Tests & Measures: A Resource for Pediatric Physical Therapy Practitioners

Bruininks Osteretsky Test of Motor Proficiency (BOT-2)

Matarma T, Lagström H, Hurme S, et al. Motor skills in association with physical activity, sedentary time, body fat, and day care attendance in 5-6-year-old children—The STEPS Study.Scand J Med Sci Sports. 2018;28:2668–2676. doi:10.1111/sms.13264.

Matarma et al. (2018) investigated the relationship between motor skills and physical activity, time spent in sedentary activities, body fat percentage and day care attendance in young children; additionally, they compared the development of motor skills of healthy weight and overweight or obese children.

The 111 children included in this study were five to six years old (45 boys and 66 girls). The motor skills of each child were measured through the Bruininks-Oseretsky Test, second edition (BOT-2) which includes components such as fine manual control, manual coordination, body coordination, and strength and agility. Additionally, the times each child spent performing moderate to vigorous level physical activity (MVPA) and sedentary activity were measured objectively through use of accelerometers that the children wore for seven consecutive days; MVPA and sedentary durations were expressed as percentages of total time the accelerometer was worn. Anthropometrics were also taken, with a focus on body mass index (BMI) and body fat percentage. Day care attendance was measured via a questionnaire.

While most of the children were of healthy weight, less than a fifth of the children were overweight or obese. The healthy weight children scored higher in the motor skills of manual coordination, body coordination and strength and agility compared to the overweight or obese children; however, there were no significant differences between the groups in fine motor control scores or time spent in MVPA or sedentary activities. Interestingly, motor skill scores on the BOT-2 were not associated with sedentary time or MVPA time. Day care attendance was significantly and positively associated with higher levels of MVPA, higher strength and agility as well as body coordination motor skills scores. A correlation was found between higher body fat and poorer strength and agility motor skills in girls.

The study did well to objectively measure motor skills, physical activity, and sedentary time. The use of the BOT-2 was also a strength, as it includes a wide number of motor abilities, is norm-referenced, and is useful for research purposes. Using BIA (bio impedance analysis) to measure body composition is another strength, as it has been proven to be quick and accurate in young children.  On the other hand, the researchers note that limitations of the study include the limited ability of the accelerometers to distinguish between sedentary and physical activities at times, as they were worn on the hip; they believe that many of the strength and agility tasks would have been misinterpreted by the accelerometers as “sedentary.” Moreover, the BOT-2 has normative values that are based on children from the United States, making it more difficult to generalize to children from a different country. Small sample size and a cross-sectional study design (as opposed to longitudinal) were also limitations. Lastly, anthropometric measurements were taken about five months prior to the measurement of motor skills and physical activity, and so important variables such as body fat may not have remained the same in that window of time.

To conclude, Matarma, et. al (2018) note that because day care attendance was positively associated with higher motor skill scores and levels of physical activity, it is vital that places of early childhood education value and promote increased physical activity and development of motor skills. Because there was a relationship determined between high body fat percentage and poorer motor skills in girls, future research ought to include body composition measurements when investigating physical activity and motor skills in young children. This study has implications that impact teachers, caregivers, and parents of young children, as promotion of varied and adequate levels of physical activity, and the prevention of obesity, continues to be essential for motor development of young children.