders affecting mobility or postural control. Inability to participate consistently in sessions.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pediatric Balance Scale (PBS) | Assessed at Baseline (Week 0) and Post-intervention (Week 6). | It is a comprehensive and effective scale evaluating the balance in the following three dimensions: static balance, anticipatory balance, and functional movement transitions. The scale comprises 14 items including sitting balance, standing balance, sitting to standing/standing to sitting, transfers, stepping, reaching forward with outstretched arm, reaching the floor, turning, and placing foot on stool items. Each item ranked from 0 to 4. 0 shows inability to perform the instruction, while 4 shows the ability to perform without any difficulty. Maximum total score is 56. The intraobserver agreement of the PBS total score was high, perfectly (ICC=0.927).(15, 16) PBS can be considered a simple, valid scale for examining functional balance capacity in children with neurological disorders. |
| Finger-to-Nose Test | Assessed at Baseline and Week 6 | A widely used neurological test for evaluating cerebellar function and upper limb coordination, the finger-to-nose test involves the patient alternately touching the examiner's finger and their nose in a smooth, controlled manner. Its reliability is generally moderate to good. Its validity is thought to be good for detecting gross cerebellar dysfunction, coordination, intention tremor, and dysmetria. Sensitivity roughly 60-85% and specificity around 70-90, while its reliability is usually moderate to good, with inter-rater reliability coefficients (ICC or kappa) commonly reported in the range of 0.60-0.85. |
| Heel-to-Shin Test | Assessed at Baseline and Week 6 | The heel-to-shin test is a neurological examination used to evaluate lower-limb coordination and cerebellar function. The patient is asked to place the heel of one foot on the opposite knee and smoothly slide it down the shin to the ankle. Normal performance is smooth and accurate; abnormal findings, such as irregular movement, side-to-side wavering, inability to maintain contact, or intention tremor, suggest cerebellar dysfunction, sensory ataxia. Studies report sensitivity ranging approximately from 65-90% and specificity around 70-95% for detecting significant cerebellar dysfunction, depending on standardization and patient population, while its reliability is generally moderate to good, with reported inter-rater and intra-rater reliability coefficients (ICC or kappa) typically between 0.60 and 0.85. |
| Past-Pointing Test | Assessed at Baseline and Week 6 | When a person consistently overshoots or undershoots a target during voluntary, goal-directed movements, it is a sign of impaired cerebellar coordination. It reflects defective error correction and timing of agonist-antagonist muscle activity normally regulated by the cerebellum, leading to dysmetria. It becomes more pronounced when visual guidance is removed, which worsens primarily with eyes closed, multiple sclerosis, and autism. Sensitivity (\~60-80%) and good specificity (\~70-90%). |
Countries
Pakistan
Outcome results
None listed