Intellectual disability, exercise and aging: the IDEA study: study protocol for a randomized controlled trial

Cardiac autonomic modulation and exercise capacity in older adults with intellectual disability: A 6-month randomised control trial

BACKGROUND

Despite reported physical and functional improvements with aerobic and sprint interval training (SIT) protocols in individuals with intellectual disability (ID), it is not known if these interventions' effectivity would promote improvements in cardiac autonomic modulation. This study aimed to investigate if a 6-month SIT or a continuous aerobic programme could enhance physical performance and cardiac autonomic modulation at rest, during physical activity (PA) and after it in older adults with an ID.

METHODS

This is a randomised control trial. Participants with ID (age: 50.58 ± 7.25) were allocated to one of three groups [multicomponent aerobic training group (MATG), multicomponent interval sprint training group (MISTG) and control group (CG)]. The programmes lasted 24 weeks, with three sessions/week, 75-90 min per session. The HRV was analysed at rest and recovery, the delta of heart rate (HR) was analysed during 6MWT, and the HR t-off kinetics was analysed in recovery after 6MWT.

RESULTS

There were not found differences between groups, moments, or interaction for cardiac autonomic modulation at rest and recovery. During exercise, only MSITG showed a significant increase of HR between rest and the first 30 s of exercise (P < 0.05). Physical performance increased only in MSITG (P < 0.05), while CG showed a significant reduction (P < 0.01).

CONCLUSIONS

The MSITG improved the physical performance and the vagal withdrawal at the beginning of the submaximal exercise. These findings suggest that high-intensity exercise may positively impact baroreflex function, mitigating the decline in autonomic reflex response capacity associated with aging in individuals with ID.

A Study of Blood Pressure and Physical Fitness in People with Intellectual Disabilities in South Korea

Individuals with intellectual disabilities have a shorter lifespan and significantly higher prevalence of conditions such as hypertension and cardiovascular diseases than healthy individuals. Thus, assessing the elements that contribute to their physical fitness is crucial. This cross-sectional study examined the relationship between the blood pressure and physical fitness of people with intellectual disabilities in South Korea, considering differences across sexes, age groups, physical attributes, and disability levels. It used data from 8502 individuals with intellectual disabilities aged 20-59 years who participated in a survey of a National Fitness Standard Center (NFSC) between 2018 and 2021. A series of t-tests, one-way analysis of variance, logistic regression, and the four-quartile method were used for data analyses. The results showed differences in physical fitness levels between men and women considering all aspects except for BMI (Body Mass Index), with men showing higher blood pressure levels. Lower grip strength, lower PEI (physical efficiency index) scores, and higher BMI were associated with increased blood pressure. Additionally, individuals with higher levels of disability tended to have lower levels of physical fitness, while higher physical fitness levels were associated with lower blood pressure. Therefore, low fitness levels and hypertension risk may be important health indicators for people with intellectual disabilities.

Cut-off points for isometric handgrip and low limb explosive strength in relation to indicators of overweight/obesity in people with intellectual disabilities: analysis by age groups

BACKGROUND

The prevalence of overweight/obesity has been increasing globally and in people with Intellectual Disabilities (IDs), this problem is exacerbated even more, which added to a low physical condition that contributes to the deterioration of functionality and increases the risk of developing chronic diseases in the course of life. Therefore, the aim of this study was to establish cut-off points for levels of isometric handgrip and low limb explosive strength in children, adolescents and adults, which identify overweight/obesity in people with IDs and their respective associations.

METHODS

The sample was made up of 131 individuals with IDs, belonging to four special and community educational centres in the city of Santiago, Chile. Body mass index (BMI) and waist-to-height ratio (WHR) were used as indicators of overweight/obesity. Handgrip strength was used as a measure of isometric strength, and countermovement jump was used as a measure of low limb explosive strength. For the comparison of variables by age group, the analysis of Ancova, Kruskal-Wallis and chi-square tests were used. The total area under the receiver operating characteristic curve of isometric handgrip and low limb explosive strength was identified as an indicator of overweight/obesity according to age groups. A logistic regression model was used to quantify the effect that strength categories below the cut-off point have on the risk of overweight and obesity.

RESULTS

Significant differences were observed between the age groups for body weight, height, BMI and WHR, as well as in the levels of absolute handgrip strength and vertical jump with countermovement (P ≤ 0.05). Children showed the lowest cut-off points for absolute and relative strength. The adolescent group showed the highest cut-off points for relative strength and countermovement jump and adults showed the highest value for absolute strength as indicators of overweight/obesity. Different associations between cut-off points with BMI and WHR were found.

CONCLUSIONS

Adolescents showed the highest cut-off point for relative strength and countermovement jump, and adults showed the highest value for absolute strength, according to overweight/obesity indicators (BMI and WHR). It is suggested to adjust resistance training programmes according to age categories for the prevention of overweight/obesity in people with IDs.

Muscle strength and psychometric properties of the health-related quality of life in patients with soft tissue sarcoma resection in the thigh

OBJECTIVES

The aim of this study was to evaluate the effect of STS resection in the thigh on MS and the HRQoL.

METHODS

Fourteen adults patients with STS in the thigh who underwent wide resection and limb preservation were evaluated. The patients were submitted to the Mini-Mental State Examination (MMSE). A hand-held dynamometer was used to measure the MS the flexors, adductors, abductors, and extensors muscles of the operated and non-operated thighs and between the dominant and non-dominant operated sides. The Musculoskeletal Tumor Society (MSTS) and Short Form Health Survey-36 (SF-36) questionnaires were applied to quantify the psychometric properties of the HRQoL. The data were submitted to statistical analysis using the Wilcoxon test (MS), and Mann-Whitney and Spearman correlation (MSTS and SF-36) (α = 0.05).

RESULTS

There was no significant difference in MS between the operated side and the non-operated side, and between the dominant and non-dominant operated side (ρ > 0.05). The MSTS presented a significant difference in the emotional acceptance for patients submitted to radiotherapy (ρ = 0.029). The SF-36 showed significant differences in the emotional aspect for patients submitted to chemotherapy (ρ = 0.027) and in the social aspect between the dominant and non-dominant operated side (ρ = 0.024).

CONCLUSIONS

The HRQoL of adult patients is hampered after the treatment of STS even when MS is maintained.

Physical Activity and Quality of Life among People with Intellectual Disabilities: The Role of Gender and the Practice Characteristics

Staying physically active is synonymous with good health and well-being, and its benefits on the health of people with intellectual disabilities (PWIDs) have been studied. However, there is a lack of information on how it can influence their quality of life (QoL). This study aimed to analyze the relationship between QoL and physical activity in PWIDs according to gender and the characteristics of the practiced activity. A questionnaire was administered to 380 PWIDs (mean age of 28.23 ± 12.53), 54.21% of which were men. The QoL dimensions and second-order factors were studied in relation to practicing physical activity, the practice type, the context, and gender. The results indicate that people who practiced any activity showed better QoL values. Those who engaged in a nonregulated physical activity had better values in self-determination, emotional well-being, social inclusion, and personal development, while those who did sports presented higher scores in interpersonal relationships and physical well-being. In addition, it also appears that the association between physical activity and the QoL dimensions is distinct in inclusive and specific contexts. In conclusion, physical activity is related to a better QoL, although the impact of the practice type and context differs for each QoL dimension.

Rare Diseases: Needs and Impact for Patients and Families: A Cross-Sectional Study in the Valencian Region, Spain

Families with rare diseases (RDs) have unmet needs that are often overlooked by health professionals. Describing these needs and the impact of the disease could improve their medical care. A total of 163 surveys were obtained from patients visiting primary care centres in the Valencian Region (Spain), during 2015-2017, with a confirmed or suspected diagnosis of RD. Of the 84.7% with a confirmed diagnosis, 50.4% had a diagnostic delay exceeding one year, and it was more prevalent among adults (62.2%). Families with paediatric patients were in a worse economic situation, with lower incomes and higher monthly disease-related expenses (€300 on average). These expenses were incurred by 66.5% of families and were mainly for medication (40.3%). Among them, 58.5% reported not being able to afford adjuvant therapies. The disease had an impact on 73.1% of families, especially on their routine and emotional state. Expenses, needs, and impacts were more frequent among families of patients with a history of hospitalisation or deterioration. Patients with delayed diagnosis had a higher consumption of drugs prior to diagnosis. People affected by RDs in the Valencian Region need therapies to improve their autonomy and emotional state. Health professionals should be aware of these needs.

Considerations for the Design of a Physical Fitness Battery to Assess Adults with Intellectual Disabilities: Preliminary Reference Values for the SAMU DIS-FIT Study

For the assessment of the health-related physical fitness (PF) of individuals with intellectual disabilities (ID), tools designed for people without disabilities have generally been used. Also, the results of these assessments have routinely been compared with the scores obtained by people without ID. The objectives of the present study are to present the rationale for the design of an assessment battery for PF, the so-called SAMU DIS-FIT battery, and to present the results obtained by the participants classified according to age, sex, and level of PF (physical fitness). The selection criteria for the tests that would make up the battery were: (i) utility, (ii) psychometric properties, (iii) easiness and diversity, (iv) simplicity of execution, (v) familiarity and motivation, and (vi) economy of resources. A cross-sectional study was designed to assess the PF of 261 individuals with ID. To interpret the results obtained by the participants, each of the quantitative variables of PF was categorized into three levels: lower-fit, mid-fit, and higher-fit. The findings of this study serve as a first step in establishing PF baseline values for individuals with ID.