Martial Arts as an Intervention for Pediatric Patients

Ryan Rubio, SPT
Flickr / Sebastian : Black belt
 Provide a definition of
martial arts
 Discuss the research
 Give pediatric physical
therapists basic
techniques that they can
Creative Commons: Flickr / Michael Holler - Alicia Stewart from USA doing a yop chagi in Moon-Moo. First round in the ITF Taekw
on-Do Worlds 2007 in Quebec. Original file
What Are Martial Arts?
Wikimedia Commons/Cpl. Kristin E. Moreno: A taekwondo student on the Kyung Hee University Demon Team launches
off a student to kick a board being held by another student during the Exercise Foal Eagle 2010 Korean - U.S. Friendship
Styles of Martial Arts
Some of the more common styles include:
 Taekwondo highlights discipline, respect, and
personal growth and focuses on kicking
techniques. 1
 Karate is a traditional Japanese form that is
normally practiced without weapons.1
 Judo is known for a variety of throwing
techniques. 1
Styles of Martial Arts
 Kung fu is one of the oldest forms, and is mainly
known for its powerful blocks. 1
 Aikido teaches a nonaggressive approach to selfdefense, focusing on joint locks, throws, and
restraining techniques. 1
 Jujutsu emphasizes techniques that allow a smaller
fighter to overcome a bigger, stronger opponent,
focusing on ground fighting and grappling. 1
That’s me in 1995!
Why Use Martial Arts?
Martial Arts can do the following:
 provide a therapeutic activity.
 keep kids engaged.
 give a therapist more treatment options.
Creative Commons / Flickr / Sean Dreillinger: original file
Aspects of Martial
Arts Practice 
Bilateral upper extremity use
Jumping and spinning
Creative Commons/ Flickr / Republic of Korea: K Tigers
The K Tigers Taekwondo provides world-class teaching and training the Korean martial arts emphasizing respect, health and fitness.
Wikimedia Commons/Cpl. Kristin E. Moreno: A
taekwondo student on the Kyung Hee University
Demon Team jumps to kick a board being held by
another student during the Exercise Foal Eagle 2010
Korean - U.S. Friendship Event.
What does research show?
Creative Commons: Flickr/Derek Mueller
Developmental Coordination Disorder
After three months of Taekwondo subjects
showed improvement in these areas2-6:
 single-leg stance time
 vestibular function
 lower limb strength
Autism Spectrum Disorder
An 11-week martial arts program resulted in
these changes7:
 improved balance and play skills.
 more frequent eye contact.
 fewer instances of disruptive behaviors.
Deficits in Executive Function
Martial arts sessions included physical activity
and required each student to answer three
 Where am I?
 What am I doing?
 What should I be doing?
Children with Epilepsy
After a martial arts intervention there were
positive trends in these outcome measures10:
 Parenting Stress Index
 Quality of Life in Childhood Epilepsy
 Piers-Harris Children’s Self-Concept Scale
Attention Deficit Hyperactivity Disorder
There is a belief that various aspects of Martial
Arts practice can reduce impulsivity and
improve concentration in children with ADHD,
but further research is needed to confirm this.11
Creative Commons: Flickr/Flavio
Karate Summer Camp 2013 Link
Martial Arts and Aggression
 Research indicates that
practicing martial arts
does not foster aggressive
behaviors.11, 12
 It is important that the
martial arts instructor
emphasizes a proper
attitude of respect and
Creative Commons / Flickr / Bart:
Advancing martial arts students bowing in respect.
Wheelchair Martial Arts
Video: Wheelchair kata
Video: Wheelchair karate
Video: Martial arts and United
Cerebral Palsy
Video: Wheelchair self defense
YouTube/Joe Demanuele: Wheelchair kata
More Research Is Needed
 Several studies do not show statistically
significant improvement after a martial arts
 There are few well-designed studies.
 Most positive findings come from case
studies or anecdotal evidence.
Martial Arts in Action
Amy Sturkey, a PT in the Charlotte, N.C., area has
found that martial arts-themed physical therapy:
 provides a good alternative to “typical physical
 helps children who have had trouble transitioning
into community-based, gross motor-oriented
recreation programs.
Martial Arts in Action
 The classes are used for children with a wide array of
 Every child has a one-on-one assistant in addition to
the karate instructor and the PT.
 The PT and karate instructor work collaboratively to
meet the needs of each child and to modify each
exercise as needed.
Amy has seen her clients
improve their balance,
UE/LE strengthening, motor planning,
bilateral coordination, endurance,
social skills, and group-play skills.
Flickr /Kevin Makice : Balance
A Rewarding Experience
 Her clients who can’t stand, walk or even sit on their
own enjoy the opportunity to do things that their
typically developed peers take for granted.
 They often work harder in a martial arts-themed
session than they do during typical PT.
 Amy believes martial arts are an effective medium for
PT, similar to hippotherapy and aquatic therapy.
My Clinical Rotation Experience
My Clinical Rotation Experience
“Emotional and physical benefits were observed during
[Juan's] karate sessions with Ryan. [Juan] began smiling
more, sitting up straighter in his power wheelchair and
initiating conversations with more confidence. He was
eager to demonstrate his karate moves to school staff
and peers. With karate, [Juan] demonstrated a
connection and true sense of excitement regarding
physical exercise, that had not been observed in the
previous months.”
-Shelley Rhudy, MPT
"Martial arts was an excellent motivator for a child with attention
and balance difficulties, and it can be tailored towards the child's
interests and functional needs. The young man we did martial arts
with had difficulty with balance and trunk rotation. With every
kick, punch, and block, he was willingly challenged to work on
impairments that he otherwise was likely to become frustrated with
and walk away.
Martial arts is a good activity for peers to work on as well. I had a
young lady who did better with a classmate model. They enjoyed
taking turns blocking and 'karate chopping.' The blocking was
excellent for hand eye coordination and balance. The chopping for
power, endurance and trunk rotation."
-Melissa Scales, PT, DPT
Finding Instruction
 Call local martial arts schools and speak with the
head instructor.
 Make the family aware that bumps and bruises can
 The physical therapist should accompany the family
to the first lesson.
 Contact the city parks and recreation department to
see if they provide any lessons or activities.
Thank You
1. Healthy Healthy Living: Martial Arts. Available at:
Accessed November 22, 2013.
2. Fong SS, Tsang WW, Ng GY. Taekwondo training improves sensory organization and balance
control in children with developmental coordination disorder: a randomized controlled trial. Res
Dev Disabil. 2012 Jan-Feb;33(1):85-95. doi: 10.1016/j.ridd.2011.08.023. Epub 2011 Oct 4. PubMed
PMID: 22093652.
3. Fong SS, Chung JW, Chow LP, Ma AW, Tsang WW. Differential effect of Taekwondo training
on knee muscle strength and reactive and static balance control in children with developmental
coordination disorder: a randomized controlled trial. Res Dev Disabil. 2013 May;34(5):1446-55.
doi: 10.1016/j.ridd.2013.01.025. Epub 2013 Mar 5. PubMed PMID: 23474997
4. Fong SM, Ng GY. Sensory integration and standing balance in adolescent taekwondo
practitioners. Pediatr Exerc Sci. 2012 Feb;24(1):142-51. PubMed PMID: 22433259.
5. Fong, SM William W.N. Tsang, Relationship between the duration of taekwondo training and
lower limb muscle strength in adolescents, Hong Kong Physiotherapy Journal, Volume 30, Issue
1, June 2012, Pages 25-28, ISSN 1013-7025,
6. Fong SS, Tsang WW, Ng GY. Altered postural control strategies and sensory organization in
children with developmental coordination disorder. Hum Mov Sci. 2012 Oct;31(5):1317-27. doi:
10.1016/j.humov.2011.11.003. Epub 2012 Jan 4. PubMed PMID: 22221468.
7. Bahrami F, Movahedi A, Marandi SM, Abedi A. Kata techniques training consistently
decreases stereotypy in children with autism spectrum disorder. Res Dev Disabil. 2012 JulAug;33(4):1183-93. doi: 10.1016/j.ridd.2012.01.018. Epub 2012 Mar 22. PubMed PMID: 22502844.
8. Lakes KD, Hoyt WT. Promoting self-regulation through school-based martial arts training.
Journal of Applied Developmental Psychology, Volume 25, Issue 3, May–June 2004, Pages 283-302.
9. Diamond A, Lee K. Interventions shown to aid executive function development in children 4
to 12 years old. Science. 2011 Aug 19;333(6045):959-64. doi: 10.1126/science.1204529. Review.
PubMed PMID: 21852486; PubMed Central PMCID: PMC3159917.
10. Conant KD, Morgan AK, Muzykewicz D, Clark DC, Thiele EA. A karate program for
improving self-concept and quality of life in childhood epilepsy: results of a pilot study. Epilepsy
Behav. 2008 Jan;12(1):61-5. Epub 2007 Oct 17. PubMed PMID: 17923439.
11. Woodward TW. A review of the effects of martial arts practice on health. WMJ. 2009
Feb;108(1):40-3. Review. PubMed PMID: 19326635.
12. Trulson, M.E. (1986) Martial Arts Training: A Novel "Cure" for Juvenile Delinquency. Human
Relations 39: 1131-1140
Additional Articles
Itamar N, Schwartz D, Melzer I. Postural control: differences between youth judokas
and swimmers. J Sports Med Phys Fitness. 2013 Oct;53(5):483-9. PubMed PMID:
Liberman L, Ratzon N, Bart O. The profile of performance skills and emotional
factors in the context of participation among young children with Developmental
Coordination Disorder. Res Dev Disabil. 2013 Jan;34(1):87-94. doi:
10.1016/j.ridd.2012.07.019. Epub 2012 Aug 30. PubMed PMID: 22940162.
Strayhorn JM, Strayhorn JC. Martial arts as a mental health intervention for
children? Evidence from the ECLS-K. Child Adolesc Psychiatry Ment Health. 2009
Oct 14;3(1):32. doi: 10.1186/1753-2000-3-32. PubMed PMID: 19828027; PubMed
Central PMCID: PMC2766365.

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