Balance-Cognitive-Strength Training for Balance, Inhibitory Control, and Gait in Preschool Children

Relationship Between Balance Ability and Gait Performance in Preschool Children: The Mediating Role of Inhibitory Control and Verification Through an Exercise-Cognitive Intervention

This randomized controlled study evaluated whether an 8-week balance-cognitive-strength training program improved balance ability, inhibitory control, and gait performance in preschool children aged 3 to 6 years. Children completed balance tests, single-task walking tests, dual-task walking tests, and an iPad-based Go/No-Go task before and after the intervention. The intervention group received exercise-cognitive integrated training 3 times per week for 8 weeks, and the control group maintained usual daily activities.

Preschool children aged 3 to 6 years were recruited from a kindergarten in Weifang, China. Eligible children completed baseline assessments of balance ability, gait performance, and inhibitory control. Balance was assessed using static and dynamic balance tasks on a Zebris force platform. Gait was assessed during single-task walking and dual-task walking while counting backward. Inhibitory control was assessed using an iPad-based Go/No-Go task.

Participants were randomly assigned to a balance-cognitive-strength training group or a usual daily activity control group. The training group received an 8-week exercise-cognitive integrated training program, 3 sessions per week and 40 minutes per session. Training activities included balance exercises, lower-limb strength activities, brisk walking games, and embedded cognitive tasks such as counting, verbal naming, memory tasks, and response inhibition tasks. The control group maintained usual daily activities during the same period.

Outcomes were assessed at baseline and immediately after the 8-week intervention.

Inclusion Criteria:

• Children aged 3 to 6 years.
• Children enrolled in the participating kindergarten in Weifang, China.
• Children able to understand and follow simple instructions for motor, gait, balance, and cognitive testing.
• Children able to participate in regular physical activity and complete the 8-week intervention or usual activity period.
• Written informed consent provided by a parent or legal guardian.

Exclusion Criteria:

• Diagnosed neurological, developmental, or motor disorder.
• Serious cardiovascular, respiratory, musculoskeletal, or other medical condition that would limit safe participation in physical activity.
• Lower-limb injury, deformity, or disease affecting standing, walking, balance, or jumping.
• Visual or hearing impairment that would prevent completion of the study tasks.
• Inability to complete the baseline assessments or comply with study procedures.
• Participation in another structured motor or cognitive intervention during the study period.