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Background and aim: Human knee joints experience very large loads and motions during regular daily, occupational and sport activities. Consequently, they are at high risk of being exposed to injuries and degeneration. Osteoarthritis and ligament injuries often inflict knee joints causing considerable pain and loss of productivity involving thus significant human and economic costs. Hence, biomechanics of human knee joints has been the focus of many investigations with the primary aim to improve understanding of joint function in normal and perturbed conditions. The existing prevention and treatment programs have been based on such studies.
Material and Methods: Due to inherent costs, limitations, difficulties and ethical concerns associated with in vivo and in vitro cadaveric studies, finite element model studies have been developed as effective, powerful and complementary tools to investigate knee joint biomechanics subject to internal and external mechanical conditions affecting its normal function.
Results: The advantage of finite element method in study of joint biomechanics lies in its robustness to incorporate complex 3D joint geometry, intricate boundary and loading conditions and materials with nonhomogeneous and nonlinear properties.
Conclusion:This article reviews important model studies, presents their relevant results and discusses some of the promising future directions.

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Background and aim: Virtual Reality is a computer technology with virtual environment and objects, which people manipulate virtual environment through active participation. The aim of this study was to determine the effect of practice in virtual environment on upper limb function of children with spastic hemiparetic cerebral palsy.
Materials and Methods: In this single blinded, randomized, controlled trial, 16 children with hemiparetic cerebral palsy were evaluated in a simple random sampling of Ahvaz city in 2 groups (virtual reality and control). Treatment protocol consisted of one and half hours sessions of practice in virtual environment for 4-week, every other day. Measures were conducted pre, post and 3-month after the treatment period by Pediatrics Motor Activity Log and Bruininks-Oseretsky Test of Motor proficiency. Sample randomization and data analysis by analysis of variance with repeated measures were conducted by SPSS-16 software in alpha level set at 0.05.
Results: Subjects in virtual reality group showed significant improvement (p<0.01) in post-test measures (bruininks-oseretsky test of motor proficiency, speed and dexterity: mean change from 0.25±0.06 to 1.22±0.23). Results were retained for both groups in follow up session.
Conclusion: Virtual reality technology through intensive and repetitive practice in an interactive and motivational environment is a promising method to improve upper limb function of children with hemiparetic cerebral palsy.

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Background: Flexible flat foot is a congenital common deformity in lower extremity associated with ligamentus laxity. This deformity may cause hammer toe, heel spur, inflammation of achille tendon, early muscle fatigue during sport, foot imbalance and pain in leg, knee and hip. The use of insole with medial arch support considered as one of the common treatments for patients. The purpose of this study was to determine the effect of a composite insole, Ethyl Vinyl Acetate (EVA) with Poron layer on ground reaction force on subjects with flexible flat foot in comparison with common EVA insole.

Materials and Methods: Fifty two subjects (14 Male and 38 female) between 18-40 years of age with flexible flat foot participated in this study. Twenty six subjects received Poron insole (EVA with Poron layer) and 26 subjects received common EVA insole. After assessment each subject asked to walk with normal speed across two force plate in two conditions, walking with insole and shoe and walking without insole. Then each subject asked to use insole for forty hours during two weeks. Vertical ground reaction force in the first session and after two weeks was assessed.

Results: Impact force and first peak of vertical ground reaction force (F₁) with Poron insole in comparison with shoe significantly increased in second session (P<0.05). The second peak (F₃) with common insole in comparison with shoe significantly increased in second session (P<0.05). Significant reduction was noted in first peak (F1) with common insole in second session in comparison with first session (P<0.05). There was no observable significant difference in two groups before and after intervention.

Conclusion: The results of this preliminary study show that both insoles change vertical ground reaction force in comparison with shoe alone. But using a composite Poron Layer on EVA insole has not demonstrated a significant difference with common arch support insoles. Therefore application of Poron Silicon layer on EVA insole by itself can not show a significant reduction of ground reaction force.

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Background and aim: One of the common problems in elderly people is falling. The effort to identify environmental risk factors at home and their modifications may control falls and injury in the elderly. Home FAST as a valid and reliable screening tool is used to identify elderly at risk of falling at home and in society.
Materials and methods : International quality of life assessment (IQOLA) was used for validity and reliability of Home fast. After forward and backward translation , the questionnaire was evaluated for content validity by 5 occupational therapists. Sixty participants aged over 65 were randomly selected through five geographical regions of Tehran. Inter-rater and test-retest with one week interval were conducted by two occupational therapists.
Results: Agreement among experts about the validity of screening tool of Home FAST (χ²= 25.008) were more than 96%.The correlations of test-retest with relative and absolute coefficients were high (ICC = 0.72 and SEM = 0.89). Also, the correlation coefficients between the raters with absolute and relative (ICC = 0.88 and SEM = 0.54) were significant, indicating the high reliability of this test.
Conclusion: This study shows the reliability and validity of the test are high. Since, test items are conformable to fall prevention goals, these results can be expected. The tool can be used by professionals.

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Background and Aim: Whole Body Vibration (WBV), as a new exercise modality, can improve neuromuscular performance but, there is no study to assess the effects of WBV on the reaction time as an indicator of muscular performance especially in upper extremity muscles. Therefore, the aim of the present study is to investigate the immediate effects of WBV on timing parameters of upper extremity muscles. 

Materials and Methods: Forty healthy young women were randomly assigned in two groups of intervention (with WBV) and control (without WBV). In the intervention group, timing parameters (Reaction time (RT), Premotor time (PMT), Motor time (MT)) were measured by using EMG before and after the vibration (5 sets of 30seconds at 5 mm amplitude and 30 Hz frequency) session. The same protocol but without vibration was used for control group.

Results: Whole body vibration did not alter the RT significantly (P=0.253). Premotor time was increased significantly only in the triceps muscle (P=0.006). There was also a significant difference (P=0.003) in MT of the serattus anterior muscle between two groups.

Conclusion: It seems that WBV can induce different effects on upper extremity muscles. Whole body vibration has not any significant effects on the total RT 

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Background and Aim: Measurement of reaction time and anticipation skill are used widely in therapeutic exercises or sport programs. Improvement of anticipation skill  and reaction time in any exercise or activity that need fast and correct reaction time for deciding and doing a suitable movement, can improve the motor control and its strategies as well as central processing. There is a need for an easy-to-use program that can run reaction time tasks and anticipation skills with no special experiments. There is no system for objective measurement of above variables in our country, so designing and construction of a system for reaction time test and anticipation skill estimation was carried out.

 Materials and Methods: A system that consist of software, lap top, LCD and key board was designed. The software of the system had two subsystems for measuring reaction time and estimating anticipation skill.

Results: By use of the above equipments, 6 tests of video choice reaction time, audio choice reaction time, video complex choice reaction time, audio complex choice reaction time, high speed anticipation skill and low speed anticipation skill were performed. Structural and content validity of the system was estimated very high.

 Conclusion: Current system can use in many therapeutic and sport centers simply and provide basic data about motor control strategies. By use of it, there is a better judgment about effectiveness of various treatments and sport-men selection, too.

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Background and Aim: Perceptual abilities (reaction time and anticipatory skill) are essential for successful performance in daily activities. Training in dynamic and unpredicted sport domains such as volleyball might make changes in perceptual abilities of athletes compared to non-athletes. Therefore, the aim of this study was to compare reaction time and anticipatory skill of volleyball players versus non-athletes.

 Materials and Methods: Eleven female volleyball players and 11 female non-athletes participated in this study. Auditory choice reaction time, auditory complex choice reaction time, visual choice reaction time, visual complex choice reaction time, anticipatory skill of the high speed of the ball and anticipatory skill of the low speed of ball of both groups were analyzed by a software (Speed Anticipation Reaction Test (SART)).

Results: Statistical analysis did not show any significant differences between two groups in both auditory reaction time tests (P> 0.05). However, volleyball players showed better results in visual choice reaction time, visual complex choice reaction time, anticipatory skill of the high speed of the ball and anticipatory skill of the low speed of ball tests (P> 0.05).

Conclusion: Volleyball players acquire extensive knowledge of sport specific patterns of perceptual abilities due to experiences within the volleyball domain and due to the efficient extraction of this knowledge in similar conditions such as, computerized neurocognitive tests, they have superior perceptual skills than non-athletes.

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Background and Aim: Reading skill is necessary for academic achievement, that deaf children have problems in this skill due to hearing impairment. Use of cochlear implant can improve auditory inputs. The aim of this study was to investigate the reading skills of children with cochlear implants and comparing that with normal ones.

Materials and Methods: This descriptive - analytic study was done on 24 children with cochlear implant and 24 normal ones that was selected from second and third grades students of Tehran primary schools. Children's reading performance was assessed by Nama reading test and the data were analyzed using T-test, linear regression and Pearson correlations.

Results: The results showed that the means of reading scores of normal children were significantly greater than the cochlear implanted ones (P<0.01). Also, there was a significant relationship between reading skills and period of cochlear implant (P<0.01).

Conclusion: Cochlear implanted children showed weaker performance in reading skills than normal ones due to less access to auditory and Phonological information. It seems that early surgery and cochlear implant before the age of language learning can be partially compensated reading defects of deaf children.

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  Background and Aim: Hearing impairment in critical period of speech and language development is caused defects in oral and written language. The aim of this study is to use a test for comparing the reading skills of elementary fifth grade hearing and moderately severe hearing loss students in public schools.
Materials and Methods: In this cross sectional study, 10 hearing impaired children selected from the total number of fifth grade moderately severe hearing loss students' community (public schools) based on the inclusion criteria and compared with 10 hearing children that were matched according to grade, as a control group. In order to gather the data, reading and writing tests for school students was used. Data analysis was done through SPSS-16.
Results: The findings indicated that hearing impaired children on auditory discrimination skills (P=0.001), word auditory memory (P=0.034) sentence auditory memory (P<0.001), phonological blending (P=0.034), phonological segmentation (P=0.012) and text reading comprehension (P=0.044) were significantly weaker than the control group, but they had similar function in other skills.
Conclusion: Children with hearing impairment have the same function in tasks based on visual processing to normal children, whereas, in tasks based on auditory and phonological processing are weaker than them. Keywords: Reading skills, Hearing loss children, Public schools

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Background and Aim: Reading disorder is a neurodevelopmental disorder with deficits in cognition and motor skills. According to available studies, the brain structure in thesechildren is intact, but the brain function is abnormal. So, neurofeedback as a new treatment, can improve brain function in this disorder through regulating abnormalities of electroencephalogram (EEG). The purpose of this study was to investigate the effectiveness of neurofeedback balance protocol (to inhibit 4-7 Hz while reinforcing 15-18 Hz at electrode sites O1 and O2) on EEG and balance performance in children with reading disorder.

Materials and Methods: The study was conducted in a single subject design in 20 sessions. Participants were 4 children (1girl and 3 boys) aged between 8-12 years old who completed twelve 30-min neurofeedback sessions. Repeated measurements were performed during the baseline, treatment and follow-up by means of 2nd subtest of BOTMP for balance performance and EEG for brain waves changes.

Results: The results showed that the effect of treatment on balance performance was high (Cohen’d > 0.8) in all subjects but there were no significant changes in absolute power of brain waves.

Conclusion: The results of this study indicated that neurofeedback balance protocol can improve balance in children with reading disorder and may be more treatment sessions are needed for significant brain waves changes.

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Abstract

Background and Aim: Proprioceptive problems, visuospatial deficits and muscle weakness are the main causes of weight bearing asymmetry and postural control impairment in chronic hemiparesis patients. The aim of this study was to investigate the correlation between center of pressure parameters in quiet standing with eyes open and closed and functional balance tests and symmetry index in these patients.

Materials and Methods: In this correlation study, 16 stroke patients (mean age: 52.937±10.109 years), were selected by simple non-probability sapling. Force plate, Functional Reach and Timed Up and Go tests and scales were used in order to investigate postural sway parameters in quiet standing, functional balance and symmetry index, respectively.

Results: Moderate to high significant correlation was obtained between Timed Up and Go test and symmetry index and most of the postural sway parameters in eyes closed condition, while Functional Reach test had only moderate significant correlation with standard deviation of velocity (anterior-posterior) and phase plane total. Also symmetry index showed moderate correlation with most of the postural sway parameters.

Conclusion: Current study demonstrates the role of vision and task in correlation between center of pressure parameters, balance tests and symmetry index.

Key words: Correlation, Symmetric weight bearing, Postural sway, Functional Reach, Timed Up and Go, Force plate, Quiet standing

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Background and Aim: Some of the patients with chronic low back pain commonly do not experience full recovery with the conventional physical therapy. It is revealed that may be there are some items in subjects with low back, which are not studied well till now. Since there are some evidences about breathing pattern disorder in low back pain patients, the purpose of this study was to compare between some important breathing pattern index in non-specific chronic low back pain and healthy subjects .

  

Materials and Methods : In this descriptive analysis study, there were 16 patients with chronic non-specific low back pain and 16 healthy subjects. Both groups were matched and selected by some of the demographic characteristics. Respiratory data including respiratory rate, volumetric, time depended and chemical index were calculated by K4b2 instrument.

  

Results: They have significant differences in some of the respiratory parameters including respiratory rate, inspiration and expiration times and total time of respiration between two groups, whereas inspiration total time ratio, volumetric and chemical index do not have significant differences.

  

Conclusion: Existence of disorders in some parameters of respiratory patterns in patients with low back pain are revealed that survey of respiratory system in patients with chronic non-specific low back pain can be effective in diagnosis and treatment process in physiotherapy centers.

  

Keywords: Low back pain, Breathing, Respiratory chemistry.

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Background and Aim: An immaculate review of the literature reveals some changes on the vertical ground reaction force (VGRF) in ACL deficient knee subjects. However, the details are not clear yet. The current study aimed to study these changes in the ACL-deficient and apparently healthy knees of the coper and non-coper ACL-deficient knee subjects in comparison with the normal knees.

Materials and Methods: Sixteen unilateral ACL-torn subjects included 8 copers and 8 non-copers were recruited in this quasi-experimental study and were compared with 16 normal knee subjects (8 subjects matched to each coper and non-coper groups). All subjects walked barefoot and with their preferred speed in a 6-meter walkway and placed their wanted foot on the platform of a Zebris pedobarograph tool. The patients were asked to place their injured and healthy feet separately on the platform. The control group placed their foot matched to the ACL-deficient legs on the platform. The testes were repeated so much to have five acceptable trials. The outcome measures included the peak F1Z, F2Z, F3Z of the vertical ground reaction force values and the times to reach these peak values as well as total stance time of the tested feet.

Results: The results showed only a significant lower F₁Z value in the non-coper ACL-deficient knee subjects (p=0.008). No significant changes were shown in the F₂Z, F₃Z or the times reach to F₁Z, F₂Z and F₃Z values (p>0.05). The stance time of the coper ACL-deficient knee subjects increased significantly in the non-coper ACL-deficeint knee subjects when compared to the coper and healthy knees (p=0.005).

Conclusion: The reduced F1Z of the vertical ground reaction force at initial contact as well as increased total stance time seen only in non-coper ACL-deficient knee subjects reveals inadequate compensatory mechanism in these patients as a counter force stress at initial contact and weight bearing. However, the coper ACL-deficient knee subjects compensated these forces with good strategies and walked very similar to the control group.

Keywords: Vercial ground reaction force (VGRF), Time to peak vertical ground reaction force components, Coper & non-coper ACL-deficient knee subjects, Pedobarography.

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Background and Aim: Transcranial Magnetic Stimulation is a novel technique for inhibition or excitation of brain cortical area. Dichotic listening test is a simple instrument to determine dominant ear and brain hemisphere for processing of verbal stimuli. This study aimed to determine changes in right ear advantage(REA), after applying inhibitory rTMS protocol on left Broca area.

 

Materials and Methods: In this descriptive - cross-sectional study, we compared the performances of 14 right handed normal adult Persian speakers with normal auditory and no history of psychiatric or neurological disorders. TMS was applied at 1 Hz with 90% motor threshold, for 10 minutes (600 pulses) on left Broca's area. The right ear advantage index was assessed pre and post rTMS using dichotic listening test.

  

Results: Finding of the present study showed no significant difference on right ear advantage index pre and post rTMS using paired t-test.

 

Conclusion: According to the findings of this study, it can be concluded that the use of inhibitory rTMS protocol on the left Broca area , has no effect for shifting in the right ear advantage. For interpretation of the results, it could be stated that it may be the protocol was used in this study isn't sufficient enough to inhibit left hemisphere for linguistic processing. Another reason could be the lack of sufficient sensitivity of Dichotic Listening test to show changes in hemisphere function after TMS. However, to provide clearer description, using functional brain imaging techniques and TMS together could be helpful.

 

Key words: Trancranial Magnetic Stimulation (TMS), Lateralization, REA, Linguistic processing, Dichotic listening

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Background and Aim: Residual refractive error is one of the most common complications of keratorefractive surgeries including laser assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). This study aimed to determine the incidence rate and risk factors for re - treatment following photorefractive keratectomy (PRK) in patients with myopia and myopic astigmatism.

  

Materials and Methods: A case control study was performed on the surgical records of all eyes that underwent PRK from May 2009 to May 2012 at Farabi Eye Hospital by one surgeon. During this period, 70 eyes with indication for retreatment (cases) and 158 control eyes were identified. All of the eyes included in the study had refraction data at least 9 months post-operatively. Student t, Man-Whitney U and chi-square tests were used for univariate analysis of presumed associations. All variables with a P value of < 0.2 on univariate tests were entered in a multiple logistic regression to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the risk factors of interest.

  

Results: Pre-op (pre-operative) manifests refraction spherical equivalent ≥-5.00 diopter, intended/nominal optical zone diameter of<6 mm and ocular fixational instability during surgery were associated with an increased risk of retreatment (all P values <0.001) and maintained their significance on multiple logistic regression with strong odd ratios of 6.12, 6.71 and 7.89 respectively. No statistically significant association was found between cases and controls in variables of age, sex, follow-up time, pre-op astigmatism, pre-op keratometry reading, pre-op pachymetry reading, pupil diameter and Kappa angle (all P values>0.05).

  

Conclusion: Small optical zone, deep ablation and unstable fixation during laser ablation are strong predictors for retreatment after photorefractive keratectomy.

  

Keywords: Re-treatment, Photorefractive keratectomy, Myopia, Myopic astigmatism

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Background and Aim: Anterior cruciate ligament (ACL) injury is common in sports competition and training. Following ACL rupture, neuromuscular system performance is disrupted. Perturbation training can improve the function of patients with ACL reconstruction. The aim of the present study was to assess the effects of perturbation training on ground reaction force and functional status of these patients .

  

Materials and Methods: Twenty patients with ACL reconstruction were randomly assigned into intervention (mean age: 24/2 ±3/4 years) and control (mean age: 27/1 ± 2/5 years) groups. The intervention group performed ten sessions perturbation training with rocker board, wobble board and Bosu. Peak vertical ground reaction force (GRF) and time to peak vertical GRF were recorded by KISTLER force plate during single leg landing from a 30cm height step. In addition, cross hop test also was evaluated as a functional test.

  

Results: Before perturbation training, both GRF and time to peak vertical GRF in reconstructed knee had not significant difference between two groups (P>0/05). In addition, functional test score had not significant difference between the groups (P=0/62). Following perturbation training, peak vertical GRF in reconstructed knee was greater than that in control groups (P<0/003).Although time to peak vertical GRF in reconstructed knee increased, there was not statistically significant difference between two groups (P=0/50). Furthermore, functional test score was statistically greater in intervention group (P=0/03).

  

Conclusion: This s tudy showed that perturbation training can improve functional status in patients with ACL reconstruction. In addition, force plate findings indicated that the patients tolerated more forces at longer time in single leg landing.

  

Key words: Perturbation training, Ground reaction force, ACL reconstruction, Function

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Background and Aim: Physical and cognitive performance changes such as impairment in balance and reaction time occur with aging. In according to some studies, these disorders may be delayed by systematic physical activities. This study aimed to investigate the effect of Pilates training on the improvement of balance and reaction time of sedentary adulthood men in Kermanshah city.

  

Materials and Methods: In this study, 40 sedentary adulthood men, aged (72.15±6.74), selected and divided into two equal groups randomly. These old men lived in Elderly centers in Kermanshah. In order to measure the participants’ balance and reaction time, static balance test stork, timed up and go test and reaction time system was used. Participants participated in a course of 8-week Pilates exercise program such as stretching movements in the muscular joints balance practicing of legs, standing on one foot and deep breathing. After assurance of normality using K-S test, independent t-test was used

  for data analysis.

  

Results : The results showed in comparison with control group, participation in Pilates protocol, could improve balance and reaction time in elderly men significantly (p<.0.05).

  

Conclusion: According to results of this study , Pilates training can improve balance and reaction time of the elderly . So to improve the cognitive and motor functions of the elderly , it can be recommended to participate in physical activities such as Pilates training .

  

Key Words: Pilates training, Elderly, Static balance, Dynamic balance, Reaction time

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Background and Aim: People with multiple sclerosis (MS) suffer from respiratory disorders during the course of their disease .To express disability, much of the interest was devoted to their mobility and less attention has been paid on physiological aspects such as respiration. The aim of this study was to compare some of the important indices of breathing patterns in healthy individuals and people with MS. Furthermore the correlation between duration of disease and disability scores (EDSS) with pulmonary indices were investigated.

Materials and Methods: In this descriptive analysis study, there were 32 people with MS and 32 healthy subjects. Both groups were matched and selected by some of the demographic characteristics. We investigated biochemical parameters that were assessed by measuring end-tidal CO₂ pressure, saturation of O₂ and respiratory rate using Capnograph. Student’s t-test was applied for independent samples. The relationships between duration of disease and EDSS with pulmonary indices were analyzed by Pearson’s correlation.

Results: The end-tidal CO₂ index had significant difference between the two groups and was lower in people with MS, whereas saturation of O₂ and respiratory rate did not have significant difference. There was a significant positive correlation among the disease duration and the disability scores, but was not associated with abnormal breathing pattern.

Conclusion: Existence of disorders in some parameters of  respiratory pattern in people with MS are revealed that survey of respiratory system in people with MS can be effective in the early diagnosis and treatment process of breathing problems in physiotherapy centers.

Keywords: Multiple sclerosis, Breathing pattern, Biochemical parameter, Respiratory dysfunction

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Background and Aim: Depression is one of the most important threats to psychological well-being of individuals in the 21^st century. Individuals experiencing depression will have unpleasant feelings of sadness and discouragement. This feeling stops individuals, especially students, to have the ability of experiencing fun and joyfulness in life. The aim of this study is to investigate the effect of short-term resistance exercises on occupational performance areas and depression severity in students of Isfahan University of Medical Sciences.

 

Materials and Methods: Convenience sampling was used in this study. Participants included 40 freshmen of medical sciences in experimental group and a matching group as control group (40 participants). The Beck Depression Inventory (second edition) and Canadian Occupational Performance Measurement were tested before and after implementing the designed protocols. Participants in experimental group performed resistance exercises 3 days a week, each session last 90 minutes over an 8-weeks period. SPSS version 20 was used for data analysis.

 

Results: The paired t test expressed that there are significant differences in performance (P<.001), satisfaction (P<.001) and depression (P<.001) regarding experimental group before and after intervention of the study. The independent t test suggests significant differences in performance (P<.001), satisfaction (P<.001) and depression (P<.001) among both groups after implementing exercise program.

 

Conclusion: Short-term resistance exercises can effectively reduce depression severity and improve performance and satisfaction among students of Isfahan University of Medical Sciences.

 

Keywords: Resistance exercises, Occupational performance areas, Depression, Students

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Background and Aim: The purpose of this study was to investigate the effects of sensory-motor integration on Balance and Reaction time in children with Developmental Coordination Disorder( DCD). Motor developmental coordination disorder (DCD) is a statement that the American Psychiatric Association was described for children who have difficulty in implementing some of the skills and competencies necessary to deal with the needs of the motor suffering their everyday lives, proposed locomotors.

Materials and Methods: This study was a semi-experimental study. Twenty patients (mean age, 8.5years old) were randomly divided into two groups of experimental and control groups from the DCD children rehabilitation center in Kermanshah. Continuous performance test, test improved stork and test walk heel to toe were used. After the pretest, the experimental group had a protocol for 8 weeks, three sessions per week of 120 minutes exercise (Swinging, jumping on Trampoline, baby turn around, turn around and coach children). To investigate the differences between the groups and the effect of exercise, ANOVA with repeated measures design with 2 × 2 (two with double measurement) were used. Post hoc t-test and t-test was used to analyze differences within groups and between groups.

Results: The results showed that the experimental group showed a significant improvement in reaction time, dynamic and static balance. There was a significant difference at post-test in experimental group due to the extent of the practice.

Conclusion: Improvement in balance is more likely due to the increased proprioception and stability. It is also likely to reduce the reaction time of integrated activities due to the pre-movement or speed up of the processing of perceptual or cognitive.

Keywords:  Sensory-motor integration, Balance , Reaction time, DCD