Measuring physical fitness in Persons with Severe/Profound ...
Measuring physical fitness in Persons with Severe/Profound ...
Measuring physical fitness in Persons with Severe/Profound ...
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participants (Table 1). Thirty-six percent (17) of the <strong>in</strong>tellectual disabled participants had bothhear<strong>in</strong>g problems and visual disabilities; 60% (28) had both visual and orthopaedic disabilities;19% (9) had hear<strong>in</strong>g problems and orthopaedic disabilities. 4 Participants were diagnosed <strong>with</strong>spasticity and they also had visual, and orthopaedic disabilities.Table 1. Comb<strong>in</strong>ations of co-morbidities of participants <strong>with</strong> severe <strong>in</strong>tellectual disabilitiesHear<strong>in</strong>gdisabilitiesOrthopaedicdefectsSpasticityVisual disabilities 36% 60% 4%Hear<strong>in</strong>g disabilities - 19% 2%Orthopaedic defects - - 9%Participants were classified accord<strong>in</strong>g to an adapted GMFCS [38], a five-level system usedto classify the severity of motor abilities <strong>in</strong> people <strong>with</strong> <strong>physical</strong> disabilities. Participants <strong>with</strong>a “Level I” classification can generally walk <strong>with</strong>out restrictions but tend to have limitations <strong>in</strong>some more advanced motor skills. Participants <strong>with</strong> a “Level V” classification generally havevery limited mobility, even <strong>with</strong> the use of assistive technology. These participants always usea wheelchair. The orig<strong>in</strong>al GMFCS was adapted because most of our participants had impairedvision, and as a result they could not jump and run spontaneously. If persons spontaneously<strong>in</strong>creased their speed dur<strong>in</strong>g walk<strong>in</strong>g, <strong>in</strong>stead of jump<strong>in</strong>g and runn<strong>in</strong>g, they were classified asGMFCS level I. Participants <strong>with</strong> a “Level II” classification can walk <strong>with</strong> slight restrictions and donot spontaneously <strong>in</strong>crease their speed dur<strong>in</strong>g walk<strong>in</strong>g. The adapted version of the GMFCS waspresented to the <strong>in</strong>vestigator, who translated the orig<strong>in</strong>al version of the GMFCS <strong>in</strong>to Dutch [40]and he concluded that the adaptations did not <strong>in</strong>fluence the reliability of the system.Study DesignParticipants were tested twice, <strong>with</strong> one week between the test and the retest. Test and retestwere conducted at the same po<strong>in</strong>t <strong>in</strong> time. The participants performed first the aSRT (Netchild,the Netherlands). In order to let the participants take sufficient rest, at least after 48 hours, the6MWD [35] was performed.Ethical statementThe study was performed <strong>in</strong> agreement <strong>with</strong> the guidel<strong>in</strong>es of the Hels<strong>in</strong>ki Declaration as revised<strong>in</strong> 1975. Permission to carry out the study was obta<strong>in</strong>ed from an <strong>in</strong>stitutional ethics committee. Allparticipants were unable to give consent. Therefore, extra care and attention was given to:1) Ask<strong>in</strong>g <strong>in</strong>formed consent: Informed consent was obta<strong>in</strong>ed from legal representatives of allparticipants and also the caregivers of all participants were asked for <strong>in</strong>formed consent;2) The construction of the study group by formulat<strong>in</strong>g exclusion criteria and contra<strong>in</strong>dications:We screened the participants based on the exam<strong>in</strong>ation f<strong>in</strong>d<strong>in</strong>gs of a physician specialised <strong>in</strong><strong>in</strong>tellectual disabilities and also of a behaviour scholar;58 | Chapter 4