Enhancing Balance in Children with ID Using Figure 8 Beam

International Journal of All Research Education and Scientific Methods (IJARESM), ISSN: 2455-6211
Volume 9, Issue 10, October -2021, Impact Factor: 7.429, Available online at: www.ijaresm.com
Effect of Figure of Eight Balance Beam to Enhance the

Balance for Children with Intellectual Disability
Dr. M. Arun Kumar1, Mr. S. Saravanan2
1
Principal in Saveetha college of Occupational therapy, Saveetha Institute of Medical and Technical Sciences
(SIMATS), Saveetha Nagar Thandalam, Chennai, Tamil Nadu, India
2
Final year Student of Saveetha college of Occupational therapy, Saveetha Institute of Medical and Technical Sciences
(SIMATS), Saveetha Nagar Thandalam, Chennai, Tamil Nadu, India
-------------------------------------------------------------------*****************--------------------------------------------------------------
ABSTRACT
The present study is to determine the effects of Figure of eight balance beam to enhance the balance training for
children with Intellectual Disability. The participants of this study were children with intellectual disability aged
6-8 yrs. There were 30 children in total (male-16, female-14) and they were put into two groups in experimental
group and control group with 15 participants in each group. All children were assessed using pediatrics balance
scale for pretest and posttest scores. The participants in the experimental group received balance training using
the figure of eight balance beam for 40 mins in each session (3 sessions per week) for about three months. They
underwent training for about 36 sessions in total. Meanwhile the participants in the control group received their
occupational therapy for the same duration. Statistical analysis was done using wilcoxon signed rank test to find
the significant difference between Pretest and post test scores. The results indicated that experimental group
showed statistically significant improvement to enhance balance with the use of figure of eight balance beam
training when compared to the control group and it is concluded that Figure of eight balance beam has proved
its effect in enhancing balance among children with intellectual disability.
Keywords: Intellectual Disability, Balance, Figure of eight balance beam.
INTRODUCTION
Intellectual Disability is a term that describes the behavior of an extremely diverse group of people. They range from
children with severe developmental disabilities who need constant care to you with only mild delays who are usually
indistinguishable from their peers. These children also have diverse outcomes. All individuals with ID have
significantly low intellectual functioning and it includes difficulties in Perceiving and processing new information,
learning quickly and efficiently, Applying Knowledge and skills to solve problems, Thinking Creatively and Flexibly
Responding rapidly and accurately. Individuals with ID also show significant deficits in Adaptive Functioning. The
Diagnostic and Statistical Manual of Mental Disorders (DSM – 5; American Psychiatric Association 2013) identifies
three domains of adaptive functioning; Conceptual, Social, and Practical. To be diagnosed with ID, individuals must
show impairment in at least one domain. Intellectual disability is thought to affect about 1% of the population. Of those
affected, 85% have mild intellectual disability. The prevalence of intellectual disability has been estimated at 1-4% i.e.,
about 20 people per 1000 in the population. The reported prevalence of intellectual disability is 1% globally and vary
from 1% to 3% by country, with a male to female ratio of 2:1.
Many studies show that young people with intellectual disabilities tend to be characterized by a significantly lower
balance or postural control than typically developing peers. It is also suggested that Children with intellectual
disabilities (IDs) are an identified group with postural disturbances resulting from a lack of integration among the
visual, vestibular and proprioceptive systems. The insufficient level of maturity of the sensory systems is at least partly
responsible for disturbances in maintaining body balance. More sway can increase the risk of falls and body injuries. In
persons with intellectual disabilities (ID) or deviation of the CNS limits the motor development, including balance
skills.
Balance is the ability to maintain a controlled body position during task performance, whether it is lifting at a table,
walking the balance beam, etc. To function effectively across environment and tasks we need the ability to maintain
controlled positions during both static (still) and dynamic (moving) activities.
Static balance is the ability to hold a stationary position with control. Attractive and colorful figure 8 balance beam is a
great tool for teaching early balance skills. Sections of the beam slide and lock together to create a beam that is over 8ft
long and 4ft wide! Each section of the beam is about 4ft long and width of 4 ft. and features a stable 2" height textured
IJARESM Publication, India >>>> www.ijaresm.com Page 147

top surface. These balance beams can be made of different materials according to the cost and convenient. The figure of
eight balance used here is especially made up of play wood and is covered by polyethylene sheet which makes it
durable.
Aim of the study

To determine the effect of Figure of eight balance beam to enhance the balance for children with Intellectual Disability.
Objectives of the study

 To find out the effect of conventional Occupational therapy program in control group.
 To find out the effect of figure of eight balance beam in experimental group.
 To compare the effect of figure of eight balance beam with conventional Occupational therapy program by
using pediatric balance scale.
Research Hypothesis
There is a significant difference between the pre-test and post-test scores of the participants in experimental group.
Selection criteria
Inclusion criteria
 Children diagnosed with Mild Intellectual Disability
(Adaptive Functioning Scores 55 – 70)
 Children age from 6 to 8 years. Both males and
females are included.
 Children who have difficulty in walking and those
who have poor balance.
 Children ability to sit independently.
Exclusion criteria
 Children diagnosed with Moderate (Adaptive Functioning Scores 40 – 55) and Severe (Adaptive
Functioning Scores 35 – 40) Intellectual Disability.
 Children diagnosed with Developmental Delay, Visual impairment, Hearing impairment, are excluded.
 Children age below 6 and above 8 years is excluded.
 Children with Pediatric balance scoring below 20 are excluded.
Materials used
 Figure of eight balance beam, Pediatric balance scale.
 Patients consent form
Duration of the study

 The duration of the study was 3 months.
 45 mins per session, 3 days a week.
 36 sessions.
Procedure
Thirty children aged between 6 to 8 yrs. who were already diagnosed as mild intellectual disability participated in this
study to enhance their balance skills. The pretest assessment for balance level for all the children was assessed using
Pediatric Balance scale. After the completion of pretest assessment which includes first two sessions of the study, the
participants were divided into two groups with 15 participants in each as Experimental and control groups which
included 8 male and 7 female children in both the groups. Experimental group underwent balance training in the figure
of eight balance beam whereas the Control group attended occupational therapy sessions for 32 sessions. After the
completion of the intervention sessions (32 sessions), the Pediatric Balance scale was used to assess the posttest scores
in both the experimental and the control group to find out the effect of figure of eight balance beam to enhance balance
for children with intellectual disability.
Procedure (Intervention Protocol)

The content of the figure of eight balance beam training program: This intervention program consisted of three
components.
 Warming up phase: In this phase, five minutes of walk and stretching exercises were applied. (To
Gastrocnemius, Hamstrings, hip adductor muscles, three repeated stretching).

 Balance training phase: In this phase balance training in the figure of eight balance beam were repeatedly
performed for 8-10 times for 30 minutes.
 Cooling Phase: In this phase, the same stretching exercises in the warming up period with relaxation were
applied. (five minutes)
Balance Training:
The Experimental group participated in the figure of eight balance beam training program for 30 sessions at the
frequency of 3 times per week, in addition to participating in the occupational therapy services. Training was performed
for 30 minutes in each session.
Activities included were:

 Activities were graded up according to the abilities of the children based on
 Forward walking.
 Backward walking.
 Walking with objects
 Walking with bending activities which includes taking object form the floor
 Walking with object manipulation with simple play (throwing and catching while walking on the beam).
The exercises were made difficult with the addition of extremities and increasing the activities ranging from simple to
complex and body movements. As the training period advanced, challenging activities have incorporated for the further
improvement.
Control Group:
The control group followed only occupational therapy program at the special school which also focused on their
balance training using different conventional techniques and approaches for three times per week for 12 weeks. Balance
training were provided with the recreational activities for standing and sitting balance and also for performing their
ADLs.
Occupational therapy training to enhance balance in control group includes:

 Perceptual exercises
 Task-Task-oriented interventions
 specific reaching training
 Visual feedback training
 Balance biofeedback training
 Multisensorial Training
DATA ANALYSIS AND RESULT
Table No: 1 Statistical Analysis for pretest and posttest in control group
Test N Mean Std. Dev. Z value p value
Pre- test 29.8667 4.29063

15
-3.529 0.000*
Post-test 32.2 4.03909

15
Since the p value of 0.000 is less than 0.05, alternate hypothesis is accepted. Hence, there is statistically Slight
significant difference in control group between pre-test and post test scores of Paediatric Balance scale.

Figure No: 1Comparison between pre-test and post-test of the control group
Table No: 2 Statistical Analysis for pretest and posttest in experimental group.
Test N Mean Std. Dev. Z value p value
Pre- test 15 32.8 5.15752

-3.413 0.0001*
Post-test 15 47.0667 2.78944
In the Experimental group, since the p value of 0.0001 is less than 0.05, alternate hypothesis is accepted. Hence, there
is statistically Highly significant difference in Experimental Group between pre-test and post test scores of Pediatric
Balance scale.
Figure No: 2Comparison between pre-test and post-test of the experimental group
Difference between Experimental and Control Group
Mann Whitney U test was performed to find the significant difference between Experimental and Control Group. 5%
level of significance was observed.
Table No: 3 Statistical Analysis between post test scores of experimental and control groups
Post test N Mean Std. Dev. Z value p value
Control 15 32.2 4.03909

4.6455 0.0000*
Expt 15 47.0667 2.78944

Since the p value of 0.0000 is lesser than 0.05, alternate hypothesis is accepted. Hence, there is statistically highly
significant difference in post test scores between Experimental and Control Group of the Pediatric Balance scale.
This suggests that the intervention received by the experiment group was more effective than the intervention received
by the control group.
Figure No: 3Comparison between post-test of the control and experimental group
DISCUSSION
The main purpose of this study was to determine the effect of figure of eight balance beam to enhance balance for
children with ID. The results of this study revealed significant increases in balance levels for participants with ID after
participation in a training program that included balance training in the figure of eight balance beam. In our study, the
distribution of the assessment scores for both groups was similar, and there were no significant differences between the
groups. The subjects were able to demonstrate improvement in their balance level by performance figure of eight
balance beam training.
The children in the control group attended the special school which mainly focused on their occupational therapy
interventions along with their academic performance. The table number 1 and Figure number 1(P = 0.000*, Z = -3.529)
presented a slight significant difference between pretest and posttest scores in control group.
The data presented in the table number 2 and Figure number 2 (P = 0.0001*,Z = -3.413) revealed highly significant
difference between pretest and posttest values in experimental group, which proved the effect of figure of eight balance
beam in enhancing balance in children with ID.
This study was designed to compare the effect of figure of eight balance beam training with the conventional
occupational therapy to enhance balance for children with ID who are attending special school. The data presented in
the table and figure number 3 (P = 0.0001*, Z = -3.413) revealed highly significant differences between posttest scores
of controls and experimental. The study findings show that the training in the figure of eight balance beam was much
effective than the conventional occupational therapy interventions to enhance balance for children with ID.
CONCLUSION
Based on the analysis of the obtained results, concluded that the training in the Figure of Eight balance beam proved
effective in enhancing the balance for children with intellectual disabilities. This figure of eight balance beam
intervention also successfully have shown improvement in static and dynamic balance, and also improved the attention
and concentration skills for children with ID as referred by their parents.
Limitations
 The study was conducted in a small size population.
 This study was done only for children with ID (aged 6-8 Years)
Recommendations
 Future studies are recommended by comparison or by using different types of balance beam in enhancing
balance for children with ID.

 This study can be carried out for other conditions and population and for different aged groups.
 This study can be performed with a larger sample size.
Source of Funding: Self.

Conflicting Interest: None
Ethics Clearance: Approval from Institution Scientific Review Board (ISRB) was obtained prior to the study.
REFERENCES
[1] Admin, K. S. W. (2016, November 27). Balance & Coordination.Kid Sense Child
Development.https://childdevelopment.com.au/areas-of-concern/gross-motor-skills/balance-coordination/
[2] Ahmadi, R., Hasan, D., Hosin, B. A. (2012) The effect of 6 weeks core stabilization training program on the
dynamic balance of mentally retarded and health. jsmt. 2012; 10 (3) :77-87URL: http://jsmt.khu.ac.ir/article-1-
95-en.html
[3] Araújo, P. A. D., Starling, J. M. P., Oliveira, V. C., Gontijo, A. P. B., & Mancini, M. C. (2020). Combining
balance-training interventions with other active interventions may enhance effects on postural control in children
and adolescents with cerebral palsy: a systematic review and meta-analysis. Brazilian Journal of Physical
Therapy, 24(4), 295–305. https://doi.org/10.1016/j.bjpt.2019.04.005
[4] Beck, C. (2019, July 11). Snowflake Balance Winter Gross Motor Indoor Play Therapy Idea.The OT
Toolbox.Htt ps://www.theottoolbox.com/snowflake-balance-winter-gross-motor
[5] Drysdale, J., Casey, J., & Porter-Armstrong, A. (2008). Effectiveness of training on the community skills of
children with intellectual disabi0lities. Scandinavian Journal of Occupational Therapy, 15(4), 247–255.
https://doi.org/10.1080/11038120802456136
[6] DSM-5 Fact Sheets - Intellectual disability. (n.d.).Web Starter Kit. Retrieved June 23, 2021, from
https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/dsm-5-fact-sheets
[7] Fong, S. S., Guo, X., Cheng, Y. T., Liu, K. P., Tsang, W. W., Yam, T. T., Chung, L. M., & Macfarlane, D. J.
(2016). A Novel Balance Training Program for Children With Developmental Coordination Disorder. Medicine,
95(16), e3492.https://doi.org/10.1097/md.0000000000003492
[8] Fong, S., Guo, X., Liu, K. et al. Task-Specific Balance Training Improves the Sensory Organisation of Balance
Control in Children with Developmental Coordination Disorder: A Randomised Controlled Trial. Sci
Rep 6, 20945 (2016).https://doi.org/10.1038/srep20945
[9] Fotiadou, E. G., Neofotistou, K. H., Giagazoglou, P. F., &Tsimaras, V. K. (2017). The Effect of a Psychomotor
Education Program on the Static Balance of Children with Intellectual Disability. Journal of Strength and
Conditioning Research, 31(6), 1702–1708. https://doi.org/10.1519/jsc.0000000000001612
[10] Fotiadou, E. G., Neofotistou, K. H., Sidiropoulou, M. P., Tsimaras, V. K., Mandroukas, A. K., &Angelopoulou,
N. A. (2009). The Effect of a Rhythmic Gymnastics Program on the Dynamic Balance Ability of Individuals
with Intellectual Disability.Journal of Strength and Conditioning Research, 23(7), 2102–
2106.https://doi.org/10.1519/jsc.0b013e3181b8d3b5
[11] Giagazoglou, P., Arabatzi, F., Dipla, K., Liga, M., &Kellis, E. (2012). Effect of a hippotherapy intervention
program on static balance and strength in adolescents with intellectual disabilities.Research in Developmental
Disabilities, 33(6), 2265–2270.https://doi.org/10.1016/j.ridd.2012.07.004
[12] Giagazoglou, P., Kokaridas, D., Sidiropoulou, M., Patsiaouras, A., Karra, C., &Neofotistou, K. (2013). Effects
of a trampoline exercise intervention on motor performance and balance ability of children with intellectual
disabilities. Research in Developmental Disabilities, 34(9), 2701–
2707.https://doi.org/10.1016/j.ridd.2013.05.034
[13] Gorla, José & Costa e Silva, Anselmo& Costa, Leonardo &Araújo, Paulo. (2010). Performance of balance beam
task of K.T.K. by people with intellectual disability.MOVIMENTO e
PERCEPÇÃO.https://www.researchgate.net/publication/46391926
[14] Hayakawa, K., & Kobayashi, K. (2011). Physical and Motor Skill Training for Children with Intellectual
Disabilities. Perceptual and Motor Skills, 112(2), 573–580. https://doi.org/10.2466/06.13.15.pms.112.2.573-580
[15] Jankowicz-Szymanska, A., Mikolajczyk, E., &Wojtanowski, W. (2012). The effect of physical training on static
balance in young people with intellectual disability. Research in Developmental Disabilities, 33(2), 675–681.
https://doi.org/10.1016/j.ridd.2011.11.015
[16] McDermott, A., Bitensky, N. K., Foley, N., Speechley, M., Salbach, N. M., Yakov, M. B., &Teasell, R. (2012,
June 9). Balance Training – Strokengine.Strokengine.https://strokengine.ca/en/interventions/balance-training/
[17] Meera, R., Chakravarthi, V., Arunachalam, R., Sujatha, B., & Abraham, M. M. (2018). Effectiveness of
Modified Trunk Dissociation Retrainer in Improving Gait and Balance in Developmental Delay.Research
Journal of Pharmacy and Technology, 11(11), 4870.https://doi.org/10.5958/0974-360x.2018.00886.7

[18] Sipp, A. R., Gwin, J. T., Makeig, S., & Ferris, D. P. (2013). Loss of balance during balance beam walking elicits
a multifocal theta band electrocortical response. Journal of Neurophysiology, 110(9), 2050–2060.
https://doi.org/10.1152/jn.00744.2012
[19] Tsimaras, V. K., Giamouridou, G. A., Kokaridas, D. G., Sidiropoulou, M. P., &Patsiaouras, A. I. (2012). The
Effect of a Traditional Dance Training Program on Dynamic Balance of Individuals with Mental Retardation.
Journal of Strength and Conditioning Research, 26(1), 192–198. https://doi.org/10.1519/jsc.0b013e31821c2494
[20] Udiaver, D. (2020). The effect of balance and coordination rehabilitation exercises, on serving skills of students
with special needs, undergoing vocational training in hospitality and catering department: A prospective one-arm
interventional study. The Indian Journal of Occupational Therapy, 52(2), 37.
https://doi.org/10.4103/ijoth.ijoth_9_20

Enhancing Balance in Children with ID Using Figure 8 Beam

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International Journal of All Research Education and Scientific Methods (IJARESM), ISSN: 2455-6211

Effect of Figure of Eight Balance Beam to Enhance the

Keywords: Intellectual Disability, Balance, Figure of eight balance beam.

IJARESM Publication, India >>>> www.ijaresm.com Page 147

Aim of the study

Objectives of the study

Duration of the study

Procedure (Intervention Protocol)

IJARESM Publication, India >>>> www.ijaresm.com Page 148

Activities included were:

Occupational therapy training to enhance balance in control group includes:

DATA ANALYSIS AND RESULT

Test N Mean Std. Dev. Z value p value

Pre- test 29.8667 4.29063

Post-test 32.2 4.03909

IJARESM Publication, India >>>> www.ijaresm.com Page 149

Test N Mean Std. Dev. Z value p value

Pre- test 15 32.8 5.15752

Post test N Mean Std. Dev. Z value p value

Control 15 32.2 4.03909

IJARESM Publication, India >>>> www.ijaresm.com Page 150

IJARESM Publication, India >>>> www.ijaresm.com Page 151

Source of Funding: Self.

IJARESM Publication, India >>>> www.ijaresm.com Page 152

IJARESM Publication, India >>>> www.ijaresm.com Page 153

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