The effects of gross motor exercises on perception and praxis in children with motor coordination difficulties–randomized controlled study

Introduction Child psychomotor development is holistic, and pediatric rehabilitation increasingly emphasizes multidisciplinary approaches. Movement interventions can influence not only physical but also cognitive and executive functions. Midline crossing exercises may stimulate frontal–parietal networks, including the dorsolateral prefrontal cortex and superior parietal cortex, involved in praxis and executive control. However, their long-term effects in children with Developmental Coordination Disorder (DCD) remain unclear. Methods This study examined whether midline crossing exercises improve perceptual and praxis functions more than exercises without this element, and explored their relationship with bilateral integration. Twenty-two children aged 6–9 with DCD symptoms participated in a randomized trial. They were assigned to a research group (with midline crossing) or a control group (without it), both following a Bilateral Integration program. The intervention lasted 9–10 weeks within a 15–16-week cycle, with assessments of perception, praxis, and bilateral integration processes at three time points (t 0 , t 1 , t 2 ). Statistical analyses primarily included ANOVA tests and correlation analysis. Results Both groups showed significant improvements in Sequencing Praxis and Bilateral Motor Coordination, with no between-group differences at specific time points. However, improvements appeared earlier in the research group (t 1 ), while the control group improved only at follow-up (t 2 ). Additional gains in specific praxis tasks, lower limb coordination, and task speed were observed only in the research group. Perceptual changes were minimal overall. Discussion Bilateral Integration exercises improve praxis, coordination, and task performance speed in children with DCD symptoms. Midline crossing may accelerate therapeutic effects and selectively enhance certain functions, supporting integrated models of development.