Postural Control Outcomes Following Taekwondo and Videogame Activities in Youth with Autism Spectrum Disorder

Background: Individuals with autism spectrum disorder (ASD) demonstrate underdevelopment of postural control. Taekwondo (structured group exercise) and Nintendo Wii (game-based individual activities) are two different methods that have been shown to improve postural control for both people with and without disabilities. In addition, these activities have shown positive outcomes on postural control in children with neurological disorders who display similar postural control impairments as children with ASD. However, there is a lack of studies on the effects of TKD and Wii activities on postural control in individuals with ASD.

Objectives: To compare postural control changes following participation in TKD or Wii activities in youth with ASD.

Methods: Eight (: 10.25 years old, 8 males) and five (: 11.2 years old, 4 males and 1 female) youth with ASD participated in an 8-week TKD training or Wii activities program, respectively. Each group participated in 40-minute sessions twice a week. TKD sessions were composed of punching, kicking, and forms. Wii activities program participants played games of their choice (Wii-Fit, Just Dance, & Just Dance for Kids). Postural control was measured using a forceplate (NeuroCom Balance Manager) during static (double-leg stance & unilateral stance) and dynamic (step-n-turn & sit-to-stand) activities. Center of gravity (COG) sway velocity and time were measured to examine postural control ability. Double-leg stance was measured on a firm and a compliant surface during eyes open and closed conditions. Unilateral stance was measured on both the right and left during eyes open and closed conditions. Step-n-turn was assessed to the right and left. All assessments were taken immediately before and after TKD training and Wii activities program.

Results: A mixed model analysis of variance was used to assess the overall group interaction (TKD vs. Wii activities) and across time (pre- vs. post- results). A number of assessments revealed significant improvements across time; however, there was no significant difference between the two activities in all postural control measurements. There were significant improvements in three conditions of double-leg stance (ps<0.05) and all conditions of unilateral stance (ps<0.05). No significant difference was found in double leg stance on a firm surface during eyes closed condition (p=0.055). Dynamic measurements show significant results in right-step turn time (F=6.31, p<0.05); however, no significance were found in time during sit-to-stand and left-step turn.

Conclusions: The findings indicate that both TKD and Wii activities improved postural control in youth with ASD. TKD training and Wii activities may be effective methods to improve postural control in youth with ASD. Participants with greater deficits in postural control showed more improvements with visible reduction of postural sway following the interventions. This suggests that future study is needed to examine the effects of TKD training and Wii activities in relation to severity of individual’s postural control deficit. Also, a further study should investigate the effects of TKD training and Wii activities on postural control in a larger sample size and an extended intervention length.