Impact of Virtual reality training on executive functions and cognitive Dominance in children with developmental coordination disorder: A quasi-experimental study

Impact of Virtual reality training on executive functions and cognitive Dominance in children with developmental coordination disorder: A quasi-experimental study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Impact of Virtual reality training on executive functions and cognitive Dominance in children with developmental coordination disorder: A quasi-experimental study ayoub hashemi, Mohammad Hossein Zamani, Shahnaz Shahrbanian, Abouzar saadatian This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4172275/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 16 Mar, 2025 Read the published version in Sport Sciences for Health → Version 1 posted 9 You are reading this latest preprint version Abstract Executive functions are basic for essential for regulating, monitoring, and controlling behavior in daily life. This study aimed to investigate the effects of virtual reality training on executive functions and cognitive dominance in children with developmental coordination disorder. The show think about was a quasi-experimental pre-post intervention design. The sample population of the study included 40 boys aged 6 to 9 years with DCD and were randomly divided into experimental (n = 20) and control (n = 20) groups. Developmental Coordination Disorder Questionnaire (DCDQ7), Raven Intelligence Test, Conner's child behavior rating scale, and Wechsler Intelligence Test (WISC-IV) were used to diagnose DCD children and evaluated variables study. the experimental group performed virtual reality training (Xbox Kinect 360) for 8 weeks (2 sessions per week and 30 minutes per session). Analysis of covariance with a 95% confidence level was used to analyze the data. The comes about appeared that virtual reality training had a significant impact on executive functions (F = 110.73, P = 0.001, Eta = 0.92) and cognitive dominance (F = 222.89, P = 0.001, Eta = 0.89) Children with DCD. The results of the present study provide further support for the potential of incorporating virtual reality training into an application environment, in a way that children enjoy while enhancing cognitive abilities virtual environment Active video games processing speed working memory intelligence problem-solving Introduction Developmental Coordination Disorder (DCD) could be a characteristic of children who, without any cognitive or neurological problems, face problems in the fields of learning, growth, and motor control, and show unbalanced and incompetent motor behavior when performing a motor activity appropriate for their age ( 1 , 2 ). Coordination shortfalls essentially meddled with daily life, scholastic efficiency, and relaxation time ( 3 , 4 ). The prevalence of DCD in school-aged children is reported to be 5–6%, and According to this report, boys are 3 to 7 times more likely to have DCD than girls ( 2 , 3 ). The predominance rate of this disorder in Iran is additionally detailed as 2.7% ( 5 , 6 ). Children with or at risk of DCD have problems with fine and gross motor skills ( 2 , 7 , 8 ). Deficits in motor skills are associated with impairments in reading, writing, and math tasks ( 7 , 9 , 10 ) and in fundamental cognitive capacities, such as inhibitory control, working memory, and planning in children with DCD ( 11 , 12 ) and at risk for DCD (Alesi et al., 2019; Houwen, van der Veer, Visser, & Cantell, 2017). The results of studies indicate that DCD disorder affects executive functions ( 1 , 5 , 11 , 12 ). Executive functions are fundamental to control, screen, and control behavior toward an objective for everyday life ( 3 , 12 ). Children with DCD have tireless shortages in a few components of executive functioning which plays an imperative partin predicting the academic performance and daily activities of these children ( 1 , 3 , 5 , 12 ). working memory is one of the executive functional components that play an vital part in different viewpoints of life, counting perusing comprehension, composing, problem-solving, scientific thinking, composed dialect, and different behavioral domains( 7 , 13 ). Imperfection in working memory is considered one of the characteristics of numerous children with DCD ( 1 – 3 ). The research of Alloway et al. (2009) shows that children with DCD show weaker skills in verbal working memory compared to visuospatial working memory( 14 ). It is assumed that these children are ineffective in using phonological codes and their phonological active memory capacity is probably limited ( 11 ). As a result, in addition to executive function and working memory, most children with DCD also have serious defects in the information processing component ( 7 , 15 ). Processing speed is the amount of time required to understand information, process information, and compile and execute a response ( 15 ). Processing speed is a component that is related to the attention component ( 16 ), and research conducted on DCD children shows that these children are associated with attention deficits, since information processing speed requires attention, it can be concluded that these children have poor performance in the processing speed component ( 17 , 18 ). Cognitive Dominance means efficient processing of information, the score of which is the sum of the scores of working memory and processing speed ( 19 , 20 ). Cognitive dominance strategies help a person to prepare their newly acquired information to combine with previously learned information and store them in long-term memory and increase the amount of learning, retention, and continuity of children's learning ( 20 , 21 ). Higher cognitive dominance in people increases the space for complex processes such as thinking, problem-solving, and learning by reducing the amount of effort required to recognize simple processes ( 19 , 21 ). DCD children with cognitive impairment have less physical participation and social interactions with their peers and spend most of their time alone ( 3 , 5 , 6 , 10 ). In later a long time, intrigued in deciding compelling intercession approaches for children with DCD is expanding. Physiotherapy and occupational therapy are designed for this population to strengthen motor ( 22 – 24 ) and cognitive ( 25 , 26 ) skills. In a systematic review, Smits-Engelsman et al. (2018) concluded that the execution of children with DCD can be progressed with task-oriented intervention approaches that have more benefits than process-oriented approaches ( 27 ). Task-oriented approaches are based on current motor control, motor learning, and natural standards, and the relative commitment of these standards is diverse between strategies ( 23 , 24 , 28 ). Be that as it may, for all approaches, rehashed hone completely different settings and nonstop feedback appear to be key components of fruitful interventions for children with DCD ( 17 , 26 , 28 ). One of the new therapeutic interventions that provides the possibility of frequent practice and continuous feedback is the use of virtual reality ( 4 , 5 , 29 ). Virtual Reality (VR) may be a frame of human-computer relationship that points to make a sensory illusion for an individual to see the virtual environment as a reality additionally utilize physical developments intuitiveness to imagine diversions ( 29 , 30 ). The studies conducted about the hypothesis of defects in action planning and prediction modeling in children with DCD indicate that the use of reinforced feedback as a conceivable treatment approach for these children appears suitable ( 5 , 31 ). The results of past research also indicate the positive effect of VR on motor function ( 4 , 8 , 22 , 27 ) and visual perception and executive function ( 5 ) of children with DCD. Jalsma et al. (2023), Gonzalez et al. (2013), and Straker et al. (2014) also reported in their studies that there was inadequately prove to bolster virtual reality training compared to non-VR training for DCD children ( 32 – 34 ). According to the recommendation of the European Academy of Pediatric Disabilities, DCD children should be treated very quickly ( 2 , 28 ). Be that as it may, with expanding mindfulness of the results of DCD, these children are presently alluded to physical and occupational therapy treatment at a more youthful age, and it gets to be critical to examine whether they can too advantage from VR-based intervention. To our knowledge, very little research has been conducted on the effects of VR training on executive functions and cognitive dominance in DCD children. Therefore, the study hypothesized that an intervention program based on the Xbox Kinect 360 game system is well tolerated by children with DCD and improves their executive function and cognitive dominance. On the off chance that the result is positive, teachers and Occupational therapists can utilize this sort of intervention as a restorative supplement to pharmacological and behavioral treatment. Methods Study Design The current investigate was a semi-experimental ponder with pre and post-design. The measurable populace of the current consider included all male understudies matured 6 to 9 within the city of Shiraz within the scholarly year 2022–2023. Wilson's developmental coordination disorder questionnaire for parents (DCDQ7) and clinical interview according to the criteria of DCD diagnosis based on DSM-5 by a child and adolescent psychiatrist subspecialist were used to diagnose children with DCD ( 2 , 28 , 31 ). Among children, living in Shiraz, who had been referred to counseling and treatment centers children with DCD were selected in a targeted and accessible way. Participants were recruited via a study research coordinator. The criteria for entering the present research include having DCD based on the opinion of a child and adolescent psychiatrist, boys aged 6 to 9 years, obtaining a score of less than 47 in the DCD questionnaire as a criterion for DCD disorder ( 2 , 28 ), Having an IQ above 70 in the Raven IQ test ( 2 , 31 ), getting consent from parents and not having cardio-respiratory and orthopedic disorders. Non-attendance at any stage of the research and absence of more than 2 sessions during the presentation of the intervention were also criteria for exiting the research. At the beginning of the research, all guardians were guaranteed that all information related to their child would stay totally secret. The ethics committee of Kharazmi University - Research Institute of Movement Sciences reviewed and approved the study Procedures before enrollment (KHU.KRC.1000.142). The study procedures were explained, and informed consent was obtained from all parents of participants before study initiation. Procedure After examining and selecting children with DCD (40 children), the children's parents completed the executive function subscales of Conner's child behavior rating scale and the Wechsler intelligence test (cognitive dominance assessment). All children were randomly placed in two experimental (n = 20) and control (n = 20) groups. The experimental group received virtual reality training, while the control group did not receive any direct intervention and only did their daily activities in schools. At the end of the final session of presenting the intervention, both the experimental and control groups were given the same tests again. Intervention Program Xbox Kinect 360 virtual reality system was used in this study. VR training was conducted Consistent with similar research for 8 weeks, 2 sessions per week, and each session lasted 30 minutes (4, 23, 29,31 ). None of the Participants were familiar with the Xbox game, so after the initial assessments, training sessions were conducted during school hours and their free time. Five 40-inch TV screens and 5 Xbox 360 game consoles were set for Participants. Kinect sports games of baseball, basketball, bowling, and football were available for children. The games were randomly selected for the participants. The program of training sessions includes 1- Attending the intervention, 2- Learning to control objects by warming up (touching parts of the body, jumping and using hula hoops with music playing and performing the butterfly movement for 2–3 minutes) 3- training at slightest two games (12 minutes each and 24 minutes of training for the whole program), and schedule activities such as balance and stretching exercises were performed for 2 to 3 minutes. If children reach the ultimate level in 12 minutes, the next game will start and children will not have time for doing nothing. They were also taught how to change the game ( 4 , 29 ). Outcome Assessment Tools Developmental Coordination Disorder Questionnaire (DCDQ-7) for Parents: The revised version of this questionnaire has been prepared for the age group of 5 to 15 years and contains 15 items, which include 3 factors of control during movement (3 questions), fine movements/handwriting (4 questions) and general coordination (6 questions). The reliability of this tool has been checked (0.83 internal consistency, 0.73 test-retest, and 0.85 Cronbach's alpha) and confirmed. It takes about 10 to 15 minutes to complete this questionnaire ( 35 ). The scoring of the survey is within the shape of a five-point Likert scale. Concurring to the assessment of this questionnaire, the full score of the children is 15 to 46, 15 to 55, and 15 to 57, respectively, and they are presented as having or helpless to DCD. In the event that the entire score of these children is 47 to 75, 56 to 75, and 58 to 75 separately, they are known to have DCD ( 27 , 35 ). Raven's Intelligence Test: This test is one of the non-verbal intelligence measurement tools used to measure intelligence ( 36 ). The abbreviated form of this test consists of 36 questions that are colored and designed for children aged 5 to 11, mentally or physically retarded. In this test, the color images that follow the logical sequence become more difficult. The child has no time limit to answer the questions. After completing the online test, you will be given a raw score that is the sum of the correct answers. IQ measurement will be obtained according to age and raw score. The Raven Children's Test determines the IQ of children in 10 spectrums (genius, gifted, intelligent, average, borderline, weak borderline, poor, etc.). The test comprises three sets of frameworks, specifically, A, AB, and B. The three sets are considered the three sub-scales of the test: A (11 things, Cronbach's alpha: 0.89), AB (12 things, Cronbach's alpha: 0.90), and B (12 things, Cronbach's alpha: 0.88). The generally unwavering quality for the 35 things was 0.89 ( 36 ). Conner's Child Behavior Rating Scale: This scale was expanded by Connors in 2004 to evaluate neuropsychological skills including executive functions (problem-solving, behavioral-emotional planning, and organization), attention, memory, learning, sensory-motor function, visual-spatial processing and academic performance for Children aged 5 to 12 years were made in four ranges (not observed, mild, moderate and severe) and it includes 26 questions with 4 options ( 37 , 38 ). The total score of the test will range from 26 to 104. If the child's score is higher than 34, it indicates a disorder. The higher the score, the greater the child's disorder and vice versa. Connors and colleagues (2006) reported the reliability of this scale as 0.90 ( 37 ). The validity of this questionnaire has been reported by the Iranian Institute of Cognitive Sciences as 0.85 ( 39 ). Revised Wechsler Intelligence Scale for Children (WISC-IV): This scale was reexamined in 1972 and measures the intelligence of children in the age groups of 6 to 16 years. This scale consists of 12 subtests. The Wechsler IQ scale for children is an analytical test that is graded according to the degree of testicular success. Scoring is all or nothing. Rather, the degree of success is considered. Validity of revised form of children based on internal consistency, general scale (96%), verbal scale (94%), and non-verbal scale (90%) and based on retest validity, general scale (95%), verbal scale (93%) and The non-verbal scale (90%) of this test was repeated in one month ( 40 ). In this research, the revised Wechsler intelligence scale for children was considered as a test of cognitive Dominance ( 21 ). Sample Size and Power G-Power software was used by Cohen's formula to calculate the sample size. In this formula, the effect size of 0.3, the desired statistical power level of 0.80, and the probability level of 0.05 were used. Concurring to the G-Power result, a test of 34 members was considered sufficient for this consider. Considering steady loss, we enrolled 40 DCD children in this research. Data analysis After collecting the data, in the descriptive statistics section, the central indicators and the dispersion of the research groups were examined. In the inferential statistics section, the Shapiro-Wilk statistical test was used to check the normality of the data distribution. According to the normal distribution of the data (P > 0.05), to compare the effects of training on each of the dependent variables between the study groups, an analysis of covariance (ANCOVA) test was used, because in this test, the effect of the pre-test values on the post-test is controlled ( 41 ). SPSS software version 22 and a significance level of 0.05 were used in all statistical tests. Results A total of 40 participants attended in this study. The statistic characteristics of the Research samples are displayed in Table 1 . Table 1 Participant's demographic information (n = 40) Characteristics Experimental group (n = 20) M(SD) Control group (n = 20) M(SD) T P Age(years) Weight(kg) Height(cm) Intelligence Quotient (IQ) 7.9 (1.45) 35.2 (2.1) 132.7 (2.60) 85.2 (2.7) 8.1 (1.03) 34.9 (2.4) 133.2 (2.12) 85.1 (3.2) 3.39 1.94 2.45 2.23 0.42 0.29 0.34 0.30 An Independent t-test was used to compare the groups in the pre-test and to check the homogeneity of the group. The results showed that there is no statistically significant difference between the two experimental and control groups in demographic characteristics (P > 0.05). Table 2 shows the mean and standard deviation of the variables related to the research subjects. The come about appeared that there's no factually critical distinction between the two experimental and control groups in demographic characteristics (P > 0.05). Table 2 appears the mean and standard deviation of the factors related to the investigate subjects. Table 2 Comparison of study outcomes between study groups Variables Pre – Intervention Post – Intervention Experimental Mean(SD) Control Mean(SD) Experimental Mean(SD) Control Mean(SD) Processing speed 23.46 (1.59) 23.34 (1.60) 28.07 (2.67) 23.42 (1.55) Working Memory 29.39 (2.33) 28.67 (2.16) 34.95 (2.20) 28.89 (2.23) Cognitive Dominance 52.85 (3.02) 52.53 (3.32) 62.80 (3.38) 52.59 (3.32) Problem-solving/planning 10.9 (1.01) 10.58 (1.24) 6.32 (1.24) 10.48 (1.10) behavioral-emotional organization 8.87 (0.87) 8.84 (0.83) 4.72 (0.99) 8.78 (0.84) Executive Function 19. 77 (1.18) 19.48 (1.24) 11.00 (1.45) 19.24 (1.18) The results of the Shapiro-Wilk test indicated that the variables of processing speed (P = 0.73), working memory (P = 0.69), problem-solving / planning (P = 0.88), and behavioral-emotional organization (P = 0.91) showed a normal distribution. Levine's test also showed that the homogeneity of variances is established in all subscales (P > 0.05) of the study. Table 3 The results of covariance analysis to compare the scores of cognitive Dominance and executive functions of subjects Variables Factor F P Eta Processing speed Pre-test 0.86 0.36 0.01 Group 115. 9 0.002 0.83 Working Memory Pre-test 0.09 0.87 0.002 Group 104.88 0.003 0.8 Cognitive Dominance Pre test 0.01 0.90 0.02 Group 222.89 0.001 0. 9 Problem-solving/planning Pre-test 0.11 0.31 0.07 Group 228.95 0.001 0.80 behavioral-emotional organization Pre-test 0.11 0.39 0.09 Group 346.50 0.001 0.94 Executive Function Pre-test 0.68 0.53 0.03 Group 110.73 0.003 0.92 The results of Table 3 show that there is a significant difference between study groups after controlling the effect of the pre-test on the post-test. The main effect of virtual reality training on processing speed (F = 115. 87, P = 0.002, Eta = 0.83), working memory (F = 104.88, P = 0.003, Eta = 0.79) and cognitive Dominance (F = 222.89, P = 0.001, Eta = 0.89) was significant. The main effect of virtual reality training on problem-solving / planning (F = 228.95, P = 0.001, Eta = 0.80), behavioral-emotional organization (F = 346.50, P = 0.001, Eta = 0.94), and executive functions (F = 110.73, P = 0.003, Eta = 0.92) were also significant. The comparison of the means shows that by controlling the effect of pre-test scores, the children who received virtual reality training obtained significantly higher scores in the post-test stage than the control group in the factors of cognitive dominance and executive functions. Discussion The aimed of this study was to examine the impact of VR training using Xbox 360-based games on executive functions and cognitive Dominance in children with DCD. The results indicated that VR training improved executive functions (problem-solving and planning, organizing emotional behavior) in children with DCD. Based on the assumption that predictive modeling deficits reveal DCD movement disorders, it was predicted that VR training can provide enhanced feedback and opportunity for observational learning, and movement imagery simultaneously facilitates the development of predictive modeling ( 2 , 4 , 7 ). The main foundation of VR training is on the flexibility of the nervous system through the mirror neurons of the frontal lobe; this causes movement observation and imitation, as well as integrating the positive benefits of training techniques, and finally, by increasing the activity of the frontal lobe and activating the neural circuits, it improves executive functions ( 30 , 33 ). VR training is an educational process during which a person's cognitive skills are challenged by repeatedly performing cognitive training that is presented with accuracy and speed and as a result of successive successes in these challenges, improvement in executive functions takes place ( 5 , 30 ). The improvement of executive functions is largely related to the child's experiences; because the child gets his experiences through various ways, especially active video games during the growth period ( 1 , 17 , 41 ). There is a hypothesis related to executive functions, according to which practice and game sessions have an effect on the volume of gray matter and greater integrity of white matter and support the progress of executive functions. Therefore, the hypothesis is that exciting environments can cause faster development of executive functions ( 1 , 11 , 12 ). The results obtained are by the research of Straker et al. (2015), Windsor. (2017), and Hashemi et al. (2022) which investigated the effect of VR training on the executive functions of children with DCD ( 5 , 16 , 34 ). The result obtained from the second finding of the research showed that VR trainings have a significant positive effect on the cognitive dominance of children with DCD. Disturbance in the information processing process is considered a type of cognitive disorder that depends on attention and concentration and is strengthened through cognitive rehabilitation of this disorder while recovering ( 9 , 43 ). The cognitive rehabilitation method gradually teaches the brain to focus only on the target stimulus and ignore the side stimuli, this capability has a significant effect on gradually increasing the speed of target information processing ( 4 , 29 , 30 ).VR trainings increase creativity, skill, social interactions, and motivation to participate in more activities among children ( 4 , 30 , 33 ). On the other hand, this type of training makes the child use all his muscles in the form of various topics such as cardiovascular endurance and for a relatively long period, which in turn affects working memory and selective attention ( 5 , 29 , 34 ); Because this type of training, due to the alignment with aerobic training, produces new cells in the olfactory bulb and dentate gyrus, as well as the larger volume of the prefrontal area and the white and gray matter of the anterior part of the brain, which are usually related to ( 25 , 30 , 33 ). Performing new training and games in each training session and adapting the level of difficulty of the training to the progress level of the subjects has a positive effect on the learning and performance of neural plasticity and will increase the child's self-confidence and reduce the fear of failure and frustration from the inability to perform the task and will improve memory performance; Because in this way it reduces stress and anxiety that hurt memory function ( 4 , 29 , 34 ). The results obtained are in line with the research of Johari & Rafiee et al. (2020) and Rezaei (2020). Johari & Rafiee et al. (2020) observed a significant improvement in the working memory of children with DCD following cognitive rehabilitation intervention (Capitan lag) ( 44 ). Rezaei (2020) also showed that cognitive rehabilitation training (brain gym) improves the processing speed and nervous response of children with DCD ( 43 ). The activity-oriented pattern is another important feature of the VR technique, in which training and activities are presented to children as a whole, and the subject continues to solve the problems in the game until he wins ( 26 , 28 , 33 ). Regarding the explanation of the results, we can also refer to the implicit learning perspective of Jelsma et al. (2014), who stated that implicit learning, including unwanted and unconscious learning, seems to exist to an optimal extent in playing video games, because the child learns how to play The game and how to improve is focused on practice and trial and error ( 32 ) As a result, video games with repetitive body movements, as well as with goal-oriented and motor tasks and supported by proprioceptive and visual feedback, can affect the child and his skills ( 4 , 23 , 43 ). In general, the results of the present research are in line with the ecological perspective and dynamic systems, which refer to the interrelationship between the person, environment, and task ( 45 ). The neurogenic reserve hypothesis also suggests that the rich environment, like VR training, stimulates angiogenesis and neurogenesis and increases cognitive function ( 27 , 28 , 45 ). Strengths and limitations This research had a few strengths. First, a quasi-experimental study was used to explore the effects of VR training on executive function and cognitive dominance in children with DCD. We also assigned a control group to investigate the actual effects of the VR training intervention. Second,, this is often one of the primary studies about that examined the impact of VR training on executive functions and especially the cognitive dominance factor of children with DCD. Third, this study was conducted on boys suffering from DCD, who are 3 to 7 times more likely to suffer from this disorder than girls. Among the limitations of this research, we can point out the small size of the sample, the selection of the sample using the available method, and the statistical population is limited to children with DCD in Shiraz city, which limits the generalization of the results of this research to other groups. Also, a longer intervention or follow-up period may be required to way better get the effects of VR training on executive function and cognitive dominance. More study is required in this area: first, to explore more openings presented by this innovation as a vital resource within the field of DCD, and second, to recognize methods and targets that best match the needs in this particular clinical area. This approach can soon lead to determining the best practices for using VR and augmented reality technology in this field of study. Also, because the present study is the first study that investigated the effect of VR training on improving cognitive dominance, more studies are needed to confirm the effectiveness of this type of intervention for cognitive skills, motor skills, and daily life activities of DCD children. Another suggestion is to investigate this intervention on two genders and compare the two genders in terms of the effect of improving executive function and cognitive dominance. Conclusion In general, results obtained from the present study indicated that VR training (Xbox 360) has a positive impact on the executive functions and cognitive dominance of children with DCD. Therefore, the use of this type of intervention is suggested as an effective intervention in preventing and reducing the problems of executive functions and improving the cognitive skills of children with DCD. The lack of safe outdoor spaces, the reduction of sports activity time, and the lack of access to enjoyable training programs are among the factors that make children less interested in performing physical activity. VR training has removed these barriers among children to a great extent such that it has the potential to promote physical activity in schools and social environments. Various schools have added VR training to their physical education curriculum. Overall, it seems that VR training can be utilized to compensate for predictive modeling as well as provide a suitable complement to physical training of cognitive and motor skills for children with DCD. Subsequently, VR may be a reasonable instructive device that can be actualized within the home environment. Declarations Compliance with Ethical Standards Funding/support this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. 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Izadi-Najafabadi, S., Gunton, C., Dureno, Z., & Zwicker, J. G. (2022). Effectiveness of Cognitive Orientation to Occupational Performance intervention in improving motor skills of children with developmental coordination disorder: A randomized waitlist-control trial. Clinical Rehabilitation, 36(6), 776–788. Thornton, A., Licari, M., Reid, S., Armstrong, J., Fallows, R., & Elliott, C. (2016). Cognitive orientation to (daily) occupational performance intervention leads to improvements in impairments, activity and participation in children with Developmental Coordination Disorder. Disability and rehabilitation, 38(10), 979–986. Smits-Engelsman, B., Vincon, S., Blank, R., Quadrado, V. H., Polatajko, H., & Wilson, P. H. (2018). Evaluating the evidence for motor-based interventions in developmental coordination disorder: A systematic review and meta-analysis. Research in developmental disabilities, 74, 72–102. Ferguson, G., Jelsma, D., Jelsma, J., & Smits-Engelsman, B. (2013). The efficacy of two task-orientated interventions for children with Developmental Coordination Disorder: Neuromotor Task Training and Nintendo Wii Fit training. Research in developmental disabilities, 34(9), 2449–2461. Lino, F., Arcangeli, V., & Chieffo, D. P. R. (2021). The virtual challenge: Virtual reality tools for intervention in children with developmental coordination disorder. Children, 8(4), 270. Bailey, J. O., & Bailenson, J. N. (2017). Immersive virtual reality and the developing child. In Cognitive development in digital contexts (pp. 181–200): Elsevier. Gonsalves, L., Campbell, A., Jensen, L., & Straker, L. (2015). Children with developmental coordination disorder play active virtual reality games differently than children with typical development. Physical therapy, 95(3), 360–368. Jelsma, D., Geuze, R. H., Mombarg, R., & Smits-Engelsman, B. C. (2014). The impact of Wii Fit intervention on dynamic balance control in children with probable Developmental Coordination Disorder and balance problems. Human Movement Science, 33, 404–418. González, C. R., Martín-Gutiérrez, J., Domínguez, M. G., HernanPérez, A. S., & Carrodeguas, C. M. (2013). Improving spatial skills: An orienteering experience in real and virtual environments with first year engineering students. Procedia Computer Science, 25, 428–435. Straker, L., Howie, E., Smith, A., Jensen, L., Piek, J., & Campbell, A. (2015). A crossover randomised and controlled trial of the impact of active video games on motor coordination and perceptions of physical ability in children at risk of developmental coordination disorder. Human Movement Science, 42, 146–160. Wilson, B., Kaplan, B., Crawford, S., & Roberts, G. (2007). The developmental coordination disorder questionnaire 2007 (DCDQ’07). Administrative manual for the DCDQ107 with psychometric properties, 267–272. Raven, J. (1989). The Raven Progressive Matrices: A review of national norming studies and ethnic and socioeconomic variation within the United States. Journal of Educational Measurement, 26(1), 1–16. Conners, C. K. (1999). Conners Rating Scales-Revised. Conners, C. K. (2008). Conners 3-Parent Short Form. North Tonawanda, NY: Multi-Health Systems Inc.[Google Scholar]. Alizadeh, H. (2005). A theoretical explanation on attention deficit/hyperactivity disorder: behavioral inhibition model and nature of self-control. Journal of Exceptional Children, 5(3), 231–252. Drozdick, L. W., Raiford, S. E., Wahlstrom, D., & Weiss, L. G. (2018). The Wechsler Adult Intelligence Scale—Fourth Edition and the Wechsler Memory Scale—Fourth Edition. Vickers, A. J., & Altman, D. G. (2001). Analysing controlled trials with baseline and follow up measurements. Bmj, 323(7321), 1123–1124. Houwen, S., van der Veer, G., Visser, J., & Cantell, M. (2017). The relationship between motor performance and parent-rated executive functioning in 3-to 5-year-old children: What is the role of confounding variables? Human Movement Science, 53, 24–36. Rezayi, R. (2020). The effectiveness of cognitive rehabilitation (brain gym) on speed processing and neuro reaction speed in children with developmental coordination disorder. Neuropsychology, 6(3), 91–104. Johari, A. S., & Rafiee, S. (2020). Effect of Nintendo ii Trainings on Spatial Working Memory and Cognitive-Motor Skills of 6–8 years Old Children with Developmental Coordination Disorder. The Scientific Journal of Rehabilitation Medicine, 9(2), 188–198. Payne, V. G. (2017). Human motor development. (No Title). Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4172275","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":284747208,"identity":"f5e84521-3ae4-4dba-9e62-7e99540ce367","order_by":0,"name":"ayoub hashemi","email":"","orcid":"","institution":"Jahrom University","correspondingAuthor":false,"prefix":"","firstName":"ayoub","middleName":"","lastName":"hashemi","suffix":""},{"id":284747209,"identity":"bdc6e82e-6556-41c3-805f-3d3f93c58c12","order_by":1,"name":"Mohammad Hossein Zamani","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYBACAyjNwy9//MCBD0AWGzuxWiRn8CQ+nAHSwkykFgaDGwzGxjwgFiEt5gzsDz/dqLkjw3C7IU3a5tc2eT5mBsYPH3Nwa7FsYEiWzjn2jIdxzsFj0rl9tw3bmBmYJWduw+OwAwwHpHPYDvMwMySkSef23GYEamFj5sWrhbH5d86/wzxsDAlm0pY9t+2J0MLMJp3bdpiHRyLB2Jjhx+1EwloOs7FZ5/Yd5pHgOZP4sLfhdnIbM2Mzfr8cb398O+fbYXv74+0HDvz4c9t2fnvzwQ8f8WhBjQXGNjDZgEc9BvhDiuJRMApGwSgYKQAAerFQHc7xYD0AAAAASUVORK5CYII=","orcid":"","institution":"Jahrom University","correspondingAuthor":true,"prefix":"","firstName":"Mohammad","middleName":"Hossein","lastName":"Zamani","suffix":""},{"id":284747210,"identity":"f2c3f434-ab5e-4c42-acbb-e9a82d258f44","order_by":2,"name":"Shahnaz Shahrbanian","email":"","orcid":"","institution":"University of Tarbiat Modares","correspondingAuthor":false,"prefix":"","firstName":"Shahnaz","middleName":"","lastName":"Shahrbanian","suffix":""},{"id":284747211,"identity":"1d4cbbac-7ead-4bad-97b1-b76e99156c40","order_by":3,"name":"Abouzar saadatian","email":"","orcid":"","institution":"Yasouj University","correspondingAuthor":false,"prefix":"","firstName":"Abouzar","middleName":"","lastName":"saadatian","suffix":""}],"badges":[],"createdAt":"2024-03-26 21:44:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4172275/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4172275/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s11332-025-01370-5","type":"published","date":"2025-03-16T15:58:39+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":78689104,"identity":"3c667452-1407-4a79-a88c-90b94e4fdd77","added_by":"auto","created_at":"2025-03-17 16:11:20","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":768581,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4172275/v1/8b4b6b10-a166-4429-82b9-473a9237dcf3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Impact of Virtual reality training on executive functions and cognitive Dominance in children with developmental coordination disorder: A quasi-experimental study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDevelopmental Coordination Disorder (DCD) could be a characteristic of children who, without any cognitive or neurological problems, face problems in the fields of learning, growth, and motor control, and show unbalanced and incompetent motor behavior when performing a motor activity appropriate for their age (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Coordination shortfalls essentially meddled with daily life, scholastic efficiency, and relaxation time (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The prevalence of DCD in school-aged children is reported to be 5\u0026ndash;6%, and According to this report, boys are 3 to 7 times more likely to have DCD than girls (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). The predominance rate of this disorder in Iran is additionally detailed as 2.7% (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Children with or at risk of DCD have problems with fine and gross motor skills (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Deficits in motor skills are associated with impairments in reading, writing, and math tasks (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) and in fundamental cognitive capacities, such as inhibitory control, working memory, and planning in children with DCD (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) and at risk for DCD (Alesi et al., 2019; Houwen, van der Veer, Visser, \u0026amp; Cantell, 2017). The results of studies indicate that DCD disorder affects executive functions (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Executive functions are fundamental to control, screen, and control behavior toward an objective for everyday life (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Children with DCD have tireless shortages in a few components of executive functioning which plays an imperative partin predicting the academic performance and daily activities of these children (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). working memory is one of the executive functional components that play an vital part in different viewpoints of life, counting perusing comprehension, composing, problem-solving, scientific thinking, composed dialect, and different behavioral domains(\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). Imperfection in working memory is considered one of the characteristics of numerous children with DCD (\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe research of Alloway et al. (2009) shows that children with DCD show weaker skills in verbal working memory compared to visuospatial working memory(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). It is assumed that these children are ineffective in using phonological codes and their phonological active memory capacity is probably limited (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). As a result, in addition to executive function and working memory, most children with DCD also have serious defects in the information processing component (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Processing speed is the amount of time required to understand information, process information, and compile and execute a response (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Processing speed is a component that is related to the attention component (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), and research conducted on DCD children shows that these children are associated with attention deficits, since information processing speed requires attention, it can be concluded that these children have poor performance in the processing speed component (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCognitive Dominance means efficient processing of information, the score of which is the sum of the scores of working memory and processing speed (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Cognitive dominance strategies help a person to prepare their newly acquired information to combine with previously learned information and store them in long-term memory and increase the amount of learning, retention, and continuity of children's learning (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). Higher cognitive dominance in people increases the space for complex processes such as thinking, problem-solving, and learning by reducing the amount of effort required to recognize simple processes (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). DCD children with cognitive impairment have less physical participation and social interactions with their peers and spend most of their time alone (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). In later a long time, intrigued in deciding compelling intercession approaches for children with DCD is expanding. Physiotherapy and occupational therapy are designed for this population to strengthen motor (\u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) and cognitive (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e) skills. In a systematic review, Smits-Engelsman et al. (2018) concluded that the execution of children with DCD can be progressed with task-oriented intervention approaches that have more benefits than process-oriented approaches (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Task-oriented approaches are based on current motor control, motor learning, and natural standards, and the relative commitment of these standards is diverse between strategies (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBe that as it may, for all approaches, rehashed hone completely different settings and nonstop feedback appear to be key components of fruitful interventions for children with DCD (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). One of the new therapeutic interventions that provides the possibility of frequent practice and continuous feedback is the use of virtual reality (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Virtual Reality (VR) may be a frame of human-computer relationship that points to make a sensory illusion for an individual to see the virtual environment as a reality additionally utilize physical developments intuitiveness to imagine diversions (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). The studies conducted about the hypothesis of defects in action planning and prediction modeling in children with DCD indicate that the use of reinforced feedback as a conceivable treatment approach for these children appears suitable (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). The results of past research also indicate the positive effect of VR on motor function (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) and visual perception and executive function (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) of children with DCD. Jalsma et al. (2023), Gonzalez et al. (2013), and Straker et al. (2014) also reported in their studies that there was inadequately prove to bolster virtual reality training compared to non-VR training for DCD children (\u003cspan additionalcitationids=\"CR33\" citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). According to the recommendation of the European Academy of Pediatric Disabilities, DCD children should be treated very quickly (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eBe that as it may, with expanding mindfulness of the results of DCD, these children are presently alluded to physical and occupational therapy treatment at a more youthful age, and it gets to be critical to examine whether they can too advantage from VR-based intervention. To our knowledge, very little research has been conducted on the effects of VR training on executive functions and cognitive dominance in DCD children. Therefore, the study hypothesized that an intervention program based on the Xbox Kinect 360 game system is well tolerated by children with DCD and improves their executive function and cognitive dominance. On the off chance that the result is positive, teachers and Occupational therapists can utilize this sort of intervention as a restorative supplement to pharmacological and behavioral treatment.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy Design\u003c/p\u003e \u003cp\u003eThe current investigate was a semi-experimental ponder with pre and post-design. The measurable populace of the current consider included all male understudies matured 6 to 9 within the city of Shiraz within the scholarly year 2022\u0026ndash;2023. Wilson's developmental coordination disorder questionnaire for parents (DCDQ7) and clinical interview according to the criteria of DCD diagnosis based on DSM-5 by a child and adolescent psychiatrist subspecialist were used to diagnose children with DCD (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Among children, living in Shiraz, who had been referred to counseling and treatment centers children with DCD were selected in a targeted and accessible way. Participants were recruited via a study research coordinator. The criteria for entering the present research include having DCD based on the opinion of a child and adolescent psychiatrist, boys aged 6 to 9 years, obtaining a score of less than 47 in the DCD questionnaire as a criterion for DCD disorder (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e), Having an IQ above 70 in the Raven IQ test (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e), getting consent from parents and not having cardio-respiratory and orthopedic disorders. Non-attendance at any stage of the research and absence of more than 2 sessions during the presentation of the intervention were also criteria for exiting the research. At the beginning of the research, all guardians were guaranteed that all information related to their child would stay totally secret. The ethics committee of Kharazmi University - Research Institute of Movement Sciences reviewed and approved the study Procedures before enrollment (KHU.KRC.1000.142). The study procedures were explained, and informed consent was obtained from all parents of participants before study initiation.\u003c/p\u003e \u003cp\u003eProcedure\u003c/p\u003e \u003cp\u003e After examining and selecting children with DCD (40 children), the children's parents completed the executive function subscales of Conner's child behavior rating scale and the Wechsler intelligence test (cognitive dominance assessment). All children were randomly placed in two experimental (n\u0026thinsp;=\u0026thinsp;20) and control (n\u0026thinsp;=\u0026thinsp;20) groups. The experimental group received virtual reality training, while the control group did not receive any direct intervention and only did their daily activities in schools. At the end of the final session of presenting the intervention, both the experimental and control groups were given the same tests again.\u003c/p\u003e \u003cp\u003eIntervention Program\u003c/p\u003e \u003cp\u003eXbox Kinect 360 virtual reality system was used in this study. VR training was conducted Consistent with similar research for 8 weeks, 2 sessions per week, and each session lasted 30 minutes (4, 23, 29,31 ). None of the Participants were familiar with the Xbox game, so after the initial assessments, training sessions were conducted during school hours and their free time. Five 40-inch TV screens and 5 Xbox 360 game consoles were set for Participants. Kinect sports games of baseball, basketball, bowling, and football were available for children. The games were randomly selected for the participants. The program of training sessions includes 1- Attending the intervention, 2- Learning to control objects by warming up (touching parts of the body, jumping and using hula hoops with music playing and performing the butterfly movement for 2\u0026ndash;3 minutes) 3- training at slightest two games (12 minutes each and 24 minutes of training for the whole program), and schedule activities such as balance and stretching exercises were performed for 2 to 3 minutes. If children reach the ultimate level in 12 minutes, the next game will start and children will not have time for doing nothing. They were also taught how to change the game (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOutcome Assessment Tools\u003c/p\u003e \u003cp\u003eDevelopmental Coordination Disorder Questionnaire (DCDQ-7) for Parents: The revised version of this questionnaire has been prepared for the age group of 5 to 15 years and contains 15 items, which include 3 factors of control during movement (3 questions), fine movements/handwriting (4 questions) and general coordination (6 questions). The reliability of this tool has been checked (0.83 internal consistency, 0.73 test-retest, and 0.85 Cronbach's alpha) and confirmed. It takes about 10 to 15 minutes to complete this questionnaire (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). The scoring of the survey is within the shape of a five-point Likert scale. Concurring to the assessment of this questionnaire, the full score of the children is 15 to 46, 15 to 55, and 15 to 57, respectively, and they are presented as having or helpless to DCD. In the event that the entire score of these children is 47 to 75, 56 to 75, and 58 to 75 separately, they are known to have DCD (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRaven's Intelligence Test: This test is one of the non-verbal intelligence measurement tools used to measure intelligence (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e). The abbreviated form of this test consists of 36 questions that are colored and designed for children aged 5 to 11, mentally or physically retarded. In this test, the color images that follow the logical sequence become more difficult. The child has no time limit to answer the questions. After completing the online test, you will be given a raw score that is the sum of the correct answers. IQ measurement will be obtained according to age and raw score. The Raven Children's Test determines the IQ of children in 10 spectrums (genius, gifted, intelligent, average, borderline, weak borderline, poor, etc.). The test comprises three sets of frameworks, specifically, A, AB, and B. The three sets are considered the three sub-scales of the test: A (11 things, Cronbach's alpha: 0.89), AB (12 things, Cronbach's alpha: 0.90), and B (12 things, Cronbach's alpha: 0.88). The generally unwavering quality for the 35 things was 0.89 (\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eConner's Child Behavior Rating Scale: This scale was expanded by Connors in 2004 to evaluate neuropsychological skills including executive functions (problem-solving, behavioral-emotional planning, and organization), attention, memory, learning, sensory-motor function, visual-spatial processing and academic performance for Children aged 5 to 12 years were made in four ranges (not observed, mild, moderate and severe) and it includes 26 questions with 4 options (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e). The total score of the test will range from 26 to 104. If the child's score is higher than 34, it indicates a disorder. The higher the score, the greater the child's disorder and vice versa. Connors and colleagues (2006) reported the reliability of this scale as 0.90 (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e). The validity of this questionnaire has been reported by the Iranian Institute of Cognitive Sciences as 0.85 (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRevised Wechsler Intelligence Scale for Children (WISC-IV): This scale was reexamined in 1972 and measures the intelligence of children in the age groups of 6 to 16 years. This scale consists of 12 subtests. The Wechsler IQ scale for children is an analytical test that is graded according to the degree of testicular success. Scoring is all or nothing. Rather, the degree of success is considered. Validity of revised form of children based on internal consistency, general scale (96%), verbal scale (94%), and non-verbal scale (90%) and based on retest validity, general scale (95%), verbal scale (93%) and The non-verbal scale (90%) of this test was repeated in one month (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e). In this research, the revised Wechsler intelligence scale for children was considered as a test of cognitive Dominance (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSample Size and Power\u003c/p\u003e \u003cp\u003eG-Power software was used by Cohen's formula to calculate the sample size. In this formula, the effect size of 0.3, the desired statistical power level of 0.80, and the probability level of 0.05 were used. Concurring to the G-Power result, a test of 34 members was considered sufficient for this consider. Considering steady loss, we enrolled 40 DCD children in this research.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eAfter collecting the data, in the descriptive statistics section, the central indicators and the dispersion of the research groups were examined. In the inferential statistics section, the Shapiro-Wilk statistical test was used to check the normality of the data distribution. According to the normal distribution of the data (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05), to compare the effects of training on each of the dependent variables between the study groups, an analysis of covariance (ANCOVA) test was used, because in this test, the effect of the pre-test values on the post-test is controlled (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). SPSS software version 22 and a significance level of 0.05 were used in all statistical tests.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 40 participants attended in this study. The statistic characteristics of the Research samples are displayed in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eParticipant's demographic information (n\u0026thinsp;=\u0026thinsp;40)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperimental group\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;20) M(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl group (n\u0026thinsp;=\u0026thinsp;20)\u003c/p\u003e \u003cp\u003eM(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eT\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge(years)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eWeight(kg)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eHeight(cm)\u003c/b\u003e\u003c/p\u003e \u003cp\u003e\u003cb\u003eIntelligence Quotient (IQ)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.9 (1.45)\u003c/p\u003e \u003cp\u003e35.2 (2.1)\u003c/p\u003e \u003cp\u003e132.7 (2.60)\u003c/p\u003e \u003cp\u003e85.2 (2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.1 (1.03)\u003c/p\u003e \u003cp\u003e34.9 (2.4)\u003c/p\u003e \u003cp\u003e133.2 (2.12)\u003c/p\u003e \u003cp\u003e85.1 (3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.39\u003c/p\u003e \u003cp\u003e1.94\u003c/p\u003e \u003cp\u003e2.45\u003c/p\u003e \u003cp\u003e2.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003cp\u003e0.29\u003c/p\u003e \u003cp\u003e0.34\u003c/p\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAn Independent t-test was used to compare the groups in the pre-test and to check the homogeneity of the group. The results showed that there is no statistically significant difference between the two experimental and control groups in demographic characteristics (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the mean and standard deviation of the variables related to the research subjects.\u003c/p\u003e \u003cp\u003eThe come about appeared that there's no factually critical distinction between the two experimental and control groups in demographic characteristics (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05). Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e appears the mean and standard deviation of the factors related to the investigate subjects.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of study outcomes between study groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003ePre \u0026ndash; Intervention\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003ePost \u0026ndash; Intervention\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExperimental\u003c/p\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eExperimental\u003c/p\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eControl\u003c/p\u003e \u003cp\u003eMean(SD)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProcessing speed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23.46 (1.59)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.34 (1.60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.07 (2.67)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23.42 (1.55)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWorking Memory\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29.39 (2.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28.67 (2.16)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34.95 (2.20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e28.89 (2.23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eCognitive Dominance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52.85 (3.02)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52.53 (3.32)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e62.80 (3.38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e52.59 (3.32)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eProblem-solving/planning\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10.9 (1.01)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.58 (1.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.32 (1.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10.48 (1.10)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ebehavioral-emotional organization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.87 (0.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.84 (0.83)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.72 (0.99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8.78 (0.84)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eExecutive Function\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19. 77 (1.18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.48 (1.24)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e11.00 (1.45)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e19.24 (1.18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe results of the Shapiro-Wilk test indicated that the variables of processing speed (P\u0026thinsp;=\u0026thinsp;0.73), working memory (P\u0026thinsp;=\u0026thinsp;0.69), problem-solving / planning (P\u0026thinsp;=\u0026thinsp;0.88), and behavioral-emotional organization (P\u0026thinsp;=\u0026thinsp;0.91) showed a normal distribution. Levine's test also showed that the homogeneity of variances is established in all subscales (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05) of the study.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe results of covariance analysis to compare the scores of cognitive Dominance and executive functions of subjects\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFactor\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eEta\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eProcessing speed\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePre-test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eGroup\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115. 9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.83\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eWorking Memory\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePre-test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eGroup\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e104.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eCognitive Dominance\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePre test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eGroup\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e222.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0. 9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eProblem-solving/planning\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePre-test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eGroup\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e228.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003ebehavioral-emotional organization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePre-test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eGroup\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e346.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eExecutive Function\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003ePre-test\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.03\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eGroup\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e110.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe results of Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e show that there is a significant difference between study groups after controlling the effect of the pre-test on the post-test. The main effect of virtual reality training on processing speed (F\u0026thinsp;=\u0026thinsp;115. 87, P\u0026thinsp;=\u0026thinsp;0.002, Eta\u0026thinsp;=\u0026thinsp;0.83), working memory (F\u0026thinsp;=\u0026thinsp;104.88, P\u0026thinsp;=\u0026thinsp;0.003, Eta\u0026thinsp;=\u0026thinsp;0.79) and cognitive Dominance (F\u0026thinsp;=\u0026thinsp;222.89, P\u0026thinsp;=\u0026thinsp;0.001, Eta\u0026thinsp;=\u0026thinsp;0.89) was significant. The main effect of virtual reality training on problem-solving / planning (F\u0026thinsp;=\u0026thinsp;228.95, P\u0026thinsp;=\u0026thinsp;0.001, Eta\u0026thinsp;=\u0026thinsp;0.80), behavioral-emotional organization (F\u0026thinsp;=\u0026thinsp;346.50, P\u0026thinsp;=\u0026thinsp;0.001, Eta\u0026thinsp;=\u0026thinsp;0.94), and executive functions (F\u0026thinsp;=\u0026thinsp;110.73, P\u0026thinsp;=\u0026thinsp;0.003, Eta\u0026thinsp;=\u0026thinsp;0.92) were also significant. The comparison of the means shows that by controlling the effect of pre-test scores, the children who received virtual reality training obtained significantly higher scores in the post-test stage than the control group in the factors of cognitive dominance and executive functions.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe aimed of this study was to examine the impact of VR training using Xbox 360-based games on executive functions and cognitive Dominance in children with DCD. The results indicated that VR training improved executive functions (problem-solving and planning, organizing emotional behavior) in children with DCD. Based on the assumption that predictive modeling deficits reveal DCD movement disorders, it was predicted that VR training can provide enhanced feedback and opportunity for observational learning, and movement imagery simultaneously facilitates the development of predictive modeling (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe main foundation of VR training is on the flexibility of the nervous system through the mirror neurons of the frontal lobe; this causes movement observation and imitation, as well as integrating the positive benefits of training techniques, and finally, by increasing the activity of the frontal lobe and activating the neural circuits, it improves executive functions (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). VR training is an educational process during which a person's cognitive skills are challenged by repeatedly performing cognitive training that is presented with accuracy and speed and as a result of successive successes in these challenges, improvement in executive functions takes place (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e). The improvement of executive functions is largely related to the child's experiences; because the child gets his experiences through various ways, especially active video games during the growth period (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e). There is a hypothesis related to executive functions, according to which practice and game sessions have an effect on the volume of gray matter and greater integrity of white matter and support the progress of executive functions. Therefore, the hypothesis is that exciting environments can cause faster development of executive functions (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The results obtained are by the research of Straker et al. (2015), Windsor. (2017), and Hashemi et al. (2022) which investigated the effect of VR training on the executive functions of children with DCD (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe result obtained from the second finding of the research showed that VR trainings have a significant positive effect on the cognitive dominance of children with DCD. Disturbance in the information processing process is considered a type of cognitive disorder that depends on attention and concentration and is strengthened through cognitive rehabilitation of this disorder while recovering (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e). The cognitive rehabilitation method gradually teaches the brain to focus only on the target stimulus and ignore the side stimuli, this capability has a significant effect on gradually increasing the speed of target information processing (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e).VR trainings increase creativity, skill, social interactions, and motivation to participate in more activities among children (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). On the other hand, this type of training makes the child use all his muscles in the form of various topics such as cardiovascular endurance and for a relatively long period, which in turn affects working memory and selective attention (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e); Because this type of training, due to the alignment with aerobic training, produces new cells in the olfactory bulb and dentate gyrus, as well as the larger volume of the prefrontal area and the white and gray matter of the anterior part of the brain, which are usually related to (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e). Performing new training and games in each training session and adapting the level of difficulty of the training to the progress level of the subjects has a positive effect on the learning and performance of neural plasticity and will increase the child's self-confidence and reduce the fear of failure and frustration from the inability to perform the task and will improve memory performance; Because in this way it reduces stress and anxiety that hurt memory function (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e). The results obtained are in line with the research of Johari \u0026amp; Rafiee et al. (2020) and Rezaei (2020). Johari \u0026amp; Rafiee et al. (2020) observed a significant improvement in the working memory of children with DCD following cognitive rehabilitation intervention (Capitan lag) (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e). Rezaei (2020) also showed that cognitive rehabilitation training (brain gym) improves the processing speed and nervous response of children with DCD (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe activity-oriented pattern is another important feature of the VR technique, in which training and activities are presented to children as a whole, and the subject continues to solve the problems in the game until he wins (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eRegarding the explanation of the results, we can also refer to the implicit learning perspective of Jelsma et al. (2014), who stated that implicit learning, including unwanted and unconscious learning, seems to exist to an optimal extent in playing video games, because the child learns how to play The game and how to improve is focused on practice and trial and error (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e) As a result, video games with repetitive body movements, as well as with goal-oriented and motor tasks and supported by proprioceptive and visual feedback, can affect the child and his skills (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn general, the results of the present research are in line with the ecological perspective and dynamic systems, which refer to the interrelationship between the person, environment, and task (\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e). The neurogenic reserve hypothesis also suggests that the rich environment, like VR training, stimulates angiogenesis and neurogenesis and increases cognitive function (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eStrengths and limitations\u003c/h3\u003e\n\u003cp\u003eThis research had a few strengths. First, a quasi-experimental study was used to explore the effects of VR training on executive function and cognitive dominance in children with DCD. We also assigned a control group to investigate the actual effects of the VR training intervention. Second,, this is often one of the primary studies about that examined the impact of VR training on executive functions and especially the cognitive dominance factor of children with DCD. Third, this study was conducted on boys suffering from DCD, who are 3 to 7 times more likely to suffer from this disorder than girls. Among the limitations of this research, we can point out the small size of the sample, the selection of the sample using the available method, and the statistical population is limited to children with DCD in Shiraz city, which limits the generalization of the results of this research to other groups. Also, a longer intervention or follow-up period may be required to way better get the effects of VR training on executive function and cognitive dominance.\u003c/p\u003e \u003cp\u003eMore study is required in this area: first, to explore more openings presented by this innovation as a vital resource within the field of DCD, and second, to recognize methods and targets that best match the needs in this particular clinical area. This approach can soon lead to determining the best practices for using VR and augmented reality technology in this field of study. Also, because the present study is the first study that investigated the effect of VR training on improving cognitive dominance, more studies are needed to confirm the effectiveness of this type of intervention for cognitive skills, motor skills, and daily life activities of DCD children. Another suggestion is to investigate this intervention on two genders and compare the two genders in terms of the effect of improving executive function and cognitive dominance.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn general, results obtained from the present study indicated that VR training (Xbox 360) has a positive impact on the executive functions and cognitive dominance of children with DCD. Therefore, the use of this type of intervention is suggested as an effective intervention in preventing and reducing the problems of executive functions and improving the cognitive skills of children with DCD. The lack of safe outdoor spaces, the reduction of sports activity time, and the lack of access to enjoyable training programs are among the factors that make children less interested in performing physical activity. VR training has removed these barriers among children to a great extent such that it has the potential to promote physical activity in schools and social environments. Various schools have added VR training to their physical education curriculum. Overall, it seems that VR training can be utilized to compensate for predictive modeling as well as provide a suitable complement to physical training of cognitive and motor skills for children with DCD. Subsequently, VR may be a reasonable instructive device that can be actualized within the home environment.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eCompliance with Ethical Standards\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding/support\u003c/strong\u003e\u0026nbsp; \u0026nbsp; this research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u0026nbsp; \u0026nbsp;\u0026nbsp;the author declares that they have no conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;\u003c/strong\u003eInformed consent was obtained from all individual participants included in the study.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAlesi, M., Pecoraro, D., \u0026amp; Pepi, A. 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(No Title).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"sport-sciences-for-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ssfh","sideBox":"Learn more about [Sport Sciences for Health](http://link.springer.com/journal/11332)","snPcode":"11332","submissionUrl":"https://submission.nature.com/new-submission/11332/3","title":"Sport Sciences for Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"virtual environment, Active video games, processing speed, working memory, intelligence, problem-solving","lastPublishedDoi":"10.21203/rs.3.rs-4172275/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4172275/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eExecutive functions are basic for essential for regulating, monitoring, and controlling behavior in daily life. This study aimed to investigate the effects of virtual reality training on executive functions and cognitive dominance in children with developmental coordination disorder. The show think about was a quasi-experimental pre-post intervention design. The sample population of the study included 40 boys aged 6 to 9 years with DCD and were randomly divided into experimental (n\u0026thinsp;=\u0026thinsp;20) and control (n\u0026thinsp;=\u0026thinsp;20) groups. Developmental Coordination Disorder Questionnaire (DCDQ7), Raven Intelligence Test, Conner's child behavior rating scale, and Wechsler Intelligence Test (WISC-IV) were used to diagnose DCD children and evaluated variables study. the experimental group performed virtual reality training (Xbox Kinect 360) for 8 weeks (2 sessions per week and 30 minutes per session). Analysis of covariance with a 95% confidence level was used to analyze the data. The comes about appeared that virtual reality training had a significant impact on executive functions (F\u0026thinsp;=\u0026thinsp;110.73, P\u0026thinsp;=\u0026thinsp;0.001, Eta\u0026thinsp;=\u0026thinsp;0.92) and cognitive dominance (F\u0026thinsp;=\u0026thinsp;222.89, P\u0026thinsp;=\u0026thinsp;0.001, Eta\u0026thinsp;=\u0026thinsp;0.89) Children with DCD. The results of the present study provide further support for the potential of incorporating virtual reality training into an application environment, in a way that children enjoy while enhancing cognitive abilities\u003c/p\u003e","manuscriptTitle":"Impact of Virtual reality training on executive functions and cognitive Dominance in children with developmental coordination disorder: A quasi-experimental study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-04-01 17:32:06","doi":"10.21203/rs.3.rs-4172275/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-02-17T10:40:51+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-15T07:52:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"93391054781944019218976871180799209311","date":"2025-02-15T05:39:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"107655430761530479502230530484995911879","date":"2025-02-13T15:15:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"30689308155371131719612394350829615001","date":"2025-02-11T15:43:31+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-01-24T17:01:42+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-03-28T01:48:44+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-03-28T01:48:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"Sport Sciences for Health","date":"2024-03-26T21:34:28+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"sport-sciences-for-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ssfh","sideBox":"Learn more about [Sport Sciences for Health](http://link.springer.com/journal/11332)","snPcode":"11332","submissionUrl":"https://submission.nature.com/new-submission/11332/3","title":"Sport Sciences for Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"ee140bd4-3f63-4900-ab6f-e9f9ad53d086","owner":[],"postedDate":"April 1st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-03-17T16:05:09+00:00","versionOfRecord":{"articleIdentity":"rs-4172275","link":"https://doi.org/10.1007/s11332-025-01370-5","journal":{"identity":"sport-sciences-for-health","isVorOnly":false,"title":"Sport Sciences for Health"},"publishedOn":"2025-03-16 15:58:39","publishedOnDateReadable":"March 16th, 2025"},"versionCreatedAt":"2024-04-01 17:32:06","video":"","vorDoi":"10.1007/s11332-025-01370-5","vorDoiUrl":"https://doi.org/10.1007/s11332-025-01370-5","workflowStages":[]},"version":"v1","identity":"rs-4172275","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4172275","identity":"rs-4172275","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}