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

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subjects are to be applied to persons with profound intellectual, visual, and motor disabilities.Chapter 3 deals with the validity and reliability of measuring waist circumference of persons withPIMD.The validity study performed with healthy participants, during which we compared waistcircumference obtained in standing and supine positions, revealed significant differences betweenstanding and supine waist circumference measurements. We found that the validity of supinewaist circumference is biased towards higher values (1.5 cm) of standing waist circumference.However, standing waist circumference can be predicted from supine measurements using asimple prediction equation. This equation allows the comparison of supine measurements ofdisabled persons with international standards of waist circumference.The test-retest study with PIMD participants, in which we measured the waist circumferenceof subjects in supine position, revealed no significant differences and showed good agreementbetween test and retest waist circumference values. It was concluded that supine waistcircumference can be reliably measured in participants with PIMD.Functional exercise and aerobic capacity measured with overgroundtestsCardiorespiratory fitness can be divided into functional exercise and aerobic capacity. Timedwalking tests are a valuable tool for assessing these components of physical fitness. Howeverfeasibility, validity and reliability of walking tests for persons with SIMD are so far unknown.Chapter 4 seeks to address the issue of the cardiorespiratory component of physical fitness.Therefore, a study is put forward with the purpose of examining the feasibility and test-retestreliability of both the six-minute walking distance test (6MWD) as an adapted shuttle run test(aSRT) for participants with SIMD. SIMD participants performed the 6MWD and the aSRT twicewhile wearing a heart rate monitor.The results show that the 6MWD is feasible and reliable for measuring functional exercisecapacity of all participants with SIMD. The aSRT is feasible and reliable for measuring aerobiccapacity of participants with the highest motor functioning level in the study population. Inaddition, we found that the participant’s motivational level can influence test outcomes, so werecommend to include both heart rate monitoring and motivational score into the protocols of theaSRT and 6MWD.Furthermore, we compared the mean distance of the 6MWD as executed by ourparticipants with values reported in other studies. This comparison indicated that personswith SIMD performed poorer on the 6MWD than those with other specific (chronic) healthconditions including heart failure or COPD. The poor 6MWD results we observed suggest thata low functional exercise capacity of persons with severe multiple disabilities is a serioushealth problem, which in turn can burden their independence in day-to-day activities. Based onthis result, further research should be aimed at developing, implementing and evaluating anappropriate intervention aimed at reducing health problems related to low functional exercisecapacity and low aerobic capacity.Summary | 155
Aerobic capacity measured with a graded treadmill testExercise tests using treadmills are a valuable tool for assessing aerobic capacity. However, atreadmill protocol for persons with SIMD is not yet available.Chapter 5 examines the feasibility, validity and reliability of the adapted Shuttle Run Testperformed on a treadmill by participants with SIMD.Participants with SIMD performed the aSRT on a treadmill twice and a validity test wasperformed afterwards. Our results show that the feasibility, validity and test-retest reliability weresufficient for the aSRT on the treadmill when testing participants with SIMD. For determining peakheart rate of SIMD individuals, the validity of the aSRT on the treadmill was better than that of theaSRT performed over ground.An equation used for estimating peak heart rate for people with ID systematicallyoverestimates peak heart rate for people with SIMD. Therefore, it is recommended to adjust thisequation in future research so as to enable a better prediction of the peak heart rate of thisspecific group.Balance ScaleSufficient balance is necessary to perform daily activities. Since the feasibility and reliability ofbalance tests are so far unknown for persons with SIMD, chapter 6 describes a study with thepurpose of determining the feasibility and reliability of the modified Berg Balance Scale (mBBS)for this specific group.Participants with SIMD performed the mBBS twice with a one week interval. The resultsshow that the test-retest reliability of 10 out of 12 mBBS tasks is acceptable. The mBBS is thus areliable test for evaluating the functional balance of persons with SIMD. Furthermore, the mBBS isa feasible instrument for the tested target group.Tests to measure muscle tone and level of spasticityThe quality of daily movement depends partly on muscle tone or level of spasticity, which can bemeasured by the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS). However,no research has been performed to determine the psychometric properties of the MTS and theMAS for persons with PIMD. The purpose of the study described in Chapter 7 was to determine thefeasibility, the test-retest and interrater reliability of the MAS and the MTS in persons with PIMD.Participants with PIMD were measured twice using both the MAS and the MTS, with a oneweekinterval between test and retest. Two observers performed the measurements.The data indicated that the feasibility of the MAS and MTS for measuring muscle tone inpersons with PIMD was good. For both test-retest and interrater reliability, measurements ofthe MAS revealed acceptable agreement. However, for both test-retest and interrater reliability,the measurements of the MTS showed insufficient agreement. The MAS may be a good methodto evaluate the quality of daily movements of individuals with PIMD. A good instruction maycontribute to a better reliability.Heart rate patternsAssessing physical activity levels of persons with PIMD is important, but these levels are difficultto reliably quantify when dealing with participants who are not able to walk. Heart rate monitoring156 | Summary
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Measuring physical fitnessin person
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Rijksuniversiteit GroningenMeasurin
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Chapter 1IntroductionChapter 1 | 9
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overweight [15]. This prevalence is
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Theoretical framework of the studyI
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Components of physical fitnessThe a
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Therefore, a study is put forward w
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2002;40:436-444.19 Temple VA, Frey
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Chapter 2Feasibility and reliabilit
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IntroductionPhysical fitness and he
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GMFCS was presented to the investig
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Body weightTo determine the body we
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Table 1 Results of Wilcoxon rank te
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Calculation of heightThe mean (SD)
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DiscussionThe results of our study
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References1 Bouchard C, Shepard RJ,
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37 Rimmer J, Kelly LE, Rosentswieg
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Chapter 3Measuring waist circumfere
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IntroductionChildren and adults wit
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participants. These calculations as
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Data analysisThe data were analyzed
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Table 2. Simple regression analysis
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IntroductionPeople with intellectua
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Eighty representatives gave permiss
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3) The measurement procedure: The m
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and whether motivation influenced t
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Table 3. Mean peak heart rate achie
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AcknowledgementsThis research was f
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21 Hopkins WG, Gaeta H, Thomas AC,
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Chapter 5Psychometric quality of a
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IntroductionIntellectual disability
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Exclusion criteria were mental or p
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participant had fulfilled the task.
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Table 2. Descriptive results peak h
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Table 3. Test-retest reliability of
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Table 4. Correlation scored motivat
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preceding GXT results on HR peak. G
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References1 Schalock R, Brown I, Br
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37 Stanish HI, Temple VA, Frey GC.
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IntroductionLocomotor skills in peo
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this study was to evaluate the feas
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obtained from the legal representat
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Modified Berg Balance Scale scoresI
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Modified Berg Balance Scale scoresT
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References1 Van Erkelens-Zwets JHJ
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39 Dorai-Raj S. Binomial Confidence
Page 106 and 107: Chapter 7Feasibility, test-retest r
Page 108 and 109: IntroductionPersons with profound i
Page 110 and 111: DesignThe muscle tone and spasticit
Page 112 and 113: Interrater reliabilityFirstly, to d
Page 114 and 115: Table 3. Summary of the statistical
Page 116 and 117: Table 6. Summary of the statistical
Page 118 and 119: RecommendationsThe feasibility of c
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Page 122 and 123: Chapter 8Heart Rate Pattern as an I
Page 124 and 125: IntroductionIt is important to gain
Page 126 and 127: 48 persons18 persons lacked permiss
Page 128 and 129: Furthermore, the mean and the range
Page 130 and 131: Table 3. Day-to-day outline of the
Page 132 and 133: Relation between heart rate pattern
Page 134 and 135: patterns in this study we can concl
Page 136 and 137: References1 Emerson E. Underweight,
Page 138 and 139: 38 Multilevel Models Project (2004)
Page 140 and 141: Chapter 9General DiscussionChapter
Page 142 and 143: on this. To sum up, testing in pers
Page 144 and 145: for future research it is recommend
Page 146 and 147: studies. Randomized Controlled Tria
Page 148 and 149: of these individuals require more?
Page 150 and 151: 19 Lahtinen U, Rintala P, Malin A.
Page 152 and 153: SummarySummary | 151
Page 154 and 155: problems in both locomotor skills a
Page 158 and 159: may be an indicator of activity lev
Page 160 and 161: SamenvattingSamenvatting | 159
Page 162 and 163: InleidingVoldoende bewegen en fithe
Page 164 and 165: verstandelijk niveau en bepaalde mo
Page 166 and 167: Hieruit bleek, dat de motivatie van
Page 168 and 169: Verder is duidelijk geworden dat me
Page 170 and 171: DankwoordDankwoord | 169
Page 172 and 173: De leden van de leescommissie, prof
Page 174 and 175: Judith van der Boom, dank je wel vo
Page 176 and 177: Dankwoord | 175
Page 178 and 179: Curriculum vitaeCurriculum vitae |
Page 180: Curriculum vitae | 179
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