Gross motor skills: what they are, characteristics and stages of development.

Let's see what gross motor skills are and which are the diseases that affect them.

Gross motor skills are those that allow us to perform large movements with the participation of different muscles and the intervention of balance, agility, strength and speed involved in each movement.

Typical gross motor movements are walking and jumping or more complex activities such as cycling or swimming, i.e., movements that require the operation of a large number of muscles. When a disease occurs that affects gross mobility, this ability is limited, which is observed in individuals with lack of coordination, with clumsy, slow and imprecise movements.

In this article we will see what is the definition of gross motor skills.The most typical characteristics, which brain areas are involved in the movement and some of the alterations or disorders that affect this type of motor skills.

What is gross motor skills?

Gross motor skills are a type of psychomotor skills which movements such as moving the arms or legs, and which involve the participation of different and that involve the participation of different muscles of the body, being also important the agility, strength and speed with which each movement is performed.

Similarly, this type of motor skills allows us to maintain balance and make changes in our body position in a coordinated manner. Compared to fine motor skills, these movements are somewhat less precise and more linked to strength.

Thus, the movements that we will be able to perform through the gross motor function are walking, jumping, running, swimming, and cycling, among others.. We see that this is a skill that encompasses different more or less complex actions; for this reason it will follow a development process that will begin in childhood. The child starts crawling and will mature to be able to execute more complex activities such as riding a bicycle.

Gross motor development process

The development process of this type of motor skills follows two psychophysiological principles two psychophysiological principles: cephalo-caudal and proximal-distal.. The first refers to the vertical axis that goes from the head to the coccyx bone, and the second is associated with the horizontal axis from the central point of the body to the extremities. In this way, first the head will move, then the arms, then the hands, the abdomen, the legs and finally the feet.

In reference to children, the Denver Developmental Test is used to measure the progress of both gross and fine motor skills, as well as language, personality and social development.The Denver Developmental Test is used to measure the progress of gross and fine motor skills, as well as language, personality and social development, from the first month of life up to 6 years of age.

Correct gross motor development in healthy children

The correct evolution of gross motor skills in children is as follows.

• At 3 months of age, the child is able to roll over intentionally.
• At 4 months he can control his head.
• At 6 months he can sit up without any support, and at 8 and a half years he can do it without help.
• Begins to crawl between 6 and 10 months.
• He stands upright at 1 year of age.
• It manages to wander approximately between 12 and 13 months.

It has been proven that gross motor skills are essential for children to be able to move around in order to explore and discover the environment around them.. It has also been found to be important for the development of learning and attention skills, as it allows training visuospatial abilities, lateral integration, orientation... abilities related to cognitive functions, especially reading and writing.

It should also be pointed out that gross motor skills begins to develop earlier than fine motor skillswhich encompasses the performance of smaller, more precise and more controlled movements, requiring smaller muscles.

Brain regions involved in gross motor skills

The lobe that is most closely related to movement is the frontal lobealthough there are also others involved, such as the parietal. Like all motor functions, it consists of a primary motor area and association areas; the primary motor area is number 4 according to Brodmann's classification, and the association areas (also called "premotor" in this case) are Brodmann's 6 and 8.

Different phases are necessary for the realization of voluntary movement.. First will take place the preparation or planning of the goal, in this first phase involves the dorsolateral area of the prefrontal cortex, responsible for the intention and planning; And the medial area of the prefrontal cortex, used for attention and motivation and the posterior cortex and crossroads, which provide sensory information.

Another phase necessary for optimal movement is programming.In this phase, the different regions of the premotor area will act mainly in order to create a motor program taking into account the spatio-temporal patterns, the desired direction and the temporal sequencing.

The last phase is the realization phaseIt is the primary motor cortex that generates the command, which is sent to the spinal cord to initiate the voluntary movement. In this way it determines the elementary characteristics of the movements and adapts them to the different environmental conditions.

The cerebellum is another important region for movement, since it has the function of making adjustments in this, also regulating posture and Muscle tone and thus allowing a correct balance.

Pathologies affecting gross motor skills.

There are different disorders that affect the correct performance of the movement.These disorders present different variations depending on when they developed and whether they are acquired or whether the patient was already affected at birth, or whether there is an increase or decrease in mobility.

The fifth edition of the Diagnostic Manual of the American Psychiatric Association (DSM 5) classifies different motor disorders, among which we find developmental coordination disorder. This is defined as an alteration in motor skills that are below what is expected given the child's age and learning opportunities. Thus, the child will show a clumsy execution of movements with slowness or inaccuracy in their realization.

This disorder appears during the developmental period, observing that children who suffer from it trip and fall more easily than usual, find it difficult to pick up and handle objects and present muscular hypotonia, which consists of a weakness in muscle tone, flaccidity.

The manual also describes stereotyped movement disorderwhich refers to aimless and apparently guided repetitive motor behavior. For example, flapping of the arms, swaying of the body or a tendency to bang the head may be observed. It will therefore be necessary to indicate whether self-injurious behavior occurs and whether the involvement is mild (if it disappears with stimulation), moderate (if protective measures are necessary) or severe (when it requires continuous monitoring to avoid serious injury).

Finally, the third disorder classified under motor disturbances in the DSM 5 is tic disorder. It is characterized by repetitive, fast, recurrent and not rhythmic movements, being able to be simple motors (like blinking), complex motors (like jumping), simple vocal (they will consist of making sounds or noises without sense) or complex vocal (where repetition of words takes place). Of the different tics raised the most frequent are the motor ones.

Different types of disorders by tics will be diagnosed according to the modality of tic that is presented and the duration of these. Thus, the Tourette's disorder presents multiple motor tics and at least one vocal tic, which persist during more than one year and which have their beginning before the age of 18 years.

Another type is the disorder of persistent tics, where appear motor or vocal tics, being necessary that they last more than one year, and that begins before the 18 years of the individual.

Finally, transient tic disorder shows motor and/or vocal tics, but these last less than a year, also starting before the age of 18.

How to treat gross motor disturbances.

Given the difficulty that is presented to execute certain movements it will be fundamental to work and to train to obtain an improvement and thus also to help to present more confidence and security in oneself. In this way, different activities are carried out both at the health professional's office and at home with the help and collaboration of the parents..

Materials, dynamic and entertaining games for children that help them to practice motor skills, such as the parachute, which consists of a cloth that allows them to play in a group, thus improving motor skills and coordination; the motor route, which allows them to gain self-confidence; or the shape circuits, where they can work on laterality, coordination and balance.

It can also be exercised through more common movements without the need for material; for example, through routines such as walking down stairs, walking on the heels or jumping. We can start with simpler exercises and increase the difficulty as confidence and security are acquired.