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McDermott S, McCarron M, Burke E, McCallion P, O'Donovan MA. Enabling older adults with intellectual disability to become physical activity leaders in their community: Pilot study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2024; 28:706-722. [PMID: 37406191 DOI: 10.1177/17446295231177190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
People with intellectual disabilities (ID) have high levels of sedentary behaviour and co-morbid health conditions. There is also increased longevity for this group which is an incredible success story but one which also poses challenges to the health system. For the first time, the mainstream health system needs to plan for and address age related health needs of people with ID. It also demands consideration of age-appropriate health-promotion efforts to support this ageing population with life-long disability. A physical activity programme, People with Intellectual Disability as Physical Activity Leaders (PPALs), was co-designed and co-developed with older adults (40+ years) with intellectual disability (ID). The process, content and outcomes of the pilot are presented in this paper. Expertise from three sectors: non-statutory academic and people with intellectual disabilities and their supporters worked collaboratively for successful completion of the project.
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Affiliation(s)
- Sonia McDermott
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Dublin, Ireland
| | - Mary McCarron
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Dublin, Ireland
| | - Eilish Burke
- Trinity Centre for Ageing and Intellectual Disability, Trinity College Dublin, Dublin, Ireland
| | - Philip McCallion
- College of Public Health, Temple University, Philadelphia, PA, USA
| | - Mary-Ann O'Donovan
- Centre for Disability Studies, Affiliate of the University of Sydney, Sydney, NSW, Australia
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Öztürk ME, Yabanci Ayhan N. The relationship between the severity of intellectual and developmental disabilities (IDDs) in adults with IDDs and eating and drinking problems and nutritional status. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2024; 68:325-339. [PMID: 38183317 DOI: 10.1111/jir.13114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Adults with intellectual and developmental disabilities (IDDs) experience eating, drinking and swallowing problems, such as chewing problems, choking, gagging, coughing during eating, aspiration and rumination syndrome, which may lead to poor nutritional status. This study aimed to determine the relationship between IDD levels, eating, drinking and swallowing problems and nutritional status in adults with IDDs. METHODS The sample consisted of 71 participants (37 men and 34 women) with a mean age of 22.5 ± 7 years (range 18-60 years). Professionals classified intellectual disability as mild, moderate or severe. The Screening Tool of Feeding Problems scale was applied to the caregivers of adults with IDDs to identify eating, drinking and swallowing problems. Dietary intake was assessed using a 24-h dietary recall and a food and nutrition photograph catalogue. The researchers measured body weight, height and middle upper arm circumference. Body mass index was calculated. Four body mass index categories were determined: underweight (<18.5 kg/m2 ), normal weight (18.5-24.9 kg/m2 ), overweight (25.0-29.9 kg/m2 ) and obese (≥30 kg/m2 ). Chi-squared tests were used to detect the relationship between IDD levels and eating and drinking problems, and analysis of variance tests were conducted to detect the relationship between IDD levels with anthropometric measurements and dietary intake. RESULTS Participants had mild (42.3%; n = 30), moderate (29.6%; n = 21) or severe IDD (28.2%; n = 20). They were underweight (12.7%; n = 9), normal weight (59.2%; n = 42) or overweight and/or obese (28.2%; n = 20). Participants with severe IDD had significantly higher Screening Tool of Feeding Problems 'nutrition-related behaviour' and 'eating and drinking skill deficit problem' sub-scale scores than those with mild IDD. However, the groups had no significant difference in 'food refusal and selectivity' sub-scale scores. Participants with severe IDD also had anorexia prevalence similar to those with mild IDD. The groups did not significantly differ in anthropometric measurements, daily energy intake and macronutrient and micronutrient intake. CONCLUSIONS While adults with severe IDD had more eating and drinking skill deficits (e.g. chewing problems and independent eating difficulties) and nutrition-related behaviour problems than those with mild IDD, the eating, drinking and swallowing problems, which may critically affect their food intake, were similar to adults with mild IDD. The anthropometric measurements and energy and nutrient intakes of adults with severe IDD were not significantly different from those with mild IDD consistently. Findings indicate that nutritional deficiencies and nutritional behaviour problems may be avoidable in adults with IDDs.
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Affiliation(s)
- M E Öztürk
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - N Yabanci Ayhan
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ankara University, Ankara, Turkey
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Özdemir A, Hall R, Lovell A, Ellahi B. Nutrition knowledge and influence on diet in the carer-client relationship in residential care settings for people with intellectual disabilities. NUTR BULL 2023; 48:74-90. [PMID: 36647738 DOI: 10.1111/nbu.12600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 01/18/2023]
Abstract
People with intellectual disabilities generally have poorer health outcomes compared with those who do not, including outcomes related to nutrition-related non-communicable diseases. Carers support people with intellectual disabilities in many aspects including habitual shopping and preparation of food, but their own nutrition knowledge and the influence this may have on dietary intakes of clients is unknown. We explored the nutrition knowledge of carers of people with intellectual disabilities in residential care settings, their dietary habits and their influence on clients' food shopping and preparation and therefore the diet consumed by their clients. Ninety-seven carers belonging to a large independent care sector organisation specialising in the care of people with an intellectual disability completed a validated general nutrition knowledge and behaviour questionnaire. Seventeen carers from the residential care settings were interviewed to contextualise practice. Knowledge about key dietary recommendations scored highly. Carers who had more work experience were found to have higher scores in 'making everyday food choices' (p = 0.034). Daily consumption of fruit and vegetables (at least one portion per day) was observed (for fruit by 46% of the carers and for vegetables by 60% of the carers), whilst most carers reported avoiding consuming full-fat dairy products, sugary foods and fried foods. The concept of a healthy diet; typical dietary habits of clients; role in food acquisition; and training in nutrition emerged as themes from the interviews. Carers discussed various topics including the importance of a balanced diet, cooking fresh foods and control of food portion sizes for clients relative to the care philosophy of a client-centred approach, which encapsulates client autonomy. Gaps in knowledge around specific nutrients, making healthy choices and cooking skills remain. Carers have an influence on clients' dietary choices; they are able to provide healthy meals and share good dietary habits with clients. Further training in nutrition is recommended for impact on clients' health.
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Affiliation(s)
- Aslıhan Özdemir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Rebecca Hall
- Department of Mental Health and Learning Disabilities, Faculty of Health and Social Care, University of Chester, Chester, UK.,School of Nursing, Midwifery and Social Work, University of Salford, Salford, UK
| | - Andrew Lovell
- Department of Social Work and Interprofessional Studies, Faculty of Health and Social Care, University of Chester, Chester, UK
| | - Basma Ellahi
- Department of Social Work and Interprofessional Studies, Faculty of Health and Social Care, University of Chester, Chester, UK
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Zwack CC, McDonald R, Tursunalieva A, Lambert GW, Lambert EA. Exploration of diet, physical activity, health knowledge and the cardiometabolic profile of young adults with intellectual disability. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2022; 66:517-532. [PMID: 35137997 PMCID: PMC9303213 DOI: 10.1111/jir.12917] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/02/2022] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Young adults with intellectual disability (ID) are experiencing early mortality, and it is suggested that they are living with undiagnosed cardiovascular and metabolic risk factors (hereafter referred to as cardiometabolic). METHODS We investigated the association between modifiable risk factors and cardiometabolic health profile in adults with ID aged 18-45 years through clinical evaluation of traditional cardiometabolic parameters, and assessment of physical activity levels, diet and associated health knowledge. RESULTS We found that young adults with ID have an increased obesity (mean body mass index; ID group: 32.9 ± 8.6 vs. control group: 26.2 ± 5.5, P = 0.001), are engaging in less physical activity than the age-matched general population (total activity minutes per week; ID group: 172.2 ± 148.9 vs. control group: 416.4 ± 277.1, P < 0.001), and overall have unhealthier diets. Additionally, knowledge about nutrition and physical activity appears to be an important predictor of cardiometabolic risk in this population. If young people with ID are to improve their cardiometabolic health to reduce morbidity and early mortality, we need to further explore how to consistently apply health messaging to get lasting behavioural change in this population.
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Affiliation(s)
- C. C. Zwack
- Iverson Health Innovation Research Institute and School of Health SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
- School of Health SciencesUniversity of SydneyNew South WalesAustralia
| | - R. McDonald
- Iverson Health Innovation Research Institute and School of Health SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
| | - A. Tursunalieva
- Department of Econometrics and Business StatisticsMonash UniversityClaytonVictoriaAustralia
| | - G. W. Lambert
- Iverson Health Innovation Research Institute and School of Health SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
| | - E. A. Lambert
- Iverson Health Innovation Research Institute and School of Health SciencesSwinburne University of TechnologyHawthornVictoriaAustralia
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Vancampfort D, Schuch F, Van Damme T, Firth J, Suetani S, Stubbs B, Van Biesen D. Prevalence of diabetes in people with intellectual disabilities and age- and gender-matched controls: A meta-analysis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:301-311. [PMID: 34658096 DOI: 10.1111/jar.12949] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/15/2021] [Accepted: 09/23/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND This meta-analysis aims to: (i) describe the pooled prevalence of diabetes in people with intellectual disabilities, (ii) investigate the association with demographic, clinical and treatment-related factors and (iii) compare the prevalence versus age- and gender-matched general population controls. METHODS Pubmed, Embase and CINAHL were searched until 01 May 2021. Random effects meta-analysis and an odds ratio analysis were conducted to compare rates with controls. RESULTS The trim- and fill-adjusted pooled diabetes prevalence amongst 55,548 individuals with intellectual disabilities (N studies = 33) was 8.5% (95% CI = 7.2%-10.0%). The trim- and fill-adjusted odds for diabetes was 2.46 times higher (95% CI = 1.89-3.21) (n = 42,684) versus controls (n = 4,177,550). Older age (R2 = .83, p < .001), smoking (R2 = .30, p = .009) and co-morbid depression (R2 = .18, p = .04), anxiety (R2 = .97, p < .001), and hypertension (R2 = 0.29, p < .001) were associated with higher diabetes prevalence rates. CONCLUSIONS Our findings demonstrate that people with intellectual disabilities are at an increased risk of diabetes, and therefore routine screening and multidisciplinary management of diabetes is needed.
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Affiliation(s)
- Davy Vancampfort
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Tine Van Damme
- KU Leuven Department of Rehabilitation Sciences, Leuven, Belgium
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Australia
| | - Shuichi Suetani
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
- School of Medicine, Griffith University, Nathan, Queensland, Australia
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
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Vlot-van Anrooij K, Naaldenberg J, Hilgenkamp TIM, Overwijk A, van der Velden K, Leusink GL. Gaining actionable knowledge to improve local health-promoting capacities in long-term care support settings for people with intellectual disabilities. PATIENT EDUCATION AND COUNSELING 2022; 105:407-415. [PMID: 34045091 DOI: 10.1016/j.pec.2021.05.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/29/2021] [Accepted: 05/19/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE People with intellectual disabilities (ID) are largely dependent on their environment to live healthily and, in this, ID-support organizations play a vital role. An environmental asset mapping tool for ID-support settings has been developed. This study aims to provide insight into whether or not the tool can provide a comprehensive view on assets in the system and actionable knowledge to improve health-promoting capacities in ID-support settings. METHODS Fifty-seven users from four setting completed the tool on availability, user satisfaction, and dreams regarding social, physical, organizational, and financial assets. RESULTS The findings provide a comprehensive view of available assets. Together with user satisfaction and dreams for improvements, they provide actionable knowledge for improving the health-promoting capacities of the settings, including: (1) how use of available assets can be improved, (2) the type of assets that should be enriched, and (3) the assets that can be added to the system. CONCLUSION The asset mapping tool provides a comprehensive view on assets in the system and actionable knowledge to improve health-promoting capacities in ID-support settings. PRACTICE IMPLICATIONS ID-support organizations can use the tool to generate actionable bottom-up knowledge for priority setting and implementing interventions to improve their health-promoting capacities.
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Affiliation(s)
- Kristel Vlot-van Anrooij
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands.
| | - Jenneken Naaldenberg
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Thessa I M Hilgenkamp
- Department of Physical Therapy, University of Nevada, Las Vegas, USA; Department of General Practice, Intellectual Disability Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Annelies Overwijk
- Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, The Netherlands; Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Koos van der Velden
- Department of Primary and Community Care, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Geraline L Leusink
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
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Ryan J, McCallion P, McCarron M, Luus R, Burke EA. Overweight/obesity and chronic health conditions in older people with intellectual disability in Ireland. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:1097-1109. [PMID: 34750916 DOI: 10.1111/jir.12900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND This study examines overweight/obesity and chronic health conditions (CHCs) in older people with intellectual disability (ID). METHODS Data for this cross-sectional observational study emanated from Wave 2 of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing, a longitudinal study assessing the health and well-being of older Irish adults with ID aged ≥40 years across all levels of ID. Participation involves an interview process and collation of objective health measures. In this study, body mass index (BMI) (n = 572), used as a measure of weight status, was examined with clustered doctor's diagnosed CHCs. Descriptive analysis was conducted where counts (n) and proportions (%) were used to summarise the variables univariately, while cross-tabulations were used for bivariate summary into counts and proportions. With overweight/obesity prevalence established and patterns described using logistical regression, Pearson's chi-squared test was used to test for significant associations. RESULTS Overweight/obesity identified in 69% of participants occurred with greater frequency in women (72%). A higher percentage of participants aged <50 years (72.5%) were overweight/obese than those aged 50-64 (70%) and 65+ (61.4%). Level of ID and residence type were significantly associated with weight status (P < 0.001), with overweight/obesity more prevalent in mild (85.7%) than moderate (72%) or severe/profound ID (51.4%). Of those who lived independently/with family, 78.4% were overweight/obese, as were 74% living in a community group home (P < 0.001). Almost all overweight/obese participants' waist measurements were in the substantially increased risk of metabolic disease waist measurement category (92%, P < 0.001). Logistical regression used to model CHCs on BMI showed significant association between BMI and gastrointestinal tract [odds ratio (OR) = 0.57, P < 0.008, 95% confidence interval (CI) = (0.37; 0.86)], respiratory condition [OR = 8.95, P < 0.004, 95% CI = (2.57; 56.72)] and musculoskeletal disorders [OR = 0.40, P < 0.001, 95% CI = (0.25; 0.63)]. CONCLUSIONS The findings illustrate the strong cross-sectional association between overweight/obesity and CHCs. These findings suggest a need to prioritise weight status as a health risk to people with ID as they age.
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Affiliation(s)
- J Ryan
- Trinity Center for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - P McCallion
- Temple School of Social Work, Temple University College of Public Health, Philadelphia, PA, USA
| | - M McCarron
- Trinity Center for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
| | - R Luus
- Department of Statistics and Population Studies, University of the Western Cape, Cape Town, South Africa
| | - E A Burke
- Trinity Center for Ageing and Intellectual Disability, School of Nursing and Midwifery, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland
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Borthwick C, Inchley J, Jones J. Health promotion in adults with Down's syndrome: Experiences of caregivers. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 25:312-330. [PMID: 31775568 DOI: 10.1177/1744629519890956] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Individuals with Down's syndrome rely on caregivers to support lifestyle behaviour change. It is therefore important to understand how caregivers put health recommendations into practice. Through conducting semi-structured interviews, the present study sought to understand the facilitators and barriers that caregivers faced when implementing health promotion advice. Five interviews were conducted with paid support staff and four with family carers of individuals attending a specialist multidisciplinary Down's syndrome health promotion screening clinic. Three main themes emerged in their accounts, including active promotion of weight management by caregivers, benefits of working practices such as record keeping and communication channels and the importance of having access to social care services and recreational activities. These findings have important implications for professionals working in specialised healthcare settings who may be able to tailor communication and services to better meet the needs of individuals with Down's syndrome and their caregivers.
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Obesity and overweight in youth and adults with Down syndrome in Morocco: Prevalence and determinants. NUTR CLIN METAB 2021. [DOI: 10.1016/j.nupar.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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10
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Participation in Regular Physical Activity According to the Type of Disability, Sex, Point of Disability Diagnosis, and Ability to Walk Independently in South Korea. Healthcare (Basel) 2021; 9:healthcare9081079. [PMID: 34442216 PMCID: PMC8392664 DOI: 10.3390/healthcare9081079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 11/29/2022] Open
Abstract
This study aimed to compare rates of participation in physical activity according to the type of disability, sex, point of disability diagnosis (congenital vs. acquired), and ability to walk independently. The study involved individuals who were registered as disabled based on the 2020 Sports Survey for the Disabled project of the Korea Ministry of Health and Welfare. Participants (mean age: 49.94 ± 12.35 years) included those with physical disabilities (n = 889), visual impairments (n = 523), hearing/speech impairments (n = 412), intellectual disabilities (n = 561), and disabilities associated with brain lesions (n = 364). Rates of severe (100%) and congenital disability (65.95%) were highest in the intellectual disability group. Acquired disability was most frequent in the physical disability group (94.71%). The highest frequency of independent walking ability was observed in the hearing/speech impairment group (99.27%). The rate of participation in physical activity was significantly higher in the acquired (odds ratio [OR] = 1.46, 95% confidence interval [CI] = 1.12–1.87, p = 0.005) and independent walking (OR = 1.43, 95% CI = 1.11–1.84, p = 0.005) hearing/speech impairment groups than in the corresponding physical disability groups after adjusting for age, sex, and severity. Our findings highlight the need to promote physical activity for people with physical and intellectual disabilities based on the factors examined in this study.
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Olsen MI, Halvorsen MB, Søndenaa E, Langballe EM, Bautz-Holter E, Stensland E, Tessem S, Anke A. How do multimorbidity and lifestyle factors impact the perceived health of adults with intellectual disabilities? JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:772-783. [PMID: 33977582 DOI: 10.1111/jir.12845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/19/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Adults with intellectual disability (ID) have poorer physical and perceived health than the general population. Knowledge of perceived health predictors is both limited and important for guiding the development of preventive actions. The aims of this study were to investigate (1) the associations between perceived health and demographics, degree of ID, physical health conditions, and weight and physical activity level and (2) lifestyle factors and multimorbidity as predictors for perceived health adjusted for age, gender, and level of ID. METHOD The North Health in Intellectual Disability study is a community based cross-sectional survey. The POMONA-15 health indicators were used. Univariate and multivariate logistic regression analyses with poor versus good health as the dependent variable were applied. RESULTS The sample included 214 adults with a mean age 36.1 (SD 13.8) years; 56% were men, and 27% reported perceiving their health as poor. In univariate analyses, there were significant associations between poor health ratings and female gender, lower motor function, number of physical health conditions and several indicators of levels of physical activity. In the final adjusted model, female gender [odds ratio (OR) 2.4, P < 0.05], level of ID (OR 0.65, P < 0.05), numbers of physical health conditions (OR 1.6, P < 0.001) and lower motor function (OR 1.5 P < 0.05) were significant explanatory variables for poor perceived health, with a tendency to independently impact failure to achieve 30 min of physical activity daily (OR 2.0, P = 0.07). CONCLUSION Adults with ID with female gender, reduced motor function and more physical health conditions are at increased risk of lower perceived health and should be given attention in health promoting interventions. A lack of physical activity tends to negatively influence perceived health.
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Affiliation(s)
- M I Olsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
| | - M B Halvorsen
- Department of Pediatric Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - E Søndenaa
- Faculty of Medicine and Health Sciences (MH), Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Brøset, St. Olavs University Hospital, Trondheim, Norway
| | - E M Langballe
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - E Bautz-Holter
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - E Stensland
- Department of Community, Medicine, UiT - The Artic University of Norway, Tromsø, Norway
| | - S Tessem
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - A Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
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Vancampfort D, Van Damme T, Firth J, Stubbs B, Schuch F, Suetani S, Arkesteyn A, Van Biesen D. Physical activity correlates in children and adolescents, adults, and older adults with an intellectual disability: a systematic review. Disabil Rehabil 2021; 44:4189-4200. [PMID: 33861676 DOI: 10.1080/09638288.2021.1909665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE Understanding enablers of and barriers for physical activity (PA) participation in people with intellectual disability (ID) is an essential first step to develop effective interventions. This systematic review examined correlates of PA across the socio-ecological model (i.e., intra-personal, inter-personal, environmental and policy level) in people with ID across the lifespan. MATERIAL AND METHODS Major electronic databases were searched from inception until 15 February 2021. Keywords included "physical activity" or "exercise" and "intellectual disability" or "mental retardation." A summary coding was used to analyze the data for adolescents (<18 years), adults (18 < 50 years), and older adults (50≤ years). RESULTS Out of 83 PA correlates, retrieved from 39 studies (n = 26,456), only three consistent (i.e., reported in four or more studies) correlates were identified. In adults, older age (7/11, 64%), more severe ID (9/9, 100%) and the presence of physical mobility problems (3/4, 75%) were associated with decreased PA. From 38 correlates identified, no consistent correlates were identified for children and adolescents and older people. CONCLUSIONS Despite the abundance of evidence of the PA benefits for people with ID, we only found consistent evidence for three correlates reliably being related to PA in adults with ID. More research, particularly among young and older people is urgently needed.IMPLICATIONS FOR REHABILITATIONMore severe intellectual disability is an important barrier for being active in adults with intellectual disability.Presence of physical health problems is an important barrier for being active in adults with intellectual disability.
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Affiliation(s)
- Davy Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center, KU Leuven, Leuven-Kortenberg, Belgium
| | - Tine Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,University Psychiatric Center, KU Leuven, Leuven-Kortenberg, Belgium
| | - Joseph Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK.,NICM Health Research Institute, Western Sydney University, Westmead, Australia
| | - Brendon Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Felipe Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - Shuichi Suetani
- Queensland Centre for Mental Health Research, Wacol, Australia.,Queensland Brain Institute, The University of Queensland, St Lucia, Australia.,School of Medicine, Griffith University, Nathan, Australia
| | - Anke Arkesteyn
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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MacDonald C, Bush PL, Foley JT. Physical activity promotion and adults with intellectual disabilities: A neglected area. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2021; 26:1744629521995345. [PMID: 33779382 DOI: 10.1177/1744629521995345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The objective was to review physical activity (PA) promotion interventions among individuals with intellectual disability and provide recommendations for increasing PA. METHODS A systematic mapping review was conducted in which physical activity intervention studies for adults with a disability were identified, selected, and appraised. Data were extracted regarding the study design, results, and authors' recommendations. Data were analyzed using a social-ecological framework. RESULTS A comprehensive search of the peer reviewed literature yielded 5 studies (3 quantitative, 1 mixed methods, and 1 pre-post delayed). Studies used physical activity promotion strategies at the intrapersonal, interpersonal, organizational, community, and policy levels have been used to date. CONCLUSIONS Recommendations are presented for researchers and practitioners seeking to increase the level of PA of adults with intellectual disability.
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Affiliation(s)
| | | | - John T Foley
- 14800State University of New York, Cortland, USA
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14
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Milroy JJ, Oakes LR, Hickerson BD. Design Thinking: Assessing the health needs of college students with intellectual and/or developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:1408-1420. [PMID: 33742525 DOI: 10.1111/jar.12882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 02/11/2021] [Accepted: 03/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is a dearth of literature related to well-being of college students with IDD. The purpose of this study was to use design thinking to identify health-related innovations for college students with IDD. METHOD Two design thinking events were conducted with participants (n = 16). Subsequent web-based surveys with a separate group of students with IDD (n = 18) assessed feasibility of each innovation. Collaborative group discussions were used to assess each innovation, and quantitate data were used to assess innovation feasibility. RESULTS A total of 16 innovations were constructed: 4 sexual health, dating and relationships, 2 drugs and/or alcohol, 2 exercise and physical activity, 2 socializing, leisure and recreation, 2 food and nutrition and 4 mental health. CONCLUSION Design thinking methods are a suitable strategy to use with individuals with IDD and led to the development of innovations with high relevancy and feasibility for college students with IDD.
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Affiliation(s)
- Jeffrey J Milroy
- Department of Public Health Education, University of North Carolina Greensboro, Greensboro, NC, USA
| | - Lindsey R Oakes
- Department of Health and Human Performance, Texas State University, San Marcos, TX, USA
| | - Benjamin D Hickerson
- Department of Community and Therapeutic Recreation, University of North Carolina Greensboro, Greensboro, NC, USA
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15
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van Alphen HJM, Waninge A, Minnaert AEMG, van der Putten AAJ. Development and process evaluation of a motor activity program for people with profound intellectual and multiple disabilities. BMC Health Serv Res 2021; 21:259. [PMID: 33743703 PMCID: PMC7981959 DOI: 10.1186/s12913-021-06264-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 03/10/2021] [Indexed: 11/30/2022] Open
Abstract
Background The support of people with profound intellectual and multiple disabilities (PIMD) rarely focused on motor activity, which might have negative consequences for the quality of life of these people. Evidence-based motor activity programs that present individually tailored and structural motor activity for these people are, regretfully, lacking. This study developed such a program for these people and evaluated the implementation process. Methods The motor activity program is developed in accordance with the theoretical premises of the educational program and consists of four methodological steps in which the content is individually filled with: motor activity structurally embedded within the activities of daily living, and 3–5 motor activities aimed at a specific goal, which is evaluated. Program delivery consisted of a manual, explanation to the teams, and coaching of one contact person per participant (n = 9). Process evaluation included the delivered fidelity, dose, reach, and adaptations made during the program. In addition, mechanisms of impact and the influence of contextual factors were evaluated. Data collection included researcher logbooks, individual program content, and staff reports. Results The intended fidelity, dose, and reach were not obtained in most participants. Content has been made explicit for seven participants, but only in one participant all critical steps in implementation were performed as intended, though later in time. In three participants, previously offered motor activities were described within the weekly program, but without all activities having a clear link with the goal set. It is showed that the core elements of the program were affected with the conceived implementation plan. The time schedule, critical elements in implementation and program content were influenced by a lack of conditions such as professionals’ motivation and responsibility, methodical working, interdisciplinarity and continuity in staff. Conclusions The results suggest that the implementation might be improved in case more attention is paid to the organizational conditions and implementation structure. The findings led to substantial changes in the implementation strategy. This study underlines the importance of process evaluation prior to testing for effectiveness. Trial registration The (overarching) study was registered at the Netherlands Trial Register (number 6627) on February 10, 2017: https://www.trialregister.nl/trial/6449.
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Affiliation(s)
- Helena J M van Alphen
- Department of Inclusive and Special Needs Education, University of Groningen, Grote Rozenstraat 38, 9712 TJ, Groningen, The Netherlands.
| | - Aly Waninge
- Research Group Healthy Ageing, Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands.,Royal Dutch Visio De Brink, Vries, The Netherlands
| | - Alexander E M G Minnaert
- Department of Inclusive and Special Needs Education, University of Groningen, Grote Rozenstraat 38, 9712 TJ, Groningen, The Netherlands
| | - Annette A J van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Grote Rozenstraat 38, 9712 TJ, Groningen, The Netherlands
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16
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Age-Group Differences in Body Mass Index, Weight, and Height in Adults With Down Syndrome and Adults With Intellectual Disability From the United States. Adapt Phys Activ Q 2021; 38:79-94. [PMID: 33310929 DOI: 10.1123/apaq.2020-0004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/26/2020] [Accepted: 05/14/2020] [Indexed: 11/18/2022] Open
Abstract
The authors examined if body mass index (BMI), weight, and height across age groups differ between adults with Down syndrome (DS) and adults with intellectual disability but without DS. They conducted secondary analyses of cross-sectional data from 45,803 individuals from the United States from 2009 to 2014 of the National Core Indicators Adult Consumer Survey across five age groups: 18-29, 30-39, 40-49, 50-59, and 60+ years. For both men and women with DS, BMI and weight increased between the 18- to 29- and the 30- to 39-year age groups and decreased thereafter. For both men and women with intellectual disability, BMI and weight increased between the 18- to 29- and the 30- to 39-year age groups, stayed about the same until the 50- to 59-year age group, and decreased thereafter. Height demonstrated a small but significant decrease with older age in all groups. These cross-sectional comparisons indicate that BMI and weight may start decreasing at a younger age in adults with DS than in adults with intellectual disability.
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Borland RL, Hu N, Tonge B, Einfeld S, Gray KM. Participation in sport and physical activity in adults with intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:908-922. [PMID: 33006215 DOI: 10.1111/jir.12782] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 08/10/2020] [Accepted: 09/02/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND People with intellectual disability face a number of barriers to participation in physical activity. This paper aimed to determine rates of sport and physical activity participation in an Australian sample of adults with intellectual disability, compared with rates of participation in the general Australian population. A secondary aim was to investigate factors that may contribute to participation of adults with intellectual disability. METHOD Participants were part of the Australian Child to Adult Development (ACAD) study, consisting of a community sample with intellectual disability (n = 305), groups of adults with autism (n = 94), Down syndrome (n = 64), fragile X syndrome (n = 52), Williams syndrome (n = 45), and Prader-Willi syndrome (n = 30). Participation in sport/physical activity was reported over the past 3 months. Rates of participation were reported for adults with intellectual disability and compared with rates in a general Australian population sample. The relationship between participation in physical activity and age, degree of intellectual disability, physical mobility, living situation, socio-economic disadvantage, and behaviour and emotional problems were also conducted. RESULTS Participants in the ACAD community sample with intellectual disability participated in sport/physical activity at lower rates than the general Australian population (42% compared with 71%). Having no physical mobility impairment was significantly associated with higher rates of participation. Those with Down syndrome participated in sport/physical activity at higher rates than the community sample with intellectual disability, while no difference in sport/physical activity participation was observed in the groups with autism or other syndromes. CONCLUSION Australian adults with intellectual disability participate in sport and physical activity at lower rates than the general population. Having a physical mobility impairment was associated with lower rates of participation. However, people living in supported accommodation were more likely to participate than those in other living situations. Having Down syndrome was associated with a higher participation rate than the community sample.
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Affiliation(s)
- R L Borland
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - N Hu
- Population Child Health Research Group, School of Women's and Children's Health, University of New South Wales, Australia
| | - B Tonge
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - S Einfeld
- Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - K M Gray
- Centre for Developmental Psychiatry and Psychology, Department of Psychiatry, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
- Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
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18
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Vancampfort D, Schuch F, Van Damme T, Firth J, Suetani S, Stubbs B, Van Biesen D. Metabolic syndrome and its components in people with intellectual disability: a meta-analysis. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:804-815. [PMID: 32893439 DOI: 10.1111/jir.12772] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND People with intellectual disability have an increased risk for cardiovascular diseases and associated premature mortality. Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The aim of this meta-analysis was to describe the pooled prevalence of MetS and its components in people with intellectual disability taking into account variations in demographic, clinical and treatment-related variables. METHODS Pubmed, Embase and CINAHL were searched until 5 August 2020 for studies reporting cross-sectional data on prevalences of MetS and its components in people with intellectual disability. Two independent reviewers extracted data. Random effects meta-analyses with subgroup and meta-regression analyses were employed. RESULTS The pooled MetS prevalence after adjusting for publication bias was 22.5% [95% confidence interval (CI) = 16.8%-29.6%; N studies = 10; n participants = 2443, median age at study level = 38.5 years; 52% male]. Abdominal obesity was observed in 52.0% (95% CI = 42.0%-61.9%; I2 = 86.5; N = 5; n = 844), hypertension in 36.7% (95% CI = 26.1%-48.7%; N = 6; n = 926), hypertriglyceridaemia in 23.5% (95% CI = 18.8%-28.9%; N = 5; n = 845), low high-density-lipoprotein-cholesterol in 23.4% (95% CI = 19.3%-28.0%; N = 6; n = 917), and hyperglycaemia in 10.2% (95% CI = 7.6%-13.3%; N = 5; n = 845). Meta-regression revealed that a higher MetS frequency was moderated by older age (coefficient = 0.03; standard error = 0.01, 95% CI = 0.008 to 0.055; N = 19; n = 2443) and a higher proportion of people on antidepressants in the study (coefficient = 7.24; standard error = 0.90, 95% CI = 5.48-9.00; N = 4; n = 546). There were insufficient data comparing MetS in people with intellectual disability with age-matched and gender-matched controls. CONCLUSIONS Considering that more than one fifth of people with intellectual disability have MetS, routine screening and multidisciplinary management of metabolic abnormalities in people with intellectual disability is needed. Attention should be given to older people and those on antidepressants.
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Affiliation(s)
- D Vancampfort
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - F Schuch
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
| | - T Van Damme
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
- University Psychiatric Center, KU Leuven, Leuven, Belgium
| | - J Firth
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
- NICM Health Research Institute, Western Sydney University, Sydney, New South Wales, Australia
| | - S Suetani
- Queensland Centre for Mental Health Research, Wacol, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
- School of Medicine, Griffith University, Nathan, Queensland, Australia
| | - B Stubbs
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - D Van Biesen
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Cugusi L, Carta MG. Conventional exercise interventions for adults with intellectual disabilities: A systematic review and meta‐analysis. TRANSLATIONAL SPORTS MEDICINE 2020. [DOI: 10.1002/tsm2.195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Lucia Cugusi
- Department of Biomedical Sciences University of Sassari Italy
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20
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Zurita-Ortega F, Ubago-Jiménez JL, Puertas-Molero P, Ramírez-Granizo IA, Muros JJ, González-Valero G. Effects of an Alternative Sports Program Using Kin-Ball in Individuals with Intellectual Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5296. [PMID: 32717831 PMCID: PMC7432726 DOI: 10.3390/ijerph17155296] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022]
Abstract
The first aim of the present work was to examine the effects of a physical activity sports program, specifically Kin-Ball, within a group of individuals with intellectual disabilities, on decreasing sedentary behavior and improving basic physical skills. The second aim was to evaluate social validity and acceptability of the intervention. In this pre-experimental study, 47 individuals participated (46.8% male and 53.2% female) with an average age of 29.85 (SD = 10.41). All participants were administered an intervention program based on the alternative sport of Kin-Ball. BMI was calculated for body composition and age-related Z-scores were interpreted with the tables provided by the WHO. Endurance was measured through a modified six-minute test, speed was analyzed using a 50 m test, and strength was estimated according to a hand-grip dynamometer. Likewise, balance and coordination were examined in line with adaptations proposed by the scientific literature. Results indicated that all cases experienced statistically significant differences following the intervention program (p = 0.000). Improvement effects were detected in all post-intervention tests (endurance, strength, speed, balance, and coordination). As a main conclusion, it is indicated that an alternative sports-based program improves physical ability and motor skills in individuals with intellectual disabilities.
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Affiliation(s)
| | | | | | | | | | - Gabriel González-Valero
- Department of Didactics of Musical, Plastic and Corporal Expression, University of Granada, 18071 Granada, Spain; (F.Z.-O.); (J.L.U.-J.); (P.P.-M.); (I.A.R.-G.); (J.J.M.)
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21
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Bassette L, Titus‐Dieringer S, Zoder‐Martell K, Cremeans M. The use of video‐based instruction to promote independent performance of physical activity skills in students with developmental disabilities in a school and community setting. PSYCHOLOGY IN THE SCHOOLS 2020. [DOI: 10.1002/pits.22414] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Laura Bassette
- Department of Special Education, Teachers College Ball State University Muncie Indiana USA
| | | | - Kim Zoder‐Martell
- Department of Special Education, Teachers College Ball State University Muncie Indiana USA
| | - McKenzie Cremeans
- Department of Psychiatry Indiana University School of Medicine Indianapolis Indiana USA
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22
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Emerson E, Savage A, Llewellyn G. Prevalence of underweight, wasting and stunting among young children with a significant cognitive delay in 47 low-income and middle-income countries. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2020; 64:93-102. [PMID: 31845425 DOI: 10.1111/jir.12698] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Undernutrition in early childhood is associated with a range of negative outcomes across the lifespan. Little is known about the prevalence of exposure to undernutrition among young children with significant cognitive delay. METHOD Secondary analysis of data collected on 161 188 three- and four-year-old children in 47 low-income and middle-income countries in Rounds 4-6 of UNICEF's Multiple Indicator Cluster Surveys. Of these, 12.3% (95% confidence interval 11.8-12.8%) showed evidence of significant cognitive delay. RESULTS In both middle-income and low-income countries, significant cognitive delay was associated with an increased prevalence of exposure to three indicators of undernutrition (underweight, wasting and stunting). Overall, children with significant cognitive delay were more than twice as likely than their peers to be exposed to severe underweight, severe wasting and severe stunting. Among children with significant cognitive delay (and after controlling for country economic classification group), relative household wealth was the strongest and most consistent predictor of exposure to undernutrition. CONCLUSIONS Given that undernutrition in early childhood is associated with a range of negative outcomes in later life, it is possible that undernutrition in early childhood may play an important role in accounting for health inequalities and inequities experienced by people with significant cognitive delay in low-income and middle-income countries.
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Affiliation(s)
- E Emerson
- Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - A Savage
- Family and Disability Studies Initiative, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - G Llewellyn
- Centre for Disability Research and Policy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Vlot-van Anrooij K, Hilgenkamp TI, Leusink GL, van der Cruijsen A, Jansen H, Naaldenberg J, van der Velden K. Improving Environmental Capacities for Health Promotion in Support Settings for People with Intellectual Disabilities: Inclusive Design of the DIHASID Tool. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E794. [PMID: 32012833 PMCID: PMC7037294 DOI: 10.3390/ijerph17030794] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/23/2020] [Accepted: 01/24/2020] [Indexed: 01/17/2023]
Abstract
People with intellectual disabilities (ID) have unhealthier lifestyles than the general population. To sustainably improve their lifestyle and health status, a whole-system approach to creating healthy environments is crucial. To gain insight into how support for physical activity and healthy nutrition can be embedded in a setting, asset mapping can be helpful. Asset mapping involves creating a bottom-up overview of promoting and protective factors for health. However, there is no asset mapping tool available for ID support settings. This study aims to develop an asset mapping tool in collaboration with people with ID to gain insight into assets for healthy nutrition and physical activity in such settings. The tool is based on previous research and development continued in an iterative and inclusive process in order to create a clear, comprehensive, and usable tool. Expert interviews (n = 7), interviews with end-users (n = 7), and pilot testing (n = 16) were conducted to refine the tool. Pilot participants perceived the tool as helpful in pinpointing perceived assets and in prompting ideas on how to create inclusive environments with support for physical activity and healthy nutrition. This overview of assets can be helpful for mobilizing assets and building the health-promoting capacities of ID support settings.
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Affiliation(s)
- Kristel Vlot-van Anrooij
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Thessa I.M. Hilgenkamp
- Department of Physical Therapy, University of Nevada, Las Vegas, NV 89154-3029, USA;
- Department of General Practice, Intellectual Disability Medicine, Erasmus University Medical Center, Rotterdam, P.O box 2040, 3000 CA Rotterdam, The Netherlands
| | - Geraline L. Leusink
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Anneke van der Cruijsen
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Henk Jansen
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Jenneken Naaldenberg
- Department of Primary and Community Care, Intellectual Disabilities and Health, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands; (G.L.L.); (A.v.d.C.); (H.J.); (J.N.)
| | - Koos van der Velden
- Department of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Center, P.O box 9101, 6500 HB Nijmegen, The Netherlands;
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Hamzaid NH, O’Connor HT, Flood VM. Observed Dietary Intake in Adults with Intellectual Disability Living in Group Homes. Nutrients 2019; 12:nu12010037. [PMID: 31877838 PMCID: PMC7020024 DOI: 10.3390/nu12010037] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 12/31/2022] Open
Abstract
Background: There is limited information on the dietary intakes of people with intellectual disability (ID) living in group homes. Objective: To describe and evaluate dietary intake in people with ID. Method: Dietary intake was assessed in a convenience sample of people with ID living in group homes. Dietary assessment used three-day weighed food records and digital food photography. Intakes were compared to the Nutrient Reference Values (NRVs) and dietary recommendations. Results: A sample of 33 adults, (men (M): n = 14; women (W): n = 19), mean age 51 ± 14 years, was recruited from seven group homes. Mean daily energy intake was low (M: 7.4 MJ; W: 7.0 MJ; p = 0.46), similar to levels recommended for bed rest. Many participants had intakes below the estimated average requirements (EARs) for the nutrients, magnesium (M: 86%; W: 63%), calcium (M: 43%; W: 78%), iodine (M: 43%; W: 47%) and zinc (M: 43%). Less than half of the recommended daily servings were consumed for vegetables (men and women) and dairy foods (women). Conclusion: Nutrient intake and diet quality of the participants in the group homes studied was poor. Education and policy to support healthier diets is required to improve dietary intake of people with intellectual disability, living in group homes.
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Affiliation(s)
- Nur Hana Hamzaid
- Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Program of Dietetics, Kuala Lumpur 50300, Malaysia;
- Faculty of Health Sciences, The University of Sydney, Discipline of Exercise and Sport Science, Lidcombe 2141, NSW, Australia;
| | - Helen T. O’Connor
- Faculty of Health Sciences, The University of Sydney, Discipline of Exercise and Sport Science, Lidcombe 2141, NSW, Australia;
- Charles Perkins Centre, The University of Sydney, Camperdown 2006, NSW, Australia
| | - Victoria M. Flood
- Faculty of Health Sciences, The University of Sydney, Discipline of Exercise and Sport Science, Lidcombe 2141, NSW, Australia;
- Westmead Hospital, Western Sydney Local Health District, Westmead 2145, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown 2006, NSW, Australia
- Correspondence: ; Tel.: +61-412-118-977
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Westrop SC, Melville CA, Muirhead F, McGarty AM. Gender differences in physical activity and sedentary behaviour in adults with intellectual disabilities: A systematic review and meta-analysis. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2019; 32:1359-1374. [PMID: 31373127 DOI: 10.1111/jar.12648] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 05/09/2019] [Accepted: 06/19/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Adults with intellectual disabilities are reported to be highly inactive, with research required to understand contributory factors. This systematic review aimed to investigate gender differences in physical activity (PA) and sedentary behaviour (SB) in adults with intellectual disabilities. METHODS This systematic review was reported in accordance with PRISMA guidelines. Seven databases were searched up to, and including, January 2018. Screening identified papers that assessed gender-specific PA and/or SB outcomes in adults with intellectual disabilities. Data were synthesized using a narrative synthesis and random effects model meta-analyses. RESULTS Twenty-six papers were included; 25 measured PA, and eight assessed SB. Women with intellectual disabilities were least active with a significant overall effect of gender identified. For SB, no consistent gender differences were found. CONCLUSIONS Reflecting the general population, men with intellectual disabilities were most active. Intellectual disability research should consider the role of gender to inform future interventions targeting inactivity.
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Affiliation(s)
- Sophie C Westrop
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Craig A Melville
- College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Fiona Muirhead
- Physical Activity and Health Research Group, University of Strathclyde, Glasgow, UK
| | - Arlene M McGarty
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Hassan NM, Landorf KB, Shields N, Munteanu SE. Effectiveness of interventions to increase physical activity in individuals with intellectual disabilities: a systematic review of randomised controlled trials. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2019; 63:168-191. [PMID: 30407677 DOI: 10.1111/jir.12562] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 09/06/2018] [Accepted: 10/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) often do not meet recommended guidelines for physical activity. The aim of this study was to systematically review available evidence that evaluated the effectiveness of interventions to increase physical activity in individuals with ID. METHOD Five electronic databases (MEDLINE, CINAHL, EMBASE, SPORTDiscus and Cochrane Central Register of Controlled Trials) were searched from inception of the database to July 2017 to identify randomised controlled trials that evaluated the effectiveness of interventions to improve physical activity among people with ID. Trials were included if they measured at least one objective measure of physical activity. Quality appraisal was completed by two independent reviewers using the Cochrane Risk of Bias Tool. The magnitude of treatment effect was estimated for each intervention by calculating the standardised mean difference (SMD) and associated 95% confidence interval. RESULTS Nine randomised controlled trials (976 participants, 501 women, age range 9 months to 83 years) were included. Four trials evaluated unimodal interventions and five trials evaluated multimodal health promotion programmes based on using supportive environments to enable sustained behavioural changes in physical activity. None of the trials were rated as low risk of bias as all had at least one item on the Cochrane Risk of Bias Tool that was considered to be high risk. No trials were able to implement participant blinding. Three trials found statistically significant beneficial effects of interventions for increasing physical activity. Results showed that a 10-week progressive resistance training programme led to maintenance of physical activity levels at 24 weeks in adolescents with Down syndrome (SMD 0.78, 95% CI 0.17 to 1.40). Additionally, a 12- to 16-month multicomponent diet and physical activity programme produced improvement in physical activity at programme completion in adults with ID (reported effect size of 0.29). Finally, an 8-month physical activity and fitness programme increased physical activity at 8 months in adults with ID (SMD 0.91, 95% CI 0.20 to 1.60). Findings regarding other interventions were inconclusive with small effects that were not statistically significant. CONCLUSIONS There is inconsistent evidence of the effects of interventions for improving physical activity levels in individuals with ID. A progressive resistance training programme was found to maintain physical activity levels in adolescents with Down syndrome, while a multicomponent diet and physical activity programme and a physical activity and fitness programme were found to improve physical activity levels in adults with ID. Future trials using rigorous research designs are required to confirm these findings and establish whether other interventions designed to increase physical activity in people with ID are effective.
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Affiliation(s)
- N M Hassan
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - K B Landorf
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - N Shields
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Physiotherapy, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - S E Munteanu
- Discipline of Podiatry, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
- Living with Disability Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
- La Trobe Sport and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
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Maine A, Brown MJ, Dickson A, Truesdale M. An evaluation of mainstream type 2 diabetes educational programmes in relation to the needs of people with intellectual disabilities: A systematic review of the literature. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2018; 32:256-279. [PMID: 30457200 DOI: 10.1111/jar.12544] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 08/15/2018] [Accepted: 08/28/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Risk reduction and self-management programs for type 2 diabetes (T2D) are commonplace. However, little is known about their appropriateness for people with intellectual disabilities (ID). This review evaluates successful components and theoretical basis of interventions and preventions in relation to the needs of people with ID with or at risk of T2D. METHOD Characteristics of 23 randomised controlled trialled T2D educational programs were systematically assessed alongside the needs of people with ID, and evaluated in terms of study design and theoretical application. RESULTS Successful components of programs align to the needs of people with ID. Further adaptations are required to ensure accessibility of materials and social support to enable reflection on illness perceptions and self-efficacy, as underpinned by Self-regulation and Social-cognitive theories. CONCLUSIONS Support is provided for further trials of self-management and preventative adaptations under development. Impact may be enhanced through preventions aimed at younger groups in educational settings.
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Affiliation(s)
- Andrew Maine
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Michael J Brown
- School of Nursing and Midwifery, Queen's University Belfast, Belfast, UK
| | - Adele Dickson
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Maria Truesdale
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
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Foley JT, Lloyd M, Turner L, Temple VA. Body mass index and waist circumference of Latin American adult athletes with intellectual disability. SALUD PUBLICA DE MEXICO 2018; 59:416-422. [PMID: 29211262 DOI: 10.21149/8204] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Accepted: 05/15/2017] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To examine both body mass index (BMI) status and waist circunference (WC) in a large international sample of adult Special Olympics participants from Latin America. It also explored the association of age and sex with obesity in this population. MATERIALS AND METHODS BMI and WC records from a total of 4174 (2683 male and 1491 female) participant records from the Special Olympics International Health Promotion database were examined. RESULTS The prevalence of overweight and obesity was quite high (i.e. > 40%), but generally lower than studies involving adults with intellectual disabilities from Europe and the USA. Chi-square analyses revealed that both increasing age and being female significantly predicted levels of overweight, obesity, and WC. CONCLUSIONS These results suggest that efforts need to be made to prevent and reduce rates of overweight and obesity among Latin American Special Olympics participants, particularly women.
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Affiliation(s)
- John T Foley
- Physical Education Department, State University of New York College at Cortland. USA
| | - Meghann Lloyd
- Faculty of Health Sciences, University of Ontario Institute of Technology. Canada
| | - Lesley Turner
- Physical Education Department, State University of New York College at Cortland. USA
| | - Viviene A Temple
- School of Exercise Science, Physical and Health Education, University of Victoria. Canada
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Price HC, Ismail K. Royal College of Psychiatrists Liaison Faculty & Joint British Diabetes Societies (JBDS): guidelines for the management of diabetes in adults and children with psychiatric disorders in inpatient settings. Diabet Med 2018; 35:997-1004. [PMID: 30152583 DOI: 10.1111/dme.13673] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2018] [Indexed: 11/30/2022]
Abstract
The Royal College of Psychiatrists Liaison Faculty & Joint British Diabetes Societies (JBDS) for Inpatient Care guidelines for the management of diabetes in adults and children with psychiatric disorders in inpatient settings are available in full at: www.diabetes.org.uk/joint-british-diabetes-society and https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group. This article summarizes the guidelines and recommendations. Commissioners are urged to ensure that the needs of people with diabetes and severe mental illness are specifically addressed in contracts with providers of inpatient care, and to avoid financial or other barriers to cross-organizational working and to ensure that patient-structured education is commissioned to meets the complex needs of people with diabetes and severe mental illness. Acute trusts are asked to develop joint pathways with mental health providers and facilitate multidisciplinary working and to screen for mental ill health in those admitted with acute complications of diabetes whose aetiology is unclear or not medically explained. Mental health trusts should create a diabetes register, screen for diabetes, particularly in those prescribed second-generation antipsychotics and ensure that staff are trained in managing and avoiding hypoglycaemia, and the safe use of insulin. Finally, clinical teams should ensure that all staff can access training in diabetes and mental health to support them to care for people with both diabetes and severe mental illness, develop local pathways for joint working and ensure best practice tariff criteria are met for diabetic ketoacidosis and hypoglycaemia, and for children and young people with diabetes.
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Affiliation(s)
- H C Price
- Southern Health NHS Foundation Trust, Southampton, UK
| | - K Ismail
- Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK
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Self-Reported Participation in Sport/Exercise Among Adolescents and Young Adults With and Without Mild to Moderate Intellectual Disability. J Phys Act Health 2018; 15:247-254. [DOI: 10.1123/jpah.2017-0035] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Pitchford EA, Dixon-Ibarra A, Hauck JL. Physical Activity Research in Intellectual Disability: A Scoping Review Using the Behavioral Epidemiological Framework. AMERICAN JOURNAL ON INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2018; 123:140-163. [PMID: 29480777 DOI: 10.1352/1944-7558-123.2.140] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Through a scoping review, the current state of physical activity research in people with intellectual disability was examined. A search of publications between 2000 and 2014 retrieved 362 articles that met inclusion criteria. Eligible studies were coded according to the Behavioral Epidemiological Framework. Of the articles identified, 48% examined associations between physical activity and health outcomes, 9% developed or tested methodology to measure physical activity, 34% examined factors that influence physical activity, 8% evaluated interventions to change physical activity, and 1% examined the dissemination of physical activity/health promotion programming. The categories with lower proportions of studies represent the need for greater population-specific research in physical activity measurement, interventional designs, and translational programs.
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Affiliation(s)
| | | | - Janet L Hauck
- Janet L. Hauck, Michigan State University. E. Andrew Pitchford is now at Iowa State University
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Kinnear D, Morrison J, Allan L, Henderson A, Smiley E, Cooper SA. Prevalence of physical conditions and multimorbidity in a cohort of adults with intellectual disabilities with and without Down syndrome: cross-sectional study. BMJ Open 2018; 8:e018292. [PMID: 29431619 PMCID: PMC5829598 DOI: 10.1136/bmjopen-2017-018292] [Citation(s) in RCA: 108] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES To investigate the prevalence of multimorbidity in adults with intellectual disabilities with and without Down syndrome. DESIGN Large, population-based cross-sectional study. SETTING The geographical area of one Health Board, Scotland. PARTICIPANTS All adults (aged 16+ years) known to general practitioners to have intellectual disabilities and adults receiving services provided or paid by intellectual disabilities health or social work services. 1023/1562 potential participants took part (65.5%); 562 (54.9%) men and 461 (45.1%) women, aged 43.9 years (16-83 years). 186 had Down syndrome and 837 did not. MAIN OUTCOME MEASURES The prevalence of International Statistical Classification of Diseases, 10th revision, physical health conditions and multimorbidity detected at a comprehensive health assessment. RESULTS The mean number of physical health conditions/participant was 11.04, and 98.7% had multimorbidity. The most prevalent conditions are painful and/or disabling and, in some cases, life threatening. The five most prevalent were visual impairment, obesity, epilepsy, constipation and ataxic/gait disorders. The pattern of multimorbidity differs from that seen in the general population and is spread across the entire adult life course. The extent of multimorbidity in the adults with Down syndrome was similar to that of the adults without Down syndrome, while the prevalence of individual conditions differed. CONCLUSIONS This robustly designed study with a large population found an extremely high prevalence of multimorbidity in adults with intellectual disabilities across the entire adult life course. This increases complexity of medical management that secondary healthcare services and medical education are not yet geared towards, as these tend to focus on single conditions. This is in addition to complexity due to limitations in communication and understanding. As the physical conditions within their multimorbidity also differ from that seen in the older general population, urgent attention is needed to develop the care pathways and guidelines that are required to inform and so improve their healthcare.
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Affiliation(s)
- Deborah Kinnear
- Mental Health and Wellbeing Research Group, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Jill Morrison
- General Practice and Primary Care Research Group, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Linda Allan
- Mental Health and Wellbeing Research Group, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Angela Henderson
- Mental Health and Wellbeing Research Group, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Elita Smiley
- East Renfrewshire Integrated Learning Disability Team, Barrhead Health & Care Centre, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Sally-Ann Cooper
- Mental Health and Wellbeing Research Group, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
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Temple VA, Frey GC, Stanish HI. Physical Activity of Adults with Mental Retardation: Review and Research Needs. Am J Health Promot 2018; 21:2-12. [PMID: 16977907 DOI: 10.1177/089011710602100103] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To characterize physical activity levels of adults with mental retardation and identify limitations in published research. Data Sources Key word searches for “mental retardation, ” “intellectual disability, ” “learning disability, ” or “developmental disability” combined with “physical activity” or “habitual exercise” identified articles from MEDLINE, Academic Search Elite, Psych Articles, Health Source, and SPORT Discus. This produced a total of 801 citations. Study Inclusion and Exclusion Criteria Published English-language literature that quantitatively measured physical activity levels of adults with mental retardation was included in this review. Fourteen articles met this criterion. Data Extraction Characteristics of participants, study design, outcome measures, methods of analyses, and findings in terms of percentages, step counts, and acceleromeler output were extracted. Data Synthesis Data were synthesized to identify the percentage of adults with mental retardation who met published health-related physical activity criteria and compare them with adults without mental retardation and to examine study limitations. Results The studies with the greatest rigor indicate that one-third of adults or fewer with mental retardation were sufficiently active to achieve health benefits. However, data are insufficient to determine whether adults with mental retardation are less active than the general community. Conclusions Future research would be enhanced by including appropriately powered representative samples, by including comparison groups, by validating physical activity questionnaires, and by determining the accuracy of proxy respondents.
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Affiliation(s)
- Viviene A Temple
- School of Physical Education, Faculty of Education, University of Victoria, PO Box 3015 STN CSC, Victoria, British Columbia V8W 3P1, Canada.
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Harris L, Melville C, Murray H, Hankey C. The effects of multi-component weight management interventions on weight loss in adults with intellectual disabilities and obesity: A systematic review and meta-analysis of randomised controlled trials. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 72:42-55. [PMID: 29107176 DOI: 10.1016/j.ridd.2017.10.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 10/20/2017] [Accepted: 10/21/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Adults with intellectual disabilities have been shown to experience higher rates of obesity in comparison to the general population. AIM To examine the effectiveness of randomised controlled trials of multi-component weight management interventions for adults with intellectual disabilities and overweight/obesity. METHODS AND PROCEDURES A systematic search of six electronic databases was conducted from database inception to January 2016. Risk of bias was assessed by the Cochrane Collaboration tool. Behavioural change techniques were defined by coding against the Coventry Aberdeen LOndon REfined (CALO-RE) taxonomy. Meta-analyses were conducted as Weighted Mean Difference (WMD) between intervention and control/comparator intervention. OUTCOMES AND RESULTS Six randomised controlled trials were included. The interventions did not adhere to clinical recommendations [the inclusion of an energy deficit diet (EDD), physical activity, and behaviour change techniques]. Meta-analysis revealed that current multi-component weight management interventions are not more effective than no treatment (WMD: -0.38kg; 95% CI -1.34kg to 0.58kg; p=0.44). CONCLUSION AND IMPLICATIONS There is a paucity of randomised controlled trials of multi-component weight management interventions for adults with intellectual disabilities and overweight/obesity. Current interventions, based on a health education approach are ineffective. Future long-term interventions that include an EDD and adhere to clinical recommendations on the management of obesity are warranted.
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Affiliation(s)
- Leanne Harris
- College of Medical Veterinary and Life Sciences, Institute of Mental Health & Wellbeing, University of Glasgow, Glasgow G12 0XH, UK.
| | - Craig Melville
- College of Medical Veterinary and Life Sciences, Institute of Mental Health & Wellbeing, University of Glasgow, Glasgow G12 0XH, UK.
| | - Heather Murray
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow G12 8QQ, UK.
| | - Catherine Hankey
- College of Medical Veterinary and Life Sciences, Institute of Health & Wellbeing, University of Glasgow, Glasgow G31 2ER, UK.
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35
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Physical activity levels in people with intellectual disability attending daily centers. SPORT SCIENCES FOR HEALTH 2017. [DOI: 10.1007/s11332-017-0414-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hoey E, Staines A, Walsh D, Corby D, Bowers K, Belton S, Meegan S, McVeigh T, McKeon M, Trépel D, Griffin P, Sweeney MR. An examination of the nutritional intake and anthropometric status of individuals with intellectual disabilities: Results from the SOPHIE study. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2017; 21:346-365. [PMID: 27402617 DOI: 10.1177/1744629516657946] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The prevalence of obesity appears greater in people with intellectual disabilities than those in the general population. This study aimed to examine the nutritional intake and anthropometric status of individuals with intellectual disabilities. Participants aged 16-64 years were recruited from intellectual disability service provider organizations ( n = 131). Data were collected using questionnaires; 4-day food dairies and weight, height and waist circumference measurements. Participants' mean body mass index (BMI) was 29.4 kg/m2 ± 6.1, 2.4% were underweight, 22.6% were normal weight, 28.2% were overweight and 46.8% were obese. Having a diagnosis of Down syndrome ( p = 0.03) was associated with increasing BMI. Increasing waist circumference was associated with increasing severity of ID ( p = 0.04). The mean-reported energy intake was 1890 kcal/day. Mean energy intakes from sugar, fat and saturated fat were above recommendations and few participants met micronutrient recommended daily amounts. This study highlights the alarming prevalence of overweight and obesity and poor diet quality of individuals with intellectual disabilities.
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Robertson J, Baines S, Emerson E, Hatton C. Constipation management in people with intellectual disability: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:709-724. [PMID: 29168259 DOI: 10.1111/jar.12426] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Constipation can lead to serious health issues and death. This systematic review summarizes international research pertaining to the management of constipation in people with intellectual disability. METHOD Studies published from 1990 to 2017 were identified using Medline, Cinahl, PsycINFO, Web of Science, email requests and cross-citations. Studies were reviewed narratively in relation to identified themes. RESULTS Eighteen studies were reviewed in relation to three themes: laxative receipt; interventions (dietary fibre, abdominal massage and macrogol); and staff issues (knowledge and training). Laxative polypharmacy was common. Studies report positive results for dietary fibre and abdominal massage although study quality was limited. CONCLUSION The main management response to constipation in people with intellectual disability is laxative use despite limited effectiveness. An improved evidence base is required to support the suggestion that an individualized, integrated bowel management programme may reduce constipation and associated health conditions in people with intellectual disability.
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Affiliation(s)
- Janet Robertson
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Susannah Baines
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Eric Emerson
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.,Centre for Disability Research and Policy, University of Sydney, Sydney, NSW, Australia
| | - Chris Hatton
- Centre for Disability Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
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The Relationship between Physical Activity and Screen Time with the Risk of Hypertension in Children and Adolescents with Intellectual Disability. BIOMED RESEARCH INTERNATIONAL 2017; 2017:1940602. [PMID: 29312991 PMCID: PMC5688362 DOI: 10.1155/2017/1940602] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 10/15/2017] [Indexed: 11/30/2022]
Abstract
Introduction Children and adolescents with intellectual disability (ID) have significantly lower levels of physical activity compared to their peers without ID. Association between the level of physical activity and screen time with hypertension (HPT) in children and adolescents with ID has not been reported yet. Aim To assess the relationship between the level of physical activity and screen time with the prevalence of HPT in students with ID. Material and Methods The study group consisted of 568 children with ID aged 7 to 18. The control group matched for age and gender consisted of 568 students without ID. Blood pressure (BP), body mass and height, level of physical activity, and screen time were assessed. Results The level of physical activity in the study group was significantly lower than in the control group (score 1.99 versus 3.02, resp., in Physical Activity Questionnaire). The risk of HPT in the students with ID with low levels of physical activity was more than 4 times higher (OR = 4.40) and more than 2 times higher when screen time was ≥2 h/day. Conclusion Low level of physical activity and long screen time were associated with significantly higher HPT risk among children and adolescents with ID.
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Maine A, Dickson A, Truesdale M, Brown M. An application of Bandura's 'Four Sources of Self-Efficacy' to the self-management of type 2 diabetes in people with intellectual disability: An inductive and deductive thematic analysis. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 70:75-84. [PMID: 28918307 DOI: 10.1016/j.ridd.2017.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/23/2017] [Accepted: 09/07/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Little is known about the successful experiences and positive perceptions of people with intellectual disabilities (ID) self-managing Type 2 Diabetes (T2D). This study sought to address this gap using Bandura's (1977) 'Four Sources of Self-Efficacy' as a framework of enquiry. METHOD Semi-structured interviews were conducted with 10 adults with ID. Interviews were recorded, transcribed verbatim and analysed using inductive and deductive thematic analysis RESULTS: Nine sub-themes were identified following analysis of the data: 1) Mastery through knowledge; 2) Mastery through tools and strategies; 3) Mastery through autonomy; 4) Influence of social setting; 5) Positive social comparisons; 6) Positive and negative self-statements; 7) Feedback from caregivers; 8) Adjustment experiences; 9) Symptom awareness. These were mapped onto Bandura's (1977) Four Sources of efficacy enhancement model and were consistent with its proposed mechanisms. CONCLUSION The Four Sources model serves as a useful mode of enquiry for exploring people with ID's experiences and perceptions of self-managing diabetes. It also confirms the appropriateness of Self-efficacy as a potential intervention component for this population. However, additional support may be required for people with ID to reflect meaningfully on their experiences and thus have a sense of self-efficacy. WHAT THIS PAPER ADDS This paper builds upon the limited existing literature on people with ID self-managing type 2 diabetes and provides a robust, qualitative account of the participants' experiences, whilst confirming some of the existing challenges, both for people with ID and their supporters. To self-manage with autonomy and overcome the difficulties of adjustment, further strategies such as training and education needs are highlighted. In addition, the meaning and relevance of the Self-efficacy construct is evaluated in the context of people with ID self-managing T2D. This provides useful information in terms of tailoring existing mainstream T2D interventions to meet the needs of people with ID, as such programs are commonly theoretically guided by Self-efficacy. Furthermore, this evaluation provides rationale for the exploration of people with IDs' Self-efficacy in relation to other chronic diseases, such as cardiovascular disease, cancer symptoms and gastrointestinal disorders.
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Affiliation(s)
- Andrew Maine
- EdinburghNapier University, School of Health and Social Care, 9 Sighthill Ct, Edinburgh EH11 4BN, United Kingdom.
| | - Adele Dickson
- Glasgow Caledonian University, School of Health and Life Sciences, Cowcaddens Rd, Glasgow G4 0BA, United Kingdom
| | - Maria Truesdale
- EdinburghNapier University, School of Health and Social Care, 9 Sighthill Ct, Edinburgh EH11 4BN, United Kingdom
| | - Michael Brown
- Glasgow Caledonian University, School of Health and Life Sciences, Cowcaddens Rd, Glasgow G4 0BA, United Kingdom
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Neumeier WH, Guerra N, Thirumalai M, Geer B, Ervin D, Rimmer JH. POWERS forID: Personalized Online Weight and Exercise Response System for Individuals with Intellectual Disability: study protocol for a randomized controlled trial. Trials 2017; 18:487. [PMID: 29058620 PMCID: PMC5653469 DOI: 10.1186/s13063-017-2239-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/04/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Intellectual disability (ID) is characterized by limitations in intellectual functioning and adaptive behavior. Adults with ID exhibit higher rates of obesity and poorer health status compared to the general population. Continuity of care and barriers to health-related activities may contribute to the poorer health status observed in this population. To address this problem, a tailored weight management online health information and communication technology platform, known as POWERSforID, was developed and is being tested to determine if this delivery mechanism can improve weight maintenance/weight loss in adults with ID. METHODS Obese adults with mild-to-moderate ID (n = 70) are randomized to the POWERS forID intervention or control group for a 24-week trial. Each group undergoes an assessment that includes body weight, waist circumference, and percent body fat at baseline and at weeks 6, 12, and 24. Physical activity barriers, healthy eating barriers, food frequency, and psychosocial wellbeing are measured at baseline and at weeks 12 and 24. Blood lipids are assessed at baseline and 24 weeks. Participants randomized to POWERS forID receive access to the POWERS forID website and calls from a health coach (weekly during weeks 1-12, biweekly during weeks 13-24). The health coach employs motivational interviewing techniques adapted for individuals with ID to promote behavior change. Participants randomized to the control group receive standard clinical weight-loss care. Differences in weight, waist circumference, blood lipids, percent body fat, and psychosocial self-report will be assessed. Barriers and facilitators of implementation as well as perception of study outcomes will be conducted via qualitative analysis. DISCUSSION POWERS forID is a novel information and communication technology platform designed to address health needs for adults with ID. This article describes the development and components of POWERS forID. The overall aim is to assess usability and feasibility of POWERS forID for promoting weight loss for obese adults with ID over the course of a 24-week randomized control trial. TRIAL REGISTRATION Clinicaltrials.gov, NCT03139760 . Registered on XXX.
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Affiliation(s)
- William H. Neumeier
- University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, 331 School of Health Professions Bldg. 1705 University Blvd, Birmingham, AL 35294-1212 USA
| | - Nichole Guerra
- The Resource Exchange, 6385 Corporate Drive, Suite 301, Colorado Springs, CO 80919 USA
| | - Mohanraj Thirumalai
- University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, 331 School of Health Professions Bldg. 1705 University Blvd, Birmingham, AL 35294-1212 USA
| | - Betty Geer
- The Resource Exchange, 6385 Corporate Drive, Suite 301, Colorado Springs, CO 80919 USA
| | - David Ervin
- The Resource Exchange, 6385 Corporate Drive, Suite 301, Colorado Springs, CO 80919 USA
| | - James H. Rimmer
- University of Alabama at Birmingham/Lakeshore Foundation Research Collaborative, 331 School of Health Professions Bldg. 1705 University Blvd, Birmingham, AL 35294-1212 USA
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Shields N, Plant S, Warren C, Wollersheim D, Peiris C. Do adults with Down syndrome do the same amount of physical activity as adults without disability? A proof of principle study. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:459-465. [PMID: 28960662 DOI: 10.1111/jar.12416] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND This study compared levels of physical activity completed by adults with and without Down syndrome. METHOD Fifteen adults with and 15 adults without Down syndrome matched for age and gender, took part. The intensity and duration of physical activity were measured using RT3 accelerometers worn for seven days. RESULTS Only, 12 participants with Down syndrome had complete physical activity data, and these participants and their matched controls (total: six females, 18 males; aged 25.8 ± 9.7) were included in the analyses. There were significantly lower levels of moderate and vigorous physical activity per day for people with Down syndrome (median = 27 min) compared to those without (median = 101 min) (p < .001). Participants without disability were twice more likely to achieve recommended levels of physical activity than people with Down syndrome. CONCLUSIONS Adults with Down syndrome appear to participate in lower levels of physical activity than adults without Down syndrome. Further research should validate these estimates.
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Affiliation(s)
- Nora Shields
- School of Allied Health, La Trobe University, Bundoora, Vic., Australia
| | - Samantha Plant
- School of Allied Health, La Trobe University, Bundoora, Vic., Australia
| | - Catherine Warren
- School of Allied Health, La Trobe University, Bundoora, Vic., Australia
| | - Dennis Wollersheim
- School of Psychology and Public Health, La Trobe University, Bundoora, Vic., Australia
| | - Casey Peiris
- School of Allied Health, La Trobe University, Bundoora, Vic., Australia
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42
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Gawlik K, Zwierzchowska A, Celebańska D. Impact of physical activity on obesity and lipid profile of adults with intellectual disability. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31:308-311. [PMID: 28892239 DOI: 10.1111/jar.12406] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION This study assessed overweight, obesity and lipid profiles in adults with intellectual disability and compared these metrics with their physical activity. MATERIALS AND METHOD Basic somatic parameters, lipid profile and weekly physical activity were examined in 27 adults with moderate intellectual disability. Chi-square independence tests and Pearson's linear correlation coefficients were used. RESULTS The participants had excess body mass, excess body fat and abdominal obesity. Very high positive correlations were shown between body mass index and both waist circumference and %fat. The lipid profiles were more favourable in the general population. Healthy levels of physical activity were observed in 8% of women and 26% of men. A high negative correlation was found between physical activity and body mass index. CONCLUSION The study group was characterized by excess body mass and insufficient levels of physical activity. Body mass index and waist circumference are sufficient indicators for identifying obesity in adults with intellectual disability.
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Affiliation(s)
- Krystyna Gawlik
- Department of Correction Body Posture, Academy of Physical Education, Katowice, Poland
| | - Anna Zwierzchowska
- Department of Special Physical Education, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Diana Celebańska
- Department of Correction Body Posture, Academy of Physical Education, Katowice, Poland
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43
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Franke ML, Heinrich M, Adam M, Sünkel U, Diefenbacher A, Sappok T. [Body weight and mental disorders : Results from a clinical psychiatric cross-sectional study of people with intellectual disabilities]. DER NERVENARZT 2017; 89:552-558. [PMID: 28849297 DOI: 10.1007/s00115-017-0411-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND People with intellectual disabilities (ID) have a shorter life expectancy and higher mortality rate and more often suffer from various physical and mental disorders (WHO: 3-4 times more often than the general population). Obesity is an important risk factor for various disorders. This cross-sectional study examined the body weight and its risk factors in a clinical population of adults with ID. METHODS The prevalence of underweight, normal weight, and overweight was determined using the body mass index (BMI) for 633 patients of an outpatient clinic for people with ID and mental disorders. A multiple logistic regression analysis was used to assess factors for alterations in body weight. RESULTS Approximately one out of two men and two out of three women with ID and mental disorders were overweight. Adults with mild and moderate ID, female gender, increasing age, Down's syndrome, behavioral disorders, and a less supported living situation were associated with a higher rate of obesity. People with dementia and autism spectrum disorders showed a lower rate of obesity. CONCLUSION Young women with ID and mental disorders were particularly at risk for obesity. The respective factors may support the development of specific prevention programs to reduce the risk of overweight and thereby lead to better mental and physical health in people with ID.
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Affiliation(s)
- M L Franke
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland.
| | - M Heinrich
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland.,Fachbereich Erziehungswissenschaften und Psychologie, Freie Universität Berlin, Berlin, Deutschland
| | - M Adam
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland
| | - U Sünkel
- Hertie-Institut für klinische Hirnforschung, Tübingen, Deutschland.,Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Tübingen, Deutschland
| | - A Diefenbacher
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland
| | - T Sappok
- Abteilung für Psychiatrie, Psychotherapie und Psychosomatik, Ev. Krankenhaus Königin Elisabeth Herzberge, Herzbergstraße 79, 10405, Berlin, Deutschland
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44
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Aherne C, Coughlan B. A preliminary investigation of the suitability of aquatics for people with severe and profound intellectual disabilities. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2017; 21:118-133. [PMID: 27166098 DOI: 10.1177/1744629516646513] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
BACKGROUND Aquatics is an under-researched but possibly appropriate form of activity for people with severe to profound intellectual disabilities (SPIDs). AIM The current pilot study investigates the suitability of an aquatics programme for service users with SPIDs. METHOD Four service users with SPID completed an 8-12-session aquatics programme. Front-line staff ( N = 6) were interviewed after the programme to explore its suitability. A thematic analysis of the interviews was utilized. RESULTS The thematic analysis unearthed main themes of effects, facilitators, barriers, strengths and needs. CONCLUSION Aquatics can be an appropriate and beneficial form of physical activity for people with SPIDs, but there are many barriers to participation. Tailored programmes are required. Further investigation of the experiences of people with SPIDs in relation to physical activity is recommended.
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45
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Ranjan S, Nasser JA, Fisher K. Prevalence and potential factors associated with overweight and obesity status in adults with intellectual developmental disorders. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31 Suppl 1:29-38. [DOI: 10.1111/jar.12370] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Sobhana Ranjan
- Department of Nutrition Sciences; College of Nursing and Health Professions; Drexel University; Philadelphia PA USA
| | - Jennifer A. Nasser
- Department of Nutrition Sciences; College of Nursing and Health Professions; Drexel University; Philadelphia PA USA
| | - Kathleen Fisher
- Doctoral Nursing Programs; College of Nursing and Health Professions; Drexel University; Philadelphia PA USA
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46
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Dunkley AJ, Tyrer F, Spong R, Gray LJ, Gillett M, Doherty Y, Martin-Stacey L, Patel N, Yates T, Bhaumik S, Chalk T, Chudasama Y, Thomas C, Sadler S, Cooper SA, Gangadharan SK, Davies MJ, Khunti K. Screening for glucose intolerance and development of a lifestyle education programme for prevention of type 2 diabetes in a population with intellectual disabilities: the STOP Diabetes research project. PROGRAMME GRANTS FOR APPLIED RESEARCH 2017. [DOI: 10.3310/pgfar05110] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BackgroundThe prevalence of type 2 diabetes mellitus (T2DM) and of cardiovascular disease (CVD) is believed to be higher among people with intellectual disability (ID) than in the general population. However, research on prevalence and prevention in this population is limited.ObjectivesThe objectives of this programme of work were to establish a programme of research that would significantly enhance the knowledge and understanding of impaired glucose regulation (IGR) and T2DM in people with ID; to test strategies for the early identification of IGR and T2DM in people with ID; and to develop a lifestyle education programme and educator training protocol to promote behaviour change in a population with ID and IGR (or at a high risk of T2DM/CVD).SettingLeicestershire, UK.ParticipantsAdults with ID were recruited from community settings, including residential homes and family homes. Adults with mild to moderate ID who had an elevated body mass index (BMI) of ≥ 25 kg/m2and/or IGR were invited to take part in the education programme.Main outcome measuresThe primary outcome of the screening programme was the prevalence of screen-detected T2DM and IGR. The uptake, feasibility and acceptability of the intervention were assessed.Data sourcesParticipants were recruited from general practices, specialist ID services and clinics, and through direct contact.ResultsA total of 930 people with ID were recruited to the screening programme: 58% were male, 80% were white and 68% were overweight or obese. The mean age of participants was 43.3 years (standard deviation 14.2 years). Bloods were obtained for 675 participants (73%). The prevalence of previously undiagnosed T2DM was 1.3% [95% confidence interval (CI) 0.5% to 2%] and of IGR was 5% (95% CI 4% to 7%). Abnormal IGR was more common in those of non-white ethnicity; those with a first-degree family history of diabetes; those with increasing weight, waist circumference, BMI, diastolic blood pressure or triglycerides; and those with lower high-density lipoprotein cholesterol. We developed a lifestyle educational programme for people with ID, informed by findings from qualitative stakeholder interviews (health-care professionals,n = 14; people with ID,n = 7) and evidence reviews. Subsequently, 11 people with ID (and carers) participated in pilot education sessions (two groups) and five people attended education for the feasibility stage (one group). We found that it was feasible to collect primary outcome measures on physical activity and sedentary behaviour using wrist-worn accelerometers. We found that the programme was relatively costly, meaning that large changes in activity or diet (or a reduction in programme costs) would be necessary for the programme to be cost-effective. We also developed a quality development process for assessing intervention fidelity.LimitationsWe were able to screen only around 30% of the population and involved only a small number in the piloting and feasibility work.ConclusionsThe results from this programme of work have significantly enhanced the existing knowledge and understanding of T2DM and IGR in people with ID. We have developed a lifestyle education programme and educator training protocol to promote behaviour change in this population.Future workFurther work is needed to evaluate the STOP Diabetes intervention to identify cost-effective strategies for its implementation.Trial registrationClinicalTrials.gov NCT02513277.FundingThe National Institute for Health Research Programme Grants for Applied Research programme and will be published in full inHealth Research Programme Grants for Applied Research; Vol. 5, No. 11. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Alison J Dunkley
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Freya Tyrer
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Rebecca Spong
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Laura J Gray
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Mike Gillett
- School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Yvonne Doherty
- Leicester Diabetes Centre, University Hospitals of Leicester, Leicester, UK
| | | | - Naina Patel
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Thomas Yates
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Sabyasachi Bhaumik
- Learning Disabilities Service, Leicestershire Partnership NHS Trust, Leicester, UK
| | - Thomas Chalk
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Yogini Chudasama
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Chloe Thomas
- School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Susannah Sadler
- School of Health & Related Research, University of Sheffield, Sheffield, UK
| | - Sally-Ann Cooper
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | - Melanie J Davies
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester, Leicester, UK
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Stevens G, Jahoda A, Matthews L, Hankey C, Melville C, Murray H, Mitchell F. A theory-informed qualitative exploration of social and environmental determinants of physical activity and dietary choices in adolescents with intellectual disabilities in their final year of school. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2017; 31 Suppl 1:52-67. [DOI: 10.1111/jar.12340] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Gemma Stevens
- Department of Physical Activity for Health; University of Strathclyde; Glasgow UK
| | - Andrew Jahoda
- Institute of Health and Wellbeing; University of Glasgow; Glasgow UK
| | - Lynsay Matthews
- Institute of Health and Wellbeing; University of Glasgow; Glasgow UK
| | - Catherine Hankey
- Human Nutrition; School of Medicine, Nursing and Dentistry; University of Glasgow; Glasgow UK
| | - Craig Melville
- Institute of Health and Wellbeing; University of Glasgow; Glasgow UK
| | - Heather Murray
- Robertson Centre for Biostatistics; University of Glasgow; Glasgow UK
| | - Fiona Mitchell
- Department of Physical Activity for Health; University of Strathclyde; Glasgow UK
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48
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Stancliffe RJ, Anderson LL. Factors associated with meeting physical activity guidelines by adults with intellectual and developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 62:1-14. [PMID: 28103494 DOI: 10.1016/j.ridd.2017.01.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/21/2016] [Accepted: 01/05/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND Many individuals with intellectual and developmental disabilities (IDD) have sedentary lifestyles. AIMS (a) compare adults with IDD with the general adult population on adherence to U.S. physical activity (PA) guidelines, and (b) determine what factors predict adherence to PA guidelines by adults with IDD. METHODS We compared adults with IDD from the 2011-2012 National Core Indicators Adult Consumer Survey (NCI-ACS) with the general U.S. population on meeting PA guidelines. We examined the association of demographic, diagnostic, mobility, health and community participation variables with meeting PA guidelines by adults with IDD. RESULTS The rate for adults with IDD meeting PA guidelines (13.5%) was less than half that of the general population (30.8%). Among adults with IDD, at-risk groups included those with more severe disability, Down syndrome, mobility impairments, obesity, poor health, mental illness, no independent access to community exercise, and less frequent participation in community exercise. Going out for exercise was the only form of community participation associated with meeting PA guidelines. People who accessed the community for exercise independently (i.e., alone) were more likely to meet PA guidelines. CONCLUSIONS Interventions aimed at increasing PA for people with IDD should consider these factors in their design.
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Affiliation(s)
- Roger J Stancliffe
- University of Sydney, Centre for Disability Research and Policy, 75 East Street, PO Box 170, Lidcombe, NSW, 1825, Australia.
| | - Lynda L Anderson
- Research and Training Center on Community Living, University of Minnesota, Pattee Hall, 150 Pillsbury Ave SE, Minneapolis, MN, 55455, USA.
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49
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Burke EA, McCallion P, Carroll R, Walsh JB, McCarron M. An exploration of the bone health of older adults with an intellectual disability in Ireland. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2017; 61:99-114. [PMID: 27097825 DOI: 10.1111/jir.12273] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Revised: 12/22/2015] [Accepted: 02/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Many risk factors have been confirmed for poor bone health among the general population including age, gender and corticosteroid use. There is a paucity of investigation among people with intellectual disability; however, research points to differing risks namely anti-epileptic medication use, Down syndrome and poor behaviour lifestyle. METHODS Data was extracted from the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing in Ireland. In total, 753 participants took part, and data was gathered on participants' health status, behavioural health, health screenings and activities of daily living. The prevalence of osteoporosis and related risk factors were specifically examined. RESULTS Overall, 8.1% reported a doctor's diagnosis of osteoporosis with over 20% reporting history of fracture. Risk identified included older age (P < 0.0001), female gender (P < 0.0001), difficulty walking (P < 0.0001) with older age and being female the stronger predictors for osteoporosis, odds ratio = 6.53; 95% confidence interval 2.82-15.11 and odds ratio = 4.58; 95% confidence interval 2.29-9.17, respectively. There was no gender difference regarding the level of fractures; however, epilepsy and anti-epileptic medication were strong predictors. Overall, 11.1% attended for bone screening diagnostics. CONCLUSION Despite low levels of reported doctor's diagnosis of osteoporosis risk factor prevalence was high. Considering the insidious nature of osteoporosis and the low levels of diagnostic screening, prevalence could be possibly higher.
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Affiliation(s)
- E A Burke
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - P McCallion
- Center for Excellence in Aging and Community Wellness, University at Albany, NY, USA
| | - R Carroll
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - J B Walsh
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - M McCarron
- Faculty of Health Sciences, Trinity College Dublin, Dublin, Ireland
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50
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Bossink LW, van der Putten AA, Waninge A, Vlaskamp C. A power-assisted exercise intervention in people with profound intellectual and multiple disabilities living in a residential facility: a pilot randomised controlled trial. Clin Rehabil 2017; 31:1168-1178. [PMID: 28074672 DOI: 10.1177/0269215516687347] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess the feasibility of conducting a randomised controlled trial to determine the effectiveness of a twenty-week power-assisted exercise intervention in people with profound intellectual and multiple disabilities and to evaluate the potential beneficial effects of this intervention. DESIGN Pilot randomised controlled trial. SETTING A large-scale twenty-four-hour residential facility in the Netherlands. SUBJECTS Thirty-seven persons with profound intellectual and multiple disabilities. INTERVENTION Participants in the intervention group received a power-assisted exercise intervention three times a week for thirty minutes over a twenty-week period. Participants in the control group received care as usual. MAIN MEASURES Trial feasibility by recruitment process and outcomes completion rates; intervention feasibility by programme compliance rates; potential outcomes by functional abilities, alertness, body composition, muscle tone, oxygen saturation, cardiovascular fitness and quality of life. RESULTS Thirty-seven participants were recruited ( M age = 32.1, SD = 14.6) and were randomly allocated to intervention ( n = 19) and control ( n = 18) groups. Programme compliance rates ranged from 54.2% to 97.7% with a mean (SD) of 81.5% (13.4). Oxygen saturation significantly increased in the intervention group. Standardised effect sizes on the difference between groups in outcome varied between 0.02 and 0.62. CONCLUSIONS The power-assisted exercise intervention and the trial design were feasible and acceptable to people with profound intellectual and multiple disabilities living in a residential facility. This pilot study suggests that the intervention improves oxygen saturation, but further implementation with the aim of improving other outcomes should be considered with caution.
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Affiliation(s)
- Leontien Wm Bossink
- 1 Department of Special Needs Education and Youth Care, University of Groningen, Groningen, the Netherlands
| | - Annette Aj van der Putten
- 1 Department of Special Needs Education and Youth Care, University of Groningen, Groningen, the Netherlands
| | - Aly Waninge
- 2 Applied Sciences in Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands.,3 Royal Dutch Visio De Brink, Vries, the Netherlands
| | - Carla Vlaskamp
- 1 Department of Special Needs Education and Youth Care, University of Groningen, Groningen, the Netherlands
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