Movement-based interventions for preschool-age children with, or at risk of, motor impairment: a systematic review.

Movement-based therapies, things like structured exercise, motor training, or physical activity programmes, are often used with young children who have or are at risk of motor impairment, including cerebral palsy, autism spectrum disorder, and developmental coordination disorder. This review asked whether such interventions actually improve motor skills in preschoolers, pulling together seventeen randomized or quasi-randomized trials across these different diagnoses and intervention types. The broad answer was disappointing but important: most studies found no statistically significant improvement, whether looking at underlying body structure and function or at children's ability to perform activities. None of the included studies even measured participation, meaning how children actually engage in everyday life and community activities.

The authors note some potential for benefit exists, but small sample sizes, inconsistent study quality, and risk of bias across the studies mean the current evidence simply cannot confirm whether these interventions work for this age group.

If you're a parent of a preschooler with, or at risk of, a motor difficulty, you may have come across programmes involving structured movement, exercise, or physical activity meant to help build motor skills. This review looked at whether the science actually backs this up, pulling together seventeen studies of children with conditions like cerebral palsy, autism spectrum disorder, or developmental coordination disorder. The honest finding is that most of these studies did not show a clear improvement, whether researchers were looking at physical abilities like strength and coordination, or at how well children could perform everyday activities.

No study looked at whether these programmes helped children participate more fully in daily life, play, or community activities, which is a notable gap. This doesn't mean movement-based approaches don't help; it means the research so far is too limited and too variable in quality to say either way. Studies were often small, and there were concerns about how rigorously some were conducted, which limits how much confidence can be placed in the results.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This systematic review synthesized seventeen randomized or quasi-randomized controlled trials evaluating movement-based interventions for preschool-age children with, or at risk of, motor impairment across heterogeneous diagnostic groups (cerebral palsy, autism spectrum disorder, developmental coordination disorder). Outcomes were mapped to the International Classification of Functioning, Disability and Health: Children and Youth version domains, with quality appraised via the PEDro scale and risk of bias via the Cochrane tool; effect sizes were calculated using Cohen's d. Across the body structure and function and activity domains, the majority of included studies reported no statistically significant between-group differences, despite some effect sizes suggesting potential benefit.

Notably, no study incorporated a participation-level outcome measure, leaving a substantial gap in understanding real-world functional impact. Marked heterogeneity in intervention type, population, and outcome measures, combined with small sample sizes and variable methodological quality and risk of bias, substantially limits confidence in pooled interpretation. The review's conclusion is that current evidence is inconclusive rather than negative, underscoring a need for more rigorous, adequately powered trials with participation-focused outcomes before firmer clinical inferences can be drawn.