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

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IntroductionIntellectual disability (ID) is characterized by significant limitations in both intellectual functioningand adaptive behaviour as expressed in conceptual, social, and practical skills [1]. The disabilityoriginates before the age of 18 [1]. Intellectual disabilities are categorized in four groups: mild,moderate, severe and profound. Persons with severe or profound ID have a prevalence of visualimpairments of 92% [2].People with intellectual disabilities tend to have low activity and fitness levels whichdecline over the years when compared with those without a disability [3, 4]. Like individualswith intellectual disabilities, persons with visual impairments also display poor performance inlocomotor skills [5] and have low levels of habitual activity [6]. Individuals who suffer from acombination of severe or profound intellectual and visual disabilities (severe or profound multipledisabilities, SIMD) are particularly at risk in terms of the potential development of deficits in bothlocomotor skills and daily functioning [7]. Furthermore, the combination of these deficits suggeststhat persons having SIMD are likely to have lower levels of habitual activity, than persons with IDwithout visual impairment.Bouchard et al. [8] describes the relationship between physical activity, health-relatedfitness and health. Good physical fitness improves wellbeing and quality of life [9, 10], anddecreases health risks, such as overweight and obesity [11]. Bouchard et al. described cardiorespiratoryfitness as an important component of health-related fitness [8]. However, aconsiderable number of persons with SIMD achieved poor results compared to other persons withspecific health conditions on health-related fitness as measured by the six minutes walking test[12]. These findings hence underscore the importance of gaining comprehensive insight into thehealth-related fitness of persons with SIMD, including the level of cardiorespiratory fitness.Waninge et al. [12] performed a feasibility and reliability study for an adapted Shuttle RunTest (aSRT) in adults with SIMD. Feasibility and test-retest reliability of this aSRT over groundwere good for participants classified on the Gross Motor Functional Classification Scale (GMFCS)as level I, yet not sufficient for those with GMFCS level II [12]. The peak heart rate (HR peak) foreach participant was estimated according to the Fernhall equation [13]. However, a significantdifference (p
In order to confirm the validity of the aSRT [12], results of both the treadmill and aSR testshould be compared to a golden standard [18]. Midgley et al. [19] reviewed available literatureregarding the verification phase following a graded exercise test and suggested performing aSupra Maximal Block Test (SMBT) to set a gold standard for HR peakon an individual basis [19]. Ifthe heart rate of the SMBT differs by no more than two beats from the HR peakreached during thecorresponding aSRT [12], the exertion during the aSRT [12] is scored as maximal [19].The purpose of this study thus is twofold; it seeks to determine the feasibility, validity andtest-retest reliability of a graded treadmill test (GXT) for participants with SIMD and GMFCS levelI, using a Supra Maximal Block Test (SMBT) as golden standard. By doing so, this study will alsoassess whether the formula of Fernhall overestimates HR peakin persons with SIMD.MethodsParticipantsThe participants were recruited from a residential care facility in the Netherlands, which ishome to 200 persons with severe or profound intellectual and visual disabilities. Only personsfunctioning at GMFCS-I level were included, because Waninge et al. have indicated the aSRTperformed over ground is only reliable for persons with GMFCS level I [12]. Probably due tovisual impairments, the participants were not able to run and jump spontaneously [5, 7, 12].Subsequently, classification was adjusted so as to include people with GMFCS-I who were able toincrease walking speed [12].A total of 30 participants were recruited (17 males, 13 females), all classified as GMFCS-I.Twenty-three participants had a severe ID and seven a profound ID. Some could not walk alonebecause of a visual impairment. Table 1 presents the participants’ characteristics.Table 1. PopulationMale (n=17) Female (n=13) Total (n=30)Age Mean (SD) 40 (11) 42 (11) 41 (11)IDSevere ID(20≤IQ
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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
Page 22 and 23: Chapter 2Feasibility and reliabilit
Page 24 and 25: IntroductionPhysical fitness and he
Page 26 and 27: GMFCS was presented to the investig
Page 28 and 29: Body weightTo determine the body we
Page 30 and 31: Table 1 Results of Wilcoxon rank te
Page 32 and 33: Calculation of heightThe mean (SD)
Page 34 and 35: DiscussionThe results of our study
Page 36 and 37: References1 Bouchard C, Shepard RJ,
Page 38 and 39: 37 Rimmer J, Kelly LE, Rosentswieg
Page 40 and 41: Chapter 3Measuring waist circumfere
Page 42 and 43: IntroductionChildren and adults wit
Page 44 and 45: participants. These calculations as
Page 46 and 47: Data analysisThe data were analyzed
Page 48: Table 2. Simple regression analysis
Page 56 and 57: IntroductionPeople with intellectua
Page 58 and 59: Eighty representatives gave permiss
Page 60 and 61: 3) The measurement procedure: The m
Page 62 and 63: and whether motivation influenced t
Page 64 and 65: Table 3. Mean peak heart rate achie
Page 66 and 67: AcknowledgementsThis research was f
Page 68 and 69: 21 Hopkins WG, Gaeta H, Thomas AC,
Page 70 and 71: Chapter 5Psychometric quality of a
Page 74 and 75: Exclusion criteria were mental or p
Page 76 and 77: participant had fulfilled the task.
Page 78 and 79: Table 2. Descriptive results peak h
Page 80 and 81: Table 3. Test-retest reliability of
Page 82 and 83: Table 4. Correlation scored motivat
Page 84 and 85: preceding GXT results on HR peak. G
Page 86 and 87: References1 Schalock R, Brown I, Br
Page 88 and 89: 37 Stanish HI, Temple VA, Frey GC.
Page 92 and 93: IntroductionLocomotor skills in peo
Page 94 and 95: this study was to evaluate the feas
Page 96 and 97: obtained from the legal representat
Page 98 and 99: Modified Berg Balance Scale scoresI
Page 100 and 101: Modified Berg Balance Scale scoresT
Page 102 and 103: References1 Van Erkelens-Zwets JHJ
Page 104 and 105: 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
Page 120 and 121: 18 Gielen EJJM. Is spasticiteit te
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Chapter 8Heart Rate Pattern as an I
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IntroductionIt is important to gain
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48 persons18 persons lacked permiss
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Furthermore, the mean and the range
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Table 3. Day-to-day outline of the
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Relation between heart rate pattern
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patterns in this study we can concl
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References1 Emerson E. Underweight,
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38 Multilevel Models Project (2004)
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Chapter 9General DiscussionChapter
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on this. To sum up, testing in pers
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for future research it is recommend
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studies. Randomized Controlled Tria
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of these individuals require more?
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19 Lahtinen U, Rintala P, Malin A.
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SummarySummary | 151
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problems in both locomotor skills a
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subjects are to be applied to perso
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may be an indicator of activity lev
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SamenvattingSamenvatting | 159
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InleidingVoldoende bewegen en fithe
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verstandelijk niveau en bepaalde mo
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Hieruit bleek, dat de motivatie van
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Verder is duidelijk geworden dat me
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DankwoordDankwoord | 169
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De leden van de leescommissie, prof
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Judith van der Boom, dank je wel vo
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Dankwoord | 175
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Curriculum vitaeCurriculum vitae |
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Curriculum vitae | 179
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