Physical activity among children with down syndrome: maternal perception

The Role of Diet and Physical Activity in Obesity and Overweight in Children with Down Syndrome in Developed Countries

Down's syndrome (DS), or Trisomy 21, represents the most common chromosomal abnormality in live births, characterized by an extra chromosome 21. Children affected by Down's syndrome are more susceptible to the development of obesity and of becoming overweight compared with other children. Furthermore, they seem to present a more unfavorable lipid profile than the non-DS obese pediatric population. Diet and physical activity are closely related to the development of overweight and obesity, and they can be assessed using questionnaires such as the Mediterranean Diet Quality Index in children and adolescents (KIDMED) and the Godin-Shephard Leisure-Time Physical Activity Questionnaire. This review aims to undertake a comprehensive analysis of the intricate interplay between diet and physical activity in children affected by Down's syndrome. Specifically, it seeks to deepen understanding regarding the question of how diet and exercise can influence and prevent the development of overweight and obesity in that special pediatric population.

What are the barriers and facilitators to participation of people with Down syndrome? A scoping review

AIM

To determine the barriers and facilitators of active community participation of children, adolescents, and adults with Down syndrome.

METHOD

Searches were completed in five electronic databases to identify original studies about participation of children, adolescents (ages < 18 years), and adults (ages 18-59 years) with Down syndrome. Barriers and facilitators to participation were categorized into four factors: personal, social, environmental, and policy and programme. Findings were analysed and validated by a young adult with Down syndrome and a family member, using the public and patient involvement strategy.

RESULTS

Fourteen studies were included: eight with children and adolescents and six with adults. Of the 14 studies, 10 were qualitative and four quantitative. Most studies (n = 9) investigated participation in physical activities, while only a few examined participation in community/social activities (n = 3), daily activities (n = 2), and leisure activities (n = 1). The most commonly cited barriers and facilitators were the availability of programmes and specialized professionals, transportation, as well as attitudes and behaviours. Physical and psychological characteristics of people with Down syndrome and facilities were also frequently mentioned as barriers. On the other hand, the desire to stay active and personal interest in the activity were among the most frequently reported facilitators.

INTERPRETATION

The participation of people with Down syndrome is mainly influenced by physical or psychological factors, the support and attitudes of parents/caregivers, and the availability of specialized programmes. Given the scarcity of research investigating the participation of people with Down syndrome in community activities, daily activities, and leisure, especially in adults, more studies are still needed.

Quais são as barreiras e facilitadores para a participação de pessoas com Síndrome de Down? Uma Revisão de Escopo

Objetivo

Determinar as barreiras e facilitadores da participação ativa na comunidade de crianças, adolescentes e adultos com Síndrome de Down (SD). Métodos: Foram realizadas buscas em cinco bases de dados eletrônicas para identificar estudos originais sobre a participação de crianças, adolescentes (idades <18 anos) e adultos (idades de 18 a 59 anos) com SD. Barreiras e facilitadores para a participação foram categorizados em fatores: pessoais, sociais, ambientais e de políticas e programas. Os achados foram analisados e validados por um jovem adulto com SD e um membro da família, utilizando a estratégia de Envolvimento do Público e Paciente. Resultados: Quatorze estudos foram incluídos, oito com crianças e adolescentes e seis com adultos. Dos 14 estudos, dez eram qualitativos e quatro quantitativos. A maioria dos estudos (n = 9) investigou a participação em atividades físicas, enquanto apenas alguns estudos examinaram a participação em atividades comunitárias/sociais (n = 3), atividades diárias (n = 2) e atividades de lazer (n = 1). As barreiras e facilitadores mais frequentemente citados foram a disponibilidade de programas e profissionais especializados, transporte, bem como atitudes e comportamentos. As características físicas e psicológicas das pessoas com SD e as instalações também foram frequentemente mencionadas como barreiras. Por outro lado, o desejo de se manter ativo e o interesse pessoal na atividade estavam entre os facilitadores mais frequentemente relatados.

Interpretação

A participação de pessoas com SD é principalmente influenciada por fatores físicos ou psicológicos, o apoio e as atitudes dos pais/cuidadores e a disponibilidade de programas especializados. Dada a escassez de pesquisas investigando a participação de pessoas com SD em atividades comunitárias, atividades diárias e lazer, especialmente em adultos, mais estudos ainda são necessários.

Parental physical activity support for parents of children with disabilities in Saudi Arabia

Physical activity (PA) is crucial for promoting physical, cognitive, and psychosocial health. Unfortunately, children with disabilities spend less time engaging in PA compared to their typically developing peers. Parents play a crucial role in supporting children with disabilities to increase their level of PA. However, there is scant research on the factors linked to parental support for PA among non-Western parents of children with disabilities, particularly in the context of Saudi Arabia. Therefore, to address this gap in the literature, the current study aimed to (i) measure parental support for encouraging PA in children with disabilities in Saudi Arabia, and (ii) examine the demographic factors associated with such support (e.g., family income, age of the child, type of disability, and parents' educational background). The sample included Saudi Arabian parents of children with disabilities (N = 239; fathers: n = 123; mothers: n = 116) who completed the Arabic version of the Parental Physical Activity Support Questionnaire for Parents of Children with Disabilities (PPSQ for PCD). The findings revealed that parental support for children with disabilities to engage in PA typically occurs less than once a week, indicating an inadequate level of support. A generalized linear model analysis demonstrated that several independent demographic variables are associated with overall parental support for PA among children with disabilities: participant age, educational background, parental engagement in PA, age of the child with a disability, disability status, club participation, knowledge of legislation or policies related to the rights of children with disabilities, and number of children in the family. The findings emphasize the significance of raising awareness among parents of children with disabilities to support their children in participating in PA, as well as addressing the barriers that hinder such support.

Physical activity status and its association with quality of life among children with down syndrome in Saudi Arabia: A comparative cross-sectional study

BACKGROUND

Down syndrome is a genetic disorder that causes physical and cognitive challenges. Identifying the impact of sedentary behavior and physical activity on people with Down syndrome is crucial for early intervention. The purpose of this study is to compare physical activity and sedentary behavior among children with Down syndrome and typically developing children, as well as assess their relationship with quality of life.

METHODS

In the cross-sectional study, 67 children between the ages of 6 and 12 were enrolled: 29 in the Down syndrome group and 38 in the typically developing group. Each child wore an ActiGraph wGT3X-BT for seven days. Accelerometer data and quality of life data were analysed.

RESULTS

Physical activity and sedentary behavior were not significantly different between the Down syndrome and typically developing groups (p ˃ .05). With large effect sizes (partial eta squares ranging from 0.21 to 0.59), typically developing children had a significantly better quality of life than children with Down syndrome. There was a weak positive correlation between moderate physical activity and school performance in children with Down syndrome. For typically developing children, there is a weak negative correlation between light physical activity and physical function, school function, and total paediatric quality of life scale scores.

CONCLUSIONS

This study indicates that children with Down syndrome have participated in more physical activities, resulting in a reduction in differences between them and typically developing children. Additionally, typically developing had higher quality of life than children with Down syndrome. For healthcare professionals and educators, these findings provide valuable insights into developing strategies to enhance physical activity for children with developmental disabilities.

Impact of Physical Activity on Autonomy and Quality of Life in Individuals with Down Syndrome: A Systematic Review

Down syndrome (DS) is the most common genetic alteration in humans, resulting from the trisomy of chromosome 21. Individuals with DS are characterized by physical traits and limitations related to intellectual functioning and the development of motor skills. People with DS tend to have lower levels of physical activity (PA) than the general population, despite its benefits for health and quality of life, which could be caused by barriers such as the lack of adapted programs or knowledge on how to adapt them. Therefore, this systematic review aimed to examine the impact of physical activity or sports programs on autonomy and quality of life in individuals with DS. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to search four databases (Scopus, Web of Science, PubMed, and SportDiscus), adhering to the population, intervention, comparison, and outcome strategy. A total of 13 studies were selected that followed different training programs (combined training, adapted football, technology-based, pulmonary training, gymnastics and dance, water-based, and whole body vibration). Most of the interventions provided benefits for autonomy or quality of life (physical, psychological, cognitive, emotional, and social) in people with DS. In conclusion, the benefits of physical activity and sports programs adapted to people with DS are positive.

Moderate-to-vigorous intensity physical activity levels of children with intellectual disability during physical education classes

Background

Physical education (PE) class is an excellent way to improve moderate-to-vigorous intensity physical activity (MVPA). Increasing number of research has explored the children's PA based on movement during PE classes, but data for children with intellectual disability (ID) is still lacking.

Purpose

The purpose of this study was to investigate the current status of MVPA levels of children with ID during PE classes in China, as well as differences of MVPA levels according to gender and grade.

Methods

Accelerometers were used to record MVPA levels of fifty-three children with severe ID from 9 to 16 years of age (mean age: 12.60 ± 1.66 years) during standard PE classes.

Results

The mean time spent in MVPA during PE classes was 8.00 ± 2.10 min, meaning only 22.88% of PE class time was spent in MVPA. As grade levels progresses, time spent in MVPA during PE classes tended to decrease; the fourth-grade children tended to spend more time in MVPA during PE classes compared with the fifth-grade and the sixth-grade (9.15 vs. 7.61 vs. 7.25 min, all p < 0.05). Boys spend significantly more time in MVPA during PE classes than girls; both in the entire sample (9.20 vs. 5.70 min) as well as in each grade (9.76 vs. 6.09 min, 9.35 vs. 5.68 min, 8.31 vs. 5.59 min, all p < 0.05).

Conclusion

Findings from this study indicate that the proportion of PE class spent in the MVPA of children with ID was lower than the 50% recommended by the U.S. Department of Health and Human Services (DHHS) and U.K. Association for Physical Education (AfPE). And the amount of MVPA participation varied by the grade and gender as well as by the activity performed. Therefore, in order to help children with ID achieve MVPA goals, educators need to reevaluate the PE curriculum as well as take due consideration of grade and gender when devising new content.

Factors That Influence Physical Activity in Individuals With Down Syndrome: Perspectives of Guardians and Health Professionals

Identifying factors that influence physical activity (PA) among individuals with Down syndrome is essential for PA promotion. Insight can be gained from guardians and health professionals. The purpose of this study was to explore the perspectives of guardians and health professionals on facilitators and barriers of PA in individuals with Down syndrome. Interviews were conducted with 11 guardians (five mothers, four fathers, and two legal guardians) and 11 professionals (four PA specialists, three physical therapists, and four occupational therapists). Grounded theory was applied. Barriers and facilitators fit the levels of the ecological model of health behavior: (a) intrapersonal (perceived rewards), (b) interpersonal (interaction), (c) community (availability of programs), (d) organizational (school systems), and (e) policy (education). Guardians and professionals agreed on the importance of enjoyment, interaction, and programs to promote PA. Differences between groups were identified at the organizational and policy levels. PA in persons with Down syndrome is influenced by interactions between individual and environmental factors.

Parental perception of facilitators and barriers to health among young children with down syndrome: a qualitative study

Background

Despite high rates of obesity and weight-related conditions observed in children with Down syndrome, little is known about how to prevent these conditions.

Purpose

The purpose of this study was to identify parent-perceived facilitators and barriers to health for toddlers (12-36 months old) with Down syndrome.

Materials and methods

We conducted in-depth, semi-structured interviews with the mothers of 25 toddlers with Down syndrome. All interviews were conducted using Zoom Video Technology, audio recorded and transcribed before being coded in NVivo software using a structured protocol. Thematic analysis was used to identify themes in perceived facilitators and barriers to health at the level of the child, family, and community. Data were triangulated using reflective journaling, video review of child meals, and member-checking techniques.

Results

We identified unique themes for facilitators (on the move and sound sleep) and barriers (co-occurring conditions and eating behaviors) at the level of the child. At the level of the family and community, overarching themes that were viewed as either a facilitator or barrier, depending on the context, were identified (role models matter, time is critical, the importance of place, and social support).

Conclusion

These themes can help clinicians and researchers tailor their health promotion interventions to meet the unique needs of children with Down syndrome by using strength-based approaches and providing families with the tools to overcome barriers.

Determinants of Physical Activity among Children with Disabilities

Maintaining children's physical activity levels is crucial to preventing obesity and improving their health and well-being. However, achieving the recommended daily level of 60 min of moderate-to-vigorous intensity physical activity can be difficult for children with disabilities. Moreover, children with disabilities spend less time engaging in physical activity than their typically developing peers. This study aimed to assess the personal, environmental, and social determinants of physical activity among children with disabilities. This quantitative, cross-sectional study was conducted through an online survey of a convenient sample, including 125 parents of children with disabilities aged between 5 and 18 years from different regions in the Kingdom of Saudi Arabia. Approximately 40.8% of the participants were aged between 41 and 50 years, and 57.6% (the participants and friends of their children) did not engage in regular exercise. Statistically significant differences were observed between the perception of children's health and physical activity summary scores and the engagement of children's friends in physical activity and physical activity summary scores. Efforts should be made to reinforce parents' perceptions of their children's health regarding physical activity and to support the social determinants of physical activity that ensure their children's friends' engagement. Specialized interventional studies are needed to support parents with children.

DSFit: a feasibility pilot study of a group exercise programme for adolescents with Down syndrome

BACKGROUND

While past research has underscored the benefits of physical activity for people with Down syndrome (DS), exercise programming that is customised to and/or accessible for children and adolescents with DS is limited. The objectives of this pilot were to (1) develop and refine an engaging exercise programme for adolescents with DS, called DSFit; (2) assess feasibility over the course of two pilot iterations; and (3) examine participant and parent feedback regarding exercise priorities and the DSFit exercise programme.

METHOD

Participants were 12 unique adolescents (ages 11-17 years) with DS. Both pilot iterations of the programme consisted of weekly group exercise sessions and home exercises to complete between sessions. Physical fitness and mood/behaviour were assessed at baseline and at the end of the intervention. Parent and child goal-setting and feedback surveys were collected before and immediately after the intervention, and a 2-month follow-up assessed physical activity and exercise attitudes. Quality improvement methodology and participant/parent feedback were used to modify the second iteration to better meet the needs of our study population. Changes included an expanded age range, modified physical assessments, decreased burden of questionnaires, and video-recorded group sessions for at-home practice.

RESULTS

Physical fitness evaluation of core/trunk strength and stability, lower- and upper-body strength, balance, flexibility, and walking was feasible, and the majority of participants in both pilot iterations improved in at least one category of physical assessment between baseline and end of intervention. Assessment of symptoms of anxiety, depression and behavioural concerns was also feasible and results showed slight improvements in some participants. Both parent and participant feedback indicated that participants enjoyed the programme and appreciated the opportunity to start developing sustainable exercise habits.

CONCLUSIONS

A group exercise programme with supported at-home components is feasible for adolescents with DS. Future iterations will continue to examine programme efficacy with improved fitness testing and larger sample sizes. Strategies to increase at-home compliance, such as virtual sessions and parent/guardian-guided physical fitness assessments, will also be incorporated.

Family factors associated with physical activity in children with intellectual disability: A systematic review

This systematic review aimed to explore the influence of family factors on physical activity in children with intellectual disability. How and what family factors that specifically influence physical activity has not been compiled and reviewed previously. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search was performed for articles published in English and Chinese without any year limits in six databases. Ten studies met the eligibility criteria and were included in the review. All studies were qualitatively integrated to identify and compare positive and negative family factors. A total of 1135 participants, of which 497 were children with intellectual disability while the other 638 participants were family members (parents, siblings and caregivers). The family factors of 6 themes and 18 sub-themes (10 positive, 7 negative and 1 inconclusive factors) were extracted. Overall, these results highlight the importance of encouragement, support and involvement by family members, concurrently it points out that parental psychological factors, socioeconomic status, responsibilities and electronic devices could both promote and hinder engagement in physical activity for children with intellectual disability. The findings accentuate the role of the family unit in helping determine the activity levels of children with intellectual disability. Future studies should include a wider range of participants and be longitudinal in nature, utilizing more accurate monitoring tools.

Assessment of the Correlation between the Levels of Physical Activity and Technology Usage among Children with Down Syndrome in the Riyadh Region

Background: Children with Down Syndrome (C-DS) have language, cognitive and communication difficulties, in addition to consistent physical inactivity that contributes to poor health and higher-disability-adjusted life years. The purpose of this study was to determine the correlation between the use of electronic technology and levels of physical activity in C-DS in the Riyadh region of Saudi Arabia. Methods: A cross-sectional study was conducted with 49 mothers, where each had a child (6-12 years of age) with Down Syndrome (DS), and who were recruited using purposive sampling from three DS centers in Riyadh, Saudi Arabia. The Children's Physical Activity Questionnaire and Research Questionnaire on the Impact of Technology on Children were used. Descriptive statistics were used to describe the demographics. Pearson's correlation, Student's t-test and the Chi-square test were used to assess the association between technology use, physical activity levels and socio-demographic variables. Results: There was no significant correlation between physical activity and the use of technology by C-DS. However, there was a negative correlation between a high level of physical activity and technology use (R = -0.037). Although, no significant correlation between the mother's characteristics and technology use was found; there was a significantly positive correlation (p = 0.05) between the education level of mothers and the technology use by C-DS. Nonetheless, there was no association between the physical activity level and the gender of the child with DS. Conclusions: This study found that no significant relationship exists between the use of electronic gadgets and the level of physical activity in C-DS.