Virtually fall free

Children with developmental coordination disorder (DCD) are characterised by movement difficulties and often struggle with balance, increasing their risk of falling. AOMI training, which involves watching a movement while imagining how it feels to perform it, has been shown to improve motor skills. This project will test whether at-home AOMI training of balance tasks delivered in virtual reality (VR) can improve balance in children with DCD.

Children with DCD often experience challenges with balance that make activities of daily living more difficult and can reduce their confidence to participate in physical activity. This limits their opportunities for social connection and physical development, with these issues extending beyond childhood. This project evaluates a home-based intervention approach designed to help children with DCD improve their ability to plan movements and practice balance skills. Delivering this training in VR is designed to improve balance and reduce fall risk in children with DCD whilst removing the social pressures associated with engagement in physical activity in school or organised sport contexts. This has the capacity to contribute to broader societal goals of equitable access to motor skill development for children with DCD, and addresses a clear need for accessible, evidence-based support for this population that extends beyond clinical settings.

Key Findings on DCD:

DCD causes problems with movement planning, execution and control (Adams et al., 2014). Children with DCD are more likely to lose balance during whole-body movements, compared with typically developing children (Geuze, 2005; Harkness-Armstrong et al., 2023). Our research has demonstrated robust movement benefits for AOMI training (Chye et al., 2022), whereby a person practices by observing and simultaneously imagining the kinaesthetic sensations involving with performing motor skills (Eaves et al., 2016). We have shown AOMI training can benefit upper-limb movements that require hand-eye coordination in children with DCD (Marshall et al., 2020; Scott et al., 2023). We have also found that healthy adults perform complex whole-body movements better after AOMI training delivered in VR (VR-AOMI; Frank et al., 2022) or through the presentation of digitally-generated avatars (Chye et al., 2024, 2025). This project will explore the efficacy of VR-AOMI training for improving balance in children with DCD.

Project Methodology:

40 children, aged 7-12 years old, will take part in a 10-week longitudinal study. They will come to the SHES Movement and Cognition Laboratory for 3 separate testing sessions, which will involve whole-body biomechanical movement analysis to measure their postural control during a battery of static and dynamic balance tests. These sessions will happen in Week 1 (pre-test), Week 6 (post-test) and Week 10 (retention-test). Participants allocated to the VR-AOMI training group will use a standalone VR headset to observe a self-selected child avatar successfully performing static poses and football-based heading and goalkeeping tasks in VR. During observation, the children will simultaneously imagine the feelings of performing the tasks, before then physically practicing the tasks in VR. The VR-AOMI training group will participate in 4 x 40 minute training sessions per week over 4 weeks (Weeks 2 - 5). The training will be remotely-delivered at home by the child’s parents/carers. The no-training control group will be waitlisted and will be invited to complete the VR-AOMI training once the whole study is finished. Based on our research evidence, we hypothesize that VR-AOMI training will improve balance and reduce self-reported fall risk in children with DCD compared to the no-training Control group.