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Measuring physical fitness in Persons with Severe/Profound ...

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Physical <strong>fitness</strong> and persons <strong>with</strong> both severe or profound ID andvisual impairmentAs a sufficient <strong>physical</strong> <strong>fitness</strong> level and <strong>physical</strong> activity improve health [26], and sufficienthealth <strong>in</strong> turn improves well-be<strong>in</strong>g and quality of life [27, 28, 29], it is imperative to ga<strong>in</strong>comprehensive <strong>in</strong>sight <strong>in</strong>to the <strong>physical</strong> <strong>fitness</strong> of persons <strong>with</strong> SPIMD.However, the feasibility and reliability of <strong>physical</strong> <strong>fitness</strong> measurements and tests <strong>in</strong> participants<strong>with</strong> SPIMD have until now not been properly scrut<strong>in</strong>ized, result<strong>in</strong>g <strong>in</strong> little reliable knowledge onthe <strong>physical</strong> <strong>fitness</strong> levels and locomotor skills of persons <strong>with</strong> SPIMD.Due to limitations both <strong>in</strong> <strong>in</strong>tellectual function<strong>in</strong>g as <strong>in</strong> adaptive behaviour related toSPIMD, the level of health-related <strong>physical</strong> <strong>fitness</strong> is difficult to quantify <strong>in</strong> a feasible and reliablemanner [1]. Therefore, improv<strong>in</strong>g feasibility of <strong>physical</strong> <strong>fitness</strong> tests <strong>in</strong> persons <strong>with</strong> SPIMD needsto be prioritized. <strong>Persons</strong> <strong>with</strong> SPIMD are not accustomed to the assessments, have difficultycomprehend<strong>in</strong>g what is required of them [30] and often cannot understand <strong>in</strong>structions [3].Furthermore, persons <strong>with</strong> visual disabilities cannot see how test tasks need to be performed [4],hence show<strong>in</strong>g them how to perform the task at hand is useless. In general, if a participant doesnot understand the tasks <strong>with</strong><strong>in</strong> a certa<strong>in</strong> test, the test will automatically fail to provide a realisticimpression of the capabilities of the participant, render<strong>in</strong>g the test <strong>in</strong>valid. Thus, test <strong>in</strong>structionsfor persons <strong>with</strong> SPIMD require our special focus.Other factors of <strong>in</strong>fluence when determ<strong>in</strong><strong>in</strong>g the feasibility, reliability and validity of <strong>physical</strong><strong>fitness</strong> tests <strong>in</strong> persons <strong>with</strong> SPIMD are the prevalence of locomotor disabilities and motivationalproblems. Adapted test procedures and specific <strong>in</strong>clusion criteria are required because persons<strong>with</strong> <strong>in</strong>tellectual, visual, and locomotor disabilities are not able to stand straight or to standat all [31]. Also, persons <strong>with</strong> SPIMD are often not motivated to exert themselves fully, whichnecessitates adjustments to and familiarization <strong>with</strong> test protocols.S<strong>in</strong>ce <strong>physical</strong> <strong>fitness</strong> is related to <strong>physical</strong> activity [26], it is important to ga<strong>in</strong> <strong>in</strong>sight <strong>in</strong>tothe <strong>physical</strong> activity level <strong>in</strong> persons <strong>with</strong> SPIMD. However, as almost 40 % of SPIMD populationis simply not able to walk, walk<strong>in</strong>g fails to be an adequate representation of a person’s overallactivity level [32].Moreover, the presumed low levels of activity <strong>in</strong> persons <strong>with</strong> such profound disabilitiesare often not accurately presented by measurement devices, like activity monitors, which arerelatively <strong>in</strong>sensitive [32]. Heart rate monitor<strong>in</strong>g may be an <strong>in</strong>dicator of activity levels assum<strong>in</strong>g arelationship between activity <strong>in</strong>tensity and heart rate [33, 34]. Heart rate monitor<strong>in</strong>g appears tobe sufficiently valid for creat<strong>in</strong>g broad <strong>physical</strong> activity categories (e.g. highly active, somewhatactive, sedentary) [35]. However, a proper method for dat<strong>in</strong>g heart rate patterns <strong>in</strong> persons <strong>with</strong>PIMD, as well as the proper correlation between heart rate monitor<strong>in</strong>g and activity levels for thisspecific group have so far not been exam<strong>in</strong>ed.12 | Chapter 1

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