Association of physical activity and body mass index with metabolic syndrome among U.S. adolescents with disabilities

Investigation of sports participation motivation in people with disabilities: a cross-sectional study of individuals with physical and hearing impairments

While reading the literature, it is seen that there are not enough studies on the motivation of disabled individuals to participate in sports. This study aims to examine the sports participation motivations of hearing impaired and physically disabled athletes. This study was a cross-sectional study. The research group of the study consists of physically and hearing-impaired individuals between the ages of 18-47. The participants of this research group consisted of 253 volunteer disabled individuals, 150 of whom were men and 103 of whom were women. Sports participation motivation scale was used for disabled individuals. The scale consists of 3 dimensions and is a 5-point Likert type. The results of the study showed that hearing-impaired people have a higher high school rate and physically person with disability have a higher bachelor's degree rate, but the primary education rate did not change between hearing and physically person with disability. Physical activity participation differed between hearing and physically person with disability, and it was observed that hearing-impaired people participated in more physical activities. The level of well-being of the physically disabled was significantly better than the hearing impaired. As conclusion, it is observed that the people with the lowest motivation to participate in sports are primary school graduates and those with high welfare have a high motivation to participate in sports.

Estimating life expectancy and years of life lost for autistic people in the UK: a matched cohort study

Background

Previous research has shown that people who have been diagnosed autistic are more likely to die prematurely than the general population. However, statistics on premature mortality in autistic people have often been misinterpreted. In this study we aimed to estimate the life expectancy and years of life lost experienced by autistic people living in the UK.

Methods

We studied people in the IQVIA Medical Research Database with an autism diagnosis between January 1, 1989 and January 16, 2019. For each participant diagnosed autistic, we included ten comparison participants without an autism diagnosis, matched by age, sex, and primary care practice. We calculated age- and sex-standardised mortality ratios comparing people diagnosed autistic to the reference group. We used Poisson regression to estimate age-specific mortality rates, and life tables to estimate life expectancy at age 18 and years of life lost. We analysed the data separately by sex, and for people with and without a record of intellectual disability. We discuss the findings in the light of the prevalence of recorded diagnosis of autism in primary care compared to community estimates.

Findings

From a cohort of nearly 10 million people, we identified 17,130 participants diagnosed autistic without an intellectual disability (matched with 171,300 comparison participants), and 6450 participants diagnosed autistic with an intellectual disability (matched with 64,500 comparison participants). The apparent estimates indicated that people diagnosed with autism but not intellectual disability had 1.71 (95% CI: 1.39-2.11) times the mortality rate of people without these diagnoses. People diagnosed with autism and intellectual disability had 2.83 (95% CI: 2.33-3.43) times the mortality rate of people without these diagnoses. Likewise, the apparent reduction in life expectancy for people diagnosed with autism but not intellectual disability was 6.14 years (95% CI: 2.84-9.07) for men and 6.45 years (95% CI: 1.37-11.58 years) for women. The apparent reduction in life expectancy for people diagnosed with autism and intellectual disability was 7.28 years (95% CI: 3.78-10.27) for men and 14.59 years (95% CI: 9.45-19.02 years) for women. However, these findings are likely to be subject to exposure misclassification biases: very few autistic adults and older-adults have been diagnosed, meaning that we could only study a fraction of the total autistic population. Those who have been diagnosed may well be those with greater support needs and more co-occurring health conditions than autistic people on average.

Interpretation

The findings indicate that there is a group of autistic people who experience premature mortality, which is of significant concern. There is an urgent need for investigation into the reasons behind this. However, our estimates suggest that the widely reported statistic that autistic people live 16-years less on average is likely incorrect. Nine out of 10 autistic people may have been undiagnosed across the time-period studied. Hence, the results of our study do not generalise to all autistic people. Diagnosed autistic adults, and particularly older adults, are likely those with greater-than-average support needs. Therefore, we may have over-estimated the reduction in life expectancy experienced by autistic people on average. The larger reduction in life expectancy for women diagnosed with autism and intellectual disability vs. men may in part reflect disproportionate underdiagnosis of autism and/or intellectual disability in women.

Funding

Dunhill Medical Trust, Medical Research Council, National Institute for Health and Care Research, and the Royal College of Psychiatrists.

Effects of a Floor Hockey Intervention on Motor Proficiency, Physical Fitness, and Adaptive Development in Youths with Mild Intellectual Disabilities

This study examined the effects of a 12-week floor hockey training program on the motor proficiency, physical fitness, and adaptive development of youths with mild intellectual disabilities (IDs). A total of 54 youths with IDs were divided into two groups: a floor hockey exercise group (EG; n = 27; age, 16.59 ± 0.56 years) and a control group (CG; n = 27; age, 16.65 ± 0.63 years). The participants in the EG attended sessions of a floor hockey training program 3 times per week over a 12-week period. The CG group maintained their standard activities of daily living. The participants' scores on the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition, Brockport Physical Fitness Test, and traditional Chinese version of the teacher form of the Adaptive Behavior Assessment System, Second Edition, were obtained before and after the intervention. The results of the study indicate that the 12-week floor hockey training program significantly increased the participants' scores for most indicators of motor proficiency (p < 0.01), physical fitness (p < 0.01), and adaptive development (p < 0.01). The findings provide evidence that physical activity interventions focusing on floor hockey training are a viable therapeutic option for treating youths with IDs.

The 24-Hour Movement Guidelines and Body Composition Among Youth Receiving Special Education Services in the United States

BACKGROUND

The purposes of this study were to examine the proportions of youth receiving special education services in the United States who individually and jointly met physical activity, screen time, and sleep duration guidelines, and to examine the impact of meeting none, one, two, and three of the guidelines on overweight and obesity.

METHODS

This cross-sectional analysis utilized data from the 2016 to 2017 National Survey for Children's Health data set on 3582 youth aged 10-17 years who received special education services. The frequency of the participants' compliance with the 24-hour movement guidelines and body weight status (based on the age- and sex-specific percentile cutoffs) were estimated. Meeting guidelines was defined as: 9-11 hours/night (5-13 y) or 8-10 hours/night (14-17 y) of sleep, ≤120 minutes per day of screen time, and ≥60 minutes per day of moderate to vigorous physical activity. A multinomial logistic regression analysis was conducted to estimate the impact of meeting none, one, two, or three guidelines on body weight status, adjusted for potential confounders.

RESULTS

Overall, 8.1% of youth met all three guidelines, 42.0% met two guidelines, 38.0% met one guideline, and 11.9% did not meet any guideline. Meeting all three guidelines was associated with an approximately 50% decreased likelihood of overweight than meeting no guideline, or sleep or screen time guidelines independently.

CONCLUSIONS

This study extends the 24-hour movement framework to children receiving special education services and should prompt the continued study of its utility for understanding health disparities experienced by this population.

Research Trends and Recommendations for Physical Activity Interventions Among Children and Youth With Disabilities: A Review of Reviews

This scoping review synthesized reviews of physical activity (PA) interventions for children and youth with disabilities to highlight promising elements of effective interventions, research methodological limitations, and research priorities. Twenty studies were eligible and underwent three rounds of review by an expert panel. Rich and diverse PA programs derived potential short-term benefits toward health, function, and PA. Strategies to increase sample sizes included embedding programs in the community and using information communication technology to deliver exercise programs. Methodological limitations of interventions included a lack of generalizability, transferability, and scientific rigor. Three research priorities were identified: develop and report precision-based intervention strategies, identify strategies that promote both long-term and sustainable PA participation and outcomes, and develop scalable interventions and recruitment strategies. If addressed, these areas could enhance the impact of PA interventions for children and youth with disabilities.

The perspectives of parents of youth with disabilities toward physical activity: A systematic review

BACKGROUND

Parents' perceptions of physical activity (PA), in particular, are critically important because children with disabilities are often dependent on their families to be able to engage in physical activities. Thus, adapted physical activity scholars have acknowledged the need for research addressing the perceptions of parents of youth with disabilities regarding their child's PA engagement.

PURPOSE

The purpose of this review was to examine published research literature pertaining to parents' perspectives toward physical activity of youth with disabilities by describing study characteristics and major findings.

METHODS

Electronic database searches were conducted to identify relevant articles published between January 2007 and January 2018.

RESULTS

Thirty-two articles met all inclusion criteria, and relevant data such as participant characteristics, theories, measurements, and dependent variables were extracted from them. Of the 32 studies, 26 were descriptive, and six were correlational. Seventeen studies explicitly stated a theoretical or conceptual framework.

CONCLUSIONS

Major findings suggest that parents have reported multiple motives to engage their children with disabilities in physical activity. However, numerous barriers (e.g., lack of program, lack of time, children's disability) were reported that negatively impact physical activity participation. As such, parents are calling for the need for training provided by qualified professionals to enhance participation for their children with disabilities.

Prevalence and Influencing Factors of Metabolic Syndrome Among Persons with Physical Disabilities

PURPOSE

Metabolic syndrome is an important cluster of coronary heart disease risk factors. However, it remains unclear to what extent metabolic syndrome is associated with demographic and potentially modifiable lifestyle factors among Korean persons with physical disabilities. This study aimed to determine the prevalence and influencing factors of metabolic syndrome among persons with physical disabilities using the Korean National Health Insurance Service-National Sample Cohort.

METHODS

The Adult Treatment Panel III criteria were used to define metabolic syndrome influencing factors and prevalence, which were evaluated in a representative sample from the 2013 Korean National Health Insurance Service-National Sample Cohort database. Characteristics were compared based on frequency using the χ² test. The associations between metabolic syndrome and its risk factors were estimated using logistic multivariable regression analysis.

RESULTS

Metabolic syndrome was detected in 31.5% of the surveyed persons with physical disabilities. Female sex, age of ≥65 years, smoking, greater alcohol consumption, physical inactivity, higher body mass index, and a family history of diabetes were associated with increased risks of metabolic syndrome.

CONCLUSION

The major risk factors for metabolic syndrome among persons with physical disabilities were obesity and older age. Performing physical activity was associated with a lower risk of metabolic syndrome. Therefore, we recommend using a continuous obesity management program and physical activity to prevent metabolic syndrome among persons with physical disabilities.

Physical activity and obesity among nine-year-old children with and without chronic health problems, illness, or disabilities in Ireland

BACKGROUND

Regular engagement in physical activity can help youth control their weight during childhood while decreasing one's chances of developing chronic diseases (e.g., coronary heart disease, diabetes) throughout the lifespan. While numerous studies have explored physical activity participation and weight status among typically developing children, few epidemiological studies utilizing nationally representative data has focused on children with chronic health problems, illness, or disabilities (CHID).

OBJECTIVE

Thus, the primary purpose of this secondary-data analysis was to examine physical activity participation and the prevalence of overweight/obesity among nine-year-old children with CHID in Ireland.

METHODS

The weighted nationally-represented data for the obesity analysis (N = 6114) and physical activity analysis (N = 6165) were derived from the Growing up in Ireland national study. Logistic regression analyses were conducted to examine associations between child weight status and likelihood of meeting physical activity guidelines. Children's primary caregiver weight status, child gender, and CHID status were correlates, while estimated household income, reported hours of weekly physical education, and locale were covariates.

RESULTS

Children with CHID had significantly higher odds (1.51, 95% CI 1.19-1.91) of being classified as overweight/obese compared to peers without CHID, when controlling for locale, income, and weekly physical education hours. Conversely, having a CHID was not significantly associated with the odds of children meeting recommended physical activity guidelines.

CONCLUSIONS

Children with CHID had significantly higher odds of being overweight/obese, and these odds increased if the child had a primary caregiver who was overweight/obese. Physical activity levels did not differ between children with and without CHID.

From Disease to Health: Physical Therapy Health Promotion Practices for Secondary Prevention in Adult and Pediatric Neurologic Populations

BACKGROUND AND PURPOSE

Over the last decade there has been a substantial increase in efforts to better understand how targeted physical activity and exercise interventions can be used to minimize secondary consequences arising from neurological damage in both adult and pediatric populations. This article offers an overview of contemporary research that addresses mediators of functional and neuroplastic adaptations associated with physical activity and exercise. We emphasize the important role that physical therapists can play to increase participation and improve well-being in adults and children with neurological disorders. We further highlight potential strategies to foster translation of evidence-based findings for use by clinicians and consumers.

SUMMARY OF KEY POINTS

Engagement in physical activity can serve as a powerful promoter of health and well-being in adults and youth with neurologic disease, and has the potential to alter the course of disease processes. Physical therapists can play a key role in promoting fitness and wellness by encouraging active living, providing early diagnosis of disease and prescribing targeted activity interventions to improve fitness and participation, and helping individuals overcome personal and environmental barriers to an active lifestyle.

RECOMMENDATIONS FOR CLINICAL PRACTICE

Physical therapists must adopt a model of rehabilitation that emphasizes secondary prevention in adults and youth with neurologic diseases. Physical therapists have a unique role in developing forward-thinking approaches in using innovative health and wellness strategies to promote positive changes in activity and exercise behaviors.

Mobility Status as a Predictor of Obesity, Physical Activity, and Screen Time Use among Children Aged 5-11 Years in the United States

OBJECTIVE

To examine physical activity participation, screen time habits, and the prevalence of overweight/obesity among children in the general population with mobility limitations and those enrolled in special education services.

STUDY DESIGN

An observational, cross-sectional analysis of the 2011-2014 National Health and Nutrition Examination Survey, a representative sample of the US population. Mobility limitations, special education services utilization, proxy-reported physical activity and screen time, and overweight/obesity status were assessed in children aged 5-11 years.

RESULTS

Boys with mobility limitations were less likely to meet physical activity guidelines (≥60 minutes daily) compared with those with no limitations (58.1% vs 74.4%, adjusted F = 4.61, P = .04). In a logistic regression model, boys with mobility limitations had significantly lower odds (0.42, 95% CI 0.20-0.86) of meeting physical activity guidelines. The prevalence of children meeting screen time recommendations (≤2 hours daily) among those receiving special education services (42.4%) was lower than children not receiving services (53.2%; adjusted F = 8.87, P < .01). In a logistic regression model, children receiving special education services showed a trend toward significantly lower odds (0.74, 95% CI 0.54-1.03, P = .07) of meeting screen time recommendations. No statistically significant differences for overweight/obesity were found.

CONCLUSIONS

Clear differences were present in physical activity between boys with and without mobility limitations. Furthermore, children receiving special education services demonstrated a lower likelihood of meeting screen time recommendations. Children with disabilities may benefit from targeted interventions aimed at increasing physical activity while decreasing screen time.

Metabolic syndrome burden in apparently healthy adolescents is adversely associated with cardiac autonomic modulation--Penn State Children Cohort

BACKGROUND

Reduced cardiac autonomic modulation (CAM) has been associated with metabolic syndrome (MetS) in adults. However, the association between MetS component cluster and CAM has not been examined in adolescents.

METHODS

We conducted a cross-sectional analysis using data from the Penn State Child Cohort follow-up examination. CAM was assessed by heart rate variability (HRV) analysis of 39-h RR intervals, including frequency (high frequency, HF; low frequency, LF; and LF/HF ratio) and time (SDNN, standard deviation of all RR intervals; RMSSD, square root of the mean of the sum of the squares of differences between adjacent RR intervals; and HR, heart rate) domain variables. To assess the MetS burden, we used continuous MetS score (cMetS)--sum of the age and sex-adjusted standardized residual (Z-score) of five established MetS components. Linear mixed-effect models were used to analyze the association between cMetS and CAM in the entire population and stratified by gender.

RESULTS

After adjusting for age, sex, and race, cMetS was significantly associated with reduced HRV and higher HR. With 1 standard deviation increase in cMetS, there was a significant decrease in HF (-0.10 (SE = 0.02)), LF (-0.07 (SE = 0.01)), SDNN (-1.97 (SE = 0.50)), and RMSSD (-1.70 (SE = 0.72)), and increase in LF/HF (0.08 (SE = 0.02)) and HR (1.40 (SE = 0.26)). All cMetS components, with the exception of high-density lipoprotein (HDL), were associated with significantly decreased HRV and increased HR. High blood pressure (MAP) and triglyceride (TG) levels were also associated with an increase in LF/HF and decrease in RMSSD. An increase in high-density lipoprotein was only associated with higher LF and SDNN. Moreover, cMetS and HRV associations were more pronounced in males than in females. The associations between HRV and. MAP, TG, and HDL were more pronounced in females.

CONCLUSIONS

cMetS score is associated with lower HRV, suggesting an adverse impact on CAM, even in apparently healthy adolescents.

Psoriasis and sport: a new ally?

BACKGROUND

Psoriasis is a common chronic multifactorial disease which can result in restrictions to social and recreational activities. Psoriasis subjects are at high risk to develop metabolic and cardiovascular diseases. Physical activity, a vital component in prevention and management of these diseases, is reported to be potentially associated in a negative way with psoriasis.

OBJECTIVE

To investigate the relationship between psoriasis and physical activity.

MATERIALS AND METHODS

Anamnestic and physical examination as well as a specific doctor-administered questionnaire was performed to a group of 416 consecutive sportive subjects and 489 sex and age-matched controls. Moreover, similar investigations were executed on 400 consecutive psoriatic patients without psoriatic arthritis.

RESULTS

Psoriasis was significantly more common in controls respect to sportive group (n = 27, 5.4% vs. n = 7, 1.7%, P < 0.01) whereas a positive familial history of psoriasis was observed in similar percentages in both groups (n = 51, 10.2% vs. n = 40, 9.6%). The number of subjects performing sports activities was significantly lower in psoriasis group compared to controls (n = 44, 11% vs. n = 106, 21.3%; P < 0.001). Of these psoriatic patients, 35/44 referred that sporting activities showed a positive influence on the natural course of their disease, whereas the remaining 11 patients did not highlight positive or negative influences on their illness. Interestingly, 23.75% of psoriatic patients (n = 95) related that they had regularly carried out sporting activities before the onset of the dermatosis referring that psoriasis represented a huge obstacle to continue practicing physical activities.

CONCLUSION

Our survey showed that regular physical activity may lower the risk of psoriasis and have a beneficial effect on the natural course of the disease, positively influencing not only the severity as well as the incidence of metabolic comorbidities, but also, through possible epigenomic, metabolic, anti-inflammatory and psycho-emotional effects, the onset of the dermatosis. However, larger birth cohort studies are needed to confirm these results.