***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Impaired motor development can significantly affect a child 's life and may result in an increased risk of a range of physical and psychological disorders . Active video game ( AVG ) interventions have been demonstrated to enhance motor skills in children with Developmental Coordination Disorder ( DCD ) ; however a home-based intervention has not been assessed . OBJECTIVES The primary aim of this study was to compare the changes in motor coordination between a 16 week period of AVG use , with 16 weeks of normal activities ( NAG ) . The secondary aim was to compare the child and parent perceptions of their physical performance between the AVG and NAG conditions . METHODS Twenty-one 9 - 12 year olds ( 10 males ) were confirmed to be at risk of DCD ( ⩽ 16th percentile Movement Assessment Battery for Children-2nd edition ( MABC-2 ) and ⩽ 15th percentile Developmental Coordination Disorder Question naire ( DCDQ ) ) and participated in this crossover r and omised and controlled trial . Data was collected at study entry , after the first 16 week condition and following the final 16 week condition , including ; ( 1 ) the MABC-2 , ( 2 ) three-dimensional motion analysis of single leg balance and finger-nose tasks , and ( 3 ) parent perception of physical skills . Participant perception of physical skills was collected only after the first and second conditions . RESULTS There was no significant difference between AVG and NAG for any of the primary variables including the MABC-2 , balance centre-of-mass path distance and finger-nose path distance . There was no significant intervention effect for secondary measures of motor coordination ; however the children perceived their motor skills to be significantly enhanced as a result of the AVG intervention in comparison to the period of no intervention . CONCLUSION A 16 week home based AVG intervention did not enhance motor skills in children with DCD , although they perceived their physical skills to be significantly improved . TRIAL REGISTRATION Australia and New Zeal and Clinical trials Registry ( ACTRN 12611000400965 ) BACKGROUND Little is known about the influence of practice schedules on motor learning and skills transfer in children with and without developmental coordination disorder ( DCD ) . Underst and ing how practice schedules affect motor learning is necessary for motor skills development and rehabilitation . AIMS The study investigated whether active video games ( exergames ) training delivered under variable practice led to better learning and transfer than repetitive practice . METHODS AND PROCEDURES 111 children aged 6 - 10 years ( M=8.0 , SD=1.0 ) with no active exergaming experience were r and omized to receive exergames training delivered under variable ( Variable Game Group ( VGG ) , n=56 ) or repetitive practice schedule ( Repetitive Game Group ( RGG ) , n=55 ) . Half the participants were identified as DCD using the DSM-5 criteria , while the rest were typically developing ( TD ) , age-matched children . Both groups participated in two 20min sessions per week for 5 weeks . OUTCOMES AND RESULTS Both participant groups ( TD and DCD ) improved equally well on game performance . There was no significant difference in positive transfer to balance tasks between practice schedules ( Repetitive and Variable ) and participant groups ( TD and DCD ) . CONCLUSIONS AND IMPLICATION S Children with and without DCD learn balance skills quite well when exposed to exergames . Gains in learning and transfer are similar regardless of the form of practice schedule employed . WHAT THIS PAPER ADDS This is the first paper to compare the effect of practice schedules on learning in children with DCD and those with typical development . No differences in motor learning were found between repetitive and variable practice schedules . When children with and without DCD spend the same amount of time on exergames , they do not show any differences in acquisition of motor skills . Transfer of motor skills is similar in children with and without DCD regardless of differences in practice schedules Background Adolescents with low motor competence participate less in physical activity and tend to exhibit decreased physical fitness compared to their peers with high motor competence . It is therefore essential to identify new methods of enhancing physical fitness in this population . Active video games ( AVG ) have been shown to improve motor performance , yet investigations of its impact on physical fitness are limited . The objective of this study was to examine the impact of the grade d Wii protocol in adolescent girls with probable Developmental Coordination Disorder ( p-DCD ) . Methods A single-group pre-post design was conducted to assess the impact of a newly developed Wii protocol in adolescent girls attending school in a low income community of Cape Town , South Africa . Sixteen participants ( aged 13 - 16 years ) with p-DCD ( ≤16th percentile on the MABC-2 test ) were recruited . Participants received 45 min Wii training for 14 weeks . Outcome measures included the six-minute walk distance and repeated sprint ability . Information on heart rate , enjoyment and perceived exertion ratings were also collected . Results Significant improvements in aerobic and anaerobic fitness were observed . The participants reported high enjoyment scores and low perceived exertion ratings . The grade d Wii protocol was easily adaptable and required little re sources ( space , equipment and expertise ) to administer . Conclusions The findings provide preliminary evidence to support the use of the grade d Wii protocol for promoting physical fitness in adolescent girls with p-DCD . Further studies are needed to confirm these results and to vali date the clinical efficacy of the protocol in a larger sample with a more robust design The purpose of this study was to investigate the effects of training with the Wii-balance board on balance and balance-related skills of children with poor motor performance . Twenty-nine children ( 23 boys , 6 girls ; aged 7 - 12 years ) participated in this study and were r and omly assigned to an experimental and control group . All children scored below the 16th percentile on a st and ardized test of motor ability and balance skills ( Movement Assessment Battery for children ( M-ABC-2 ) ) . Before and after a six-week Wii-intervention ( M=8h , 22 min , SD=53 min ) , the balance skills of the experimental group and control group were measured with the  M-ABC-2  and the  Bruininks-Oseretsky test of motor proficiency ( BOT-2  ) . Both groups improved on all tests . The M-ABC-2 and the BOT-2 total balance-scores of the experimental group improved significantly from pre to post intervention , whereas those of the control group showed no significant progress . This result ed in significant interaction-effects , favoring the experimental children . No transfer-effects of the intervention on balance-related skills were demonstrated . Our findings showed that the Wii-balance board is an effective intervention for children with poor balance control . Further development and investigation of the intervention could be directed toward the implementation of the newly acquired balance-skills in daily life Objective Transfer of motor skills is the ultimate goal of motor training in rehabilitation practice . In children with Developmental Coordination Disorder ( DCD ) , very little is known about how skills are transferred from training situations to real life context s. In this study we examined the influence of two types of practice on transfer of motor skills acquired in a virtual reality ( VR ) environment . Method One hundred and eleven children with DCD and their typically developing ( TD ) peers , aged 6–10 years ( M = 8.0 SD = 1.0 ) were r and omly assigned to either variable ( n = 56 ) or repetitive practice ( n = 55 ) . Participants in the repetitive practice played the same exergame ( ski slalom ) twice weekly for 20 minutes , over a period of 5 weeks , while those in the variable group played 10 different games .  Motor skills such as balance tasks ( hopping ) , running and agility tasks , ball skills and functional activities were evaluated before and after 5 weeks of training . Results ANOVA repeated measures indicated that both DCD and TD children demonstrated transfer effects to real life skills with identical and non-identical elements at exactly the same rate , irrespective of the type of practice they were assigned to . Conclusion Based on these findings , we conclude that motor skills acquired in the VR environment , transfers to real world context s in similar proportions for both TD and DCD children . The type of practice adopted does not seem to influence children ’s ability to transfer skills acquired in an exergame to life situations but the number of identical elements does Neuromotor Task Training ( NTT ) and Nintendo Wii Fit Training ( Wii training ) are both task-based interventions used to improve performance in children with motor coordination problems . The aim of this study was to compare the efficacy of these two interventions on the motor performance , isometric strength and cardiorespiratory fitness ( aerobic and anaerobic capacity ) of children with Developmental Coordination Disorder ( DCD ) attending mainstream schools in a low-income setting . A pragmatic , quasi-experimental study design was utilized . Children between the ages of 6 - 10 years , who scored at or below the 16th percentile on the Movement Assessment Battery for Children-2 ( MABC-2 ) and whose teacher reported a functional motor problem , were allocated to either NTT  ( n=37 ) or  Wii training ( n=19 ) groups depending on school of attendance . The MABC-2 , a h and -held dynamometer , the Functional Strength Measure , the Muscle Power Sprint Test and the 20 m Shuttle Run Test were used to assess performance at baseline and after the intervention . The main findings show that the mean motor performance scores of both groups improved over the study period . However , significant differences in improvement were detected between groups , with the NTT group showing greater improvement in motor performance , functional strength and cardiorespiratory fitness . No improvements in isometric strength were seen in either group . The Wii training group showed significant improvement in anaerobic performance . This study provides evidence to support the use of both the Wii Training and NTT for children with DCD . However , in comparison to Wii training , the NTT approach yields superior results across measures of motor proficiency , cardiorespiratory fitness and functional strength . The decision to use either approach may be influenced by re sources and time constraints OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity OBJECTIVES Physical and occupational therapists have started to use the Nintendo Wii ™ gaming system with adults and children as part of their regular treatment . Despite the growing use of the Wii and trend towards evidence -based practice , limited evidence is available on the effectiveness of virtual reality using the Wii for children with developmental delay . The purpose of this study was to determine the feasibility and preliminary effectiveness of a low-cost gaming system for young children with developmental delay . STUDY DESIGN Single-blind , r and omised controlled trial . PARTICIPANTS AND SETTING Forty children with developmental delay ( age 39 to 58 months ) who attended a segregated or integrated preschool participated in this study . All children 's parents read and signed an informed consent form approved by the institutional review board . Children were assigned at r and om to an experimental ( Wii ) group ( n=20 ) or a control group ( n=20 ) . INTERVENTION Two weekly sessions for 10 weeks using Nintendo Wii Sports ™ and Nintendo Wii Fit ™ , including balance , strength training and aerobics games . MAIN OUTCOME MEASURES Participants were evaluated 1 week before and 1 week after the programme by a blinded investigator . Primary outcomes were gait speed , timed up and go test , single leg stance test , five-times-sit-to-st and test , timed up and down stairs test , 2-minute walk test and grip strength . The Gross Motor Function Measure ( GMFM ) was used to assess gross motor skills . RESULTS The two groups were homogenous regarding all parameters at baseline . The Wii training was feasible and enjoyable for those in the experimental group . There were no adverse effects or injuries reported over 267 training sessions . Comparison of groups following the intervention indicated that the experimental group showed significant improvements compared with the control group in single leg stance test { mean difference 1.03 [ st and ard deviation ( SD ) 1.7 ] , 95 % confidence interval ( CI ) 0.2 to 1.9 ; P= 
    Output:
    
Mixed effects of video game intervention on outcome were found , with conflicting evidence across studies .
Studies that reported on feasibility found most children enjoyed and adhered to the video game interventions .