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Ballenger BK, Carter SL, Norman G, Brown SP, Fernhall B, Motl RW, Agiovlasitis S. Physical activity and arterial stiffness: is body fat a mediator? Eur J Appl Physiol 2024; 124:527-535. [PMID: 37578537 DOI: 10.1007/s00421-023-05296-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/04/2023] [Indexed: 08/15/2023]
Abstract
PURPOSE Physical activity (PA) and body fat percentage (%BF) are independently associated with arterial stiffness, but it has not been explored if there is an associative pathway among these variables. This study examined whether %BF mediates the relationship between PA or sedentary behavior levels with arterial stiffness. METHODS Fifty adults (1:1 men:women; age 28 ± 11 year) had carotid-femoral pulse wave velocity (CF-PWV) measured by applanation tonometry, %BF by bioelectrical impedance, and PA levels by accelerometry. Accelerometer data determined minutes per day spent in sedentary, light, moderate-to-vigorous physical activity (MVPA), and Total PA. RESULTS Pearson correlation indicated statistically significant associations among age, %BF, CF-PWV, MVPA, and Total PA (r = 0.34-0.65, p < 0.05). Sedentary and light PA were not associated with CF-PWV. Mediation analysis indicated significant total effects of MVPA (β = - 0.34, p = 0.044) and age (β = 0.65, p < 0.001) on CF-PWV. %BF mediated the relationship between Total PA and CF-PWV due to indirect effect of Total PA on %BF (β = - 0.34, p = 0.02) and %BF on CF-PWV (β = 0.44, p = 0.002), and partially mediated the relationship between age and CF-PWV (β = 0.54, p < 0.001). Total PA retained its significant effect on %BF (β = - 0.28, p = 0.04) and the effect of %BF on CF-PWV remained significant (β = 0.26, p = 0.03), despite age having a significant effect on both %BF (β = 0.31, p = 0.023) and CF-PWV (β = 0.54, p < 0.001). CONCLUSIONS %BF mediated the relationship between Total PA and arterial stiffness, even after accounting for age. Engagement in more Total PA may help to reduce %BF, resulting in decreased arterial stiffness.
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Affiliation(s)
- Brantley K Ballenger
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA.
| | - Sydni L Carter
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Grant Norman
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Stanley P Brown
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Bo Fernhall
- Department of Exercise and Health Science, University of Massachusetts Boston, Boston, MA, USA
| | - Robert W Motl
- Department of Kinesiology and Nutrition, Univeristy of Illinois Chicago, Chicago, IL, USA
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2
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Ballenger BK, Haider M, Brown SP, Agiovlasitis S. Analysis of sedentary behaviour levels and patterns in adults with Down syndrome. J Appl Res Intellect Disabil 2024; 37:e13176. [PMID: 37947453 DOI: 10.1111/jar.13176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 10/28/2023] [Accepted: 11/02/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Sedentary behaviour (SB) among adults with Down syndrome (DS) may differ based on personal or environmental factors. OBJECTIVE Investigate differences in SB levels and patterns of adults with DS based on sex, age, and residence-type across weekdays and weekends. METHODS Thirty-four adults with DS (15 men; 37 ± 12 years) underwent accelerometry-based measurements of sedentary time, bouts, and breaks for 7 days. We evaluated differences with 2 × 2 mixed-model (group-by-day) ANOVA. RESULTS Younger (19-36 years) individuals had less sedentary time (p = .042), and shorter (p = .048) and fewer (p = .012) bouts than older (37-60 years) individuals. Group home residents had more bouts on weekends than adults living with parent/guardians (p = .015). CONCLUSIONS Adults with DS spent half their waking hours in SB of short bouts. Age and residence may influence SB.
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Affiliation(s)
- Brantley K Ballenger
- Department of Kinesiology, Mississippi State University, Starkville, Mississippi, USA
| | - Maria Haider
- Department of Kinesiology, Mississippi State University, Starkville, Mississippi, USA
| | - Stanley P Brown
- Department of Kinesiology, Mississippi State University, Starkville, Mississippi, USA
| | - Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, Starkville, Mississippi, USA
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3
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Schultz EE, Sergi K, Twietmeyer G, Oreskovic NM, Agiovlasitis S. Factors That Influence Physical Activity in Individuals With Down Syndrome: Perspectives of Guardians and Health Professionals. Adapt Phys Activ Q 2023; 40:587-606. [PMID: 36754059 DOI: 10.1123/apaq.2022-0103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/30/2022] [Accepted: 12/02/2022] [Indexed: 02/10/2023] Open
Abstract
Identifying factors that influence physical activity (PA) among individuals with Down syndrome is essential for PA promotion. Insight can be gained from guardians and health professionals. The purpose of this study was to explore the perspectives of guardians and health professionals on facilitators and barriers of PA in individuals with Down syndrome. Interviews were conducted with 11 guardians (five mothers, four fathers, and two legal guardians) and 11 professionals (four PA specialists, three physical therapists, and four occupational therapists). Grounded theory was applied. Barriers and facilitators fit the levels of the ecological model of health behavior: (a) intrapersonal (perceived rewards), (b) interpersonal (interaction), (c) community (availability of programs), (d) organizational (school systems), and (e) policy (education). Guardians and professionals agreed on the importance of enjoyment, interaction, and programs to promote PA. Differences between groups were identified at the organizational and policy levels. PA in persons with Down syndrome is influenced by interactions between individual and environmental factors.
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Choi P, Motl RW, Agiovlasitis S. Feasibility of social cognitive theory-based fall prevention intervention for people with intellectual disabilities living in group-home. J Intellect Disabil Res 2023; 67:159-171. [PMID: 36530049 DOI: 10.1111/jir.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Adults with intellectual disability (ID) have a higher rate of fall events than the general population. Consequently, interventions for reducing fall events and improving health are highly required for individuals with ID. One essential step towards effectively delivering fall prevention interventions among adults with ID involves evaluating their feasibility. This study examined the feasibility of a home-based exercise intervention, supplemented with behavioural change strategies, among individuals with ID living in residential settings. METHOD This study provided an 8-week intervention, consisting of a workshop for support workers and sessions for participants with ID, focusing on behavioural reward/s, education regarding fall prevention/exercise and exercise training. One week prior to and 1 week following such an intervention, such participants underwent measurements for (1) physical performance, (2) fall efficacy, (3) self-efficacy for activity and (4) social support. RESULTS Participants having ID (n = 33), support workers (n = 11) and one administrator participated in this study. There were no adverse events during the intervention, and the mean adherence rate was 70.8 ± 19.5%. Two participants with ID dropped out of the programme due to a lack of interest. The participants with ID significantly improved individual physical performance, self-efficacy for activity, fall efficacy and support from friends and support workers. CONCLUSIONS Fall prevention interventions for adults with ID living in group-homes were highly promising for eventual large-scale implementation within such communities.
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Affiliation(s)
- P Choi
- Department of Kinesiology, Sonoma State University, Rohnert Park, CA, USA
| | - R W Motl
- Department of Kinesiology and Nutrition, University of Illinois, Chicago, IL, USA
| | - S Agiovlasitis
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
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5
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Agiovlasitis S, Ballenger BK, Schultz EE, Du Q, Motl RW. Calibration of hip accelerometers for measuring physical activity and sedentary behaviours in adults with Down syndrome. J Intellect Disabil Res 2023; 67:172-181. [PMID: 36514268 PMCID: PMC9839602 DOI: 10.1111/jir.13002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/23/2022] [Accepted: 11/25/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The knowledge base on physical activity and sedentary behaviour in adults with Down syndrome (DS) may advance by accelerometer calibration studies. This study aimed to develop cut-points for sedentary behaviour and moderate-to-vigorous physical activity (MVPA) for adults with DS based on output from accelerometers worn on the dominant and non-dominant hips. METHODS Sixteen adults with DS (10 men; age 31 ± 15 years) performed 12 tasks including sedentary behaviours and physical activities. We obtained metabolic equivalents (METs) with indirect calorimetry and vector magnitude (VM) output from triaxial accelerometers (wGT3X-BT, ActiGraph) worn on the dominant and non-dominant hips. Receiver operating characteristic curves were used to identify optimal VM cut-points that maximised sensitivity and specificity. RESULTS Overall classification accuracy was very high (area under the ROC curve: 0.95 and 0.92 for sedentary and MVPA models, respectively). For the non-dominant hip, the optimal VM cut-points were (1) sedentary behaviour ≤236 counts·min-1 and (2) MVPA ≥2167 counts·min-1 . For the dominant hip, optimal cut-points were (1) sedentary behaviour ≤243 counts·min-1 and (2) MVPA ≥2092 counts·min-1 . CONCLUSIONS The presented VM cut-points for sedentary behaviour and MVPA for adults with DS had high classification accuracy. There were small differences in accelerometer cut-points between the dominant and non-dominant hip.
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Affiliation(s)
| | | | | | - Qian Du
- Department of Electrical and Computer Engineering, Mississippi State University
| | - Robert W. Motl
- Department of Kinesiology and Nutrition, University of Illinois at Chicago
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Schultz EE, Sergi K, Agiovlasitis S. A Qualitative Examination Of Factors That Influence Physical Activity In Individuals With Down Syndrome. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000876560.53993.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ballenger BK, Schultz EE, Driskill M, Motl RW, Agiovlasitis S. Accelerometer Cut Points For Physical Activity: Mets Vs. Oxygen Uptake Reserve. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000880092.56190.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ballenger BK, Schultz EE, Driskill M, Richardson S, Du Q, Motl RW, Agiovlasitis S. Accelerometer-based estimation of oxygen uptake in adults with Down syndrome: vector magnitude vs. vertical axis. J Intellect Disabil Res 2022; 66:368-375. [PMID: 35174929 PMCID: PMC9013186 DOI: 10.1111/jir.12923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 01/18/2022] [Accepted: 02/02/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Triaxial accelerometer output [vector magnitude (VM) counts] may better estimate physical activity intensity as reflected in the rate of oxygen uptake (V̇O2 ) than the traditional vertical axis (VA) counts in adults with Down syndrome (DS). This study examined the accuracy of VM vs. VA counts in estimating V̇O2 in adults with and without DS across different physical activities and sedentary behaviours. METHODS Sixteen adults with DS (10 men and 6 women; 31 ± 15 years) and 19 adults without DS (10 men and 9 women; 24 ± 5 years) performed 12 tasks. V̇O2 was measured by portable spirometer (K4b2 , Cosmed) and VM and VA with an accelerometer (wGT3X-BT, Actigraph). RESULTS Vector magnitude and VA were significant predictors of V̇O2 in adults with DS (P < 0.001; R2 = 0.74 and 0.65, respectively) and adults without DS (P < 0.001; P < 0.001; R2 = 0.75 and 0.61, respectively). Absolute error of prediction was significantly smaller for VM than VA for sitting, playing app, drawing, sweeping, standing and basketball (P ≤ 0.005), but smaller for VA than VM for walking at 0.8 m·s-1 (P = 0.005). Bland-Altman plots for adults with and without DS indicated narrower limits of agreement for VM than VA (-5.57 to 5.57 and -6.44 to 6.44 mL·kg-1 ·min-1 ; -6.21 to 6.17 and -7.75 to 7.74 mL·kg-1 ·min-1 , respectively). CONCLUSIONS Vector magnitude and VA are significant predictors of V̇O2 in adults with and without DS, yet VM more accurately estimated V̇O2 than VA for most tasks. Development of accelerometer-based prediction of physical activity levels in adults with and without DS may improve by utilising VM counts.
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Affiliation(s)
| | | | | | | | - Qian Du
- Department of Electrical and Computer Engineering, Mississippi State University
| | - Robert W. Motl
- Department of Kinesiology and Nutrition, University of Illinois at Chicago
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9
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Oreskovic NM, Agiovlasitis S, Patsiogiannis V, Santoro SL, Nichols D, Skotko BG. Brief report: Caregiver perceived physical activity preferences of adults with Down syndrome. J Appl Res Intellect Disabil 2022; 35:910-915. [PMID: 35106891 DOI: 10.1111/jar.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 11/08/2021] [Accepted: 01/09/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adults with Down syndrome commonly have low levels of physical activity and face social barriers to engaging in physical activity, including boredom and companionship concerns. Adults with Down syndrome are at increased risk for several co-occurring medial conditions known to benefit from physical activity, including obesity and dementia. METHOD This study surveyed 140 caregivers of adults with Down syndrome to determine the physical activity preferences of their adult with Down syndrome. RESULTS Dancing was the most frequently caregiver-reported physical activity preference for adults with Down syndrome, followed by walking and active video gaming. Rowing, using an elliptical machine, and jogging were the least preferred activities. Most caregivers reported that their adult with Down syndrome has a companion available for physical activity. CONCLUSION Promoting dance in adults with Down syndrome, a caregiver-reported preferred form of physical activity, may help improve physical activity levels and decrease sedentary behaviours in this population.
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Affiliation(s)
- Nicolas M Oreskovic
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, Mississippi State, Mississippi, USA
| | - Vasiliki Patsiogiannis
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Stephanie L Santoro
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
| | - Dominica Nichols
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Brian G Skotko
- DS Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA
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10
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Ptomey LT, Oreskovic NM, Hendrix JA, Nichols D, Agiovlasitis S. Weight management recommendations for youth with Down syndrome: Expert recommendations. Front Pediatr 2022; 10:1064108. [PMID: 36819200 PMCID: PMC9937587 DOI: 10.3389/fped.2022.1064108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/30/2022] [Indexed: 02/05/2023] Open
Abstract
Youth with Down syndrome (DS) have a higher prevalence of overweight and obesity compared to the general youth population. Due to physiological and cognitive differences observed in youth with DS, weight management recommendations developed for the general population, may not be suitable for youth with DS. However, there are no recent recommendations for weight management in youth with DS. A workgroup of clinicians and researchers with extensive experience working with youth with DS came together to give clinicians and families guidance for weight management in youth with DS. Recommendations were developed by the workgroup via a methodical, deliberative process. After the initial development of the recommendations, they were shared with an expert review panel and caregivers who rated the strength of the recommendation and strength of the evidence. The workgroup moved forward the recommendations which the review panels rated as strong. Eight recommendations were developed which focused on screening for overweight and obesity, screening for health conditions that may impact dietary intake and physical activity, screening for feeding difficulties, setting appropriate recommendations for dietary intake and physical activity, and well as prevention and treatment of overweight and obesity using evidence-based strategies. These recommendations can be implemented by clinicians working with youth with Down syndrome as well as the family, school, and other relevant entities.
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Affiliation(s)
- Lauren T Ptomey
- Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States
| | - Nicolas M Oreskovic
- Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | | | - Dominica Nichols
- Departments of Internal Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA, United States.,Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, United States
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11
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Bertapelli F, Silveira SL, Agiovlasitis S, Motl RW. Development and Cross-Validation of a Simple Model to Estimate Percent Body Fat in Persons with Multiple Sclerosis. Int J MS Care 2021; 23:193-198. [PMID: 34720758 DOI: 10.7224/1537-2073.2020-034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Persons with multiple sclerosis (MS) have higher body composition variability compared with the general population. Monitoring body composition requires accurate methods for estimating percent body fat (%BF). We developed and cross-validated an equation for estimating %BF from body mass index (BMI) and sex in persons with MS. Methods Seventy-seven adults with MS represented the sample for the equation development. A separate sample of 33 adults with MS permitted the equation cross-validation. Dual-energy x-ray absorptiometry (DXA) provided the criterion %BF. Results The model including BMI and sex (mean ± SD age: women, 49.2 ± 8.8 years; men, 48.6 ± 9.8 years) had high predictive ability for estimating %BF (P < .001, R2 = 0.77, standard error of estimate = 4.06%). Age, MS type, Patient-Determined Disease Steps score, and MS duration did not improve the model. The equation was %BF = 3.168 + (0.895 × BMI) - (10.191 × sex); sex, 0 = woman; 1 = man. The equation was cross-validated in the separate sample (age: women, 48.4 ± 9.4 years; men, 43.8 ± 15.4 years) based on high accuracy as indicated by strong association (r = 0.89, P < .001), nonsignificant difference (mean: 0.2%, P > .05), small absolute error (mean: 2.7%), root mean square error (3.5%), and small differences and no bias in Bland-Altman analysis (mean difference: 0.2%, 95% CI: -6.98 to 6.55, rs = -0.07, P = .702) between DXA-determined and equation-estimated %BF. Conclusions Health care providers can use this developed and cross-validated equation for estimating adiposity in persons with MS when DXA is unavailable.
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Affiliation(s)
- Fabio Bertapelli
- School of Medical Sciences, University of Campinas, Campinas, Brazil (FB).,Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA (FB, SLS, RWM)
| | - Stephanie L Silveira
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA (FB, SLS, RWM)
| | | | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA (FB, SLS, RWM)
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12
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Hendrix JA, Amon A, Abbeduto L, Agiovlasitis S, Alsaied T, Anderson HA, Bain LJ, Baumer N, Bhattacharyya A, Bogunovic D, Botteron KN, Capone G, Chandan P, Chase I, Chicoine B, Cieuta-Walti C, DeRuisseau LR, Durand S, Esbensen A, Fortea J, Giménez S, Granholm AC, Hahn LJ, Head E, Hillerstrom H, Jacola LM, Janicki MP, Jasien JM, Kamer AR, Kent RD, Khor B, Lawrence JB, Lemonnier C, Lewanda AF, Mobley W, Moore PE, Nelson LP, Oreskovic NM, Osorio RS, Patterson D, Rasmussen SA, Reeves RH, Roizen N, Santoro S, Sherman SL, Talib N, Tapia IE, Walsh KM, Warren SF, White AN, Wong GW, Yi JS. Opportunities, barriers, and recommendations in down syndrome research. Transl Sci Rare Dis 2021; 5:99-129. [PMID: 34268067 PMCID: PMC8279178 DOI: 10.3233/trd-200090] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent advances in medical care have increased life expectancy and improved the quality of life for people with Down syndrome (DS). These advances are the result of both pre-clinical and clinical research but much about DS is still poorly understood. In 2020, the NIH announced their plan to update their DS research plan and requested input from the scientific and advocacy community. OBJECTIVE The National Down Syndrome Society (NDSS) and the LuMind IDSC Foundation worked together with scientific and medical experts to develop recommendations for the NIH research plan. METHODS NDSS and LuMind IDSC assembled over 50 experts across multiple disciplines and organized them in eleven working groups focused on specific issues for people with DS. RESULTS This review article summarizes the research gaps and recommendations that have the potential to improve the health and quality of life for people with DS within the next decade. CONCLUSIONS This review highlights many of the scientific gaps that exist in DS research. Based on these gaps, a multidisciplinary group of DS experts has made recommendations to advance DS research. This paper may also aid policymakers and the DS community to build a comprehensive national DS research strategy.
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Affiliation(s)
| | - Angelika Amon
- Deceased. Koch Institute for Integrative Cancer Research, Massachusetts Institute of Technology, Cambridge, MA, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA, USA; Howard Hughes Medical Institute, Chevy Chase, MD, USA
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA; MIND Institute, University of California, Davis, CA, USA
| | | | - Tarek Alsaied
- Heart Institute Department of Pediatrics Cincinnati Children’s Hospital Medical Center University of Cincinnati, Cincinnati, OH, USA
| | | | | | - Nicole Baumer
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA; Down Syndrome Program, Developmental Medicine Center, Boston Children’s Hospital, Boston, MA, USA
| | - Anita Bhattacharyya
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Cell and Regenerative Biology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Dusan Bogunovic
- Department of Microbiology, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mt. Sinai, New York, NY; Precision Immunology Institute, Icahn School of Medicine at Mt. Sinai, New York, NY, USA; Mindich Child Health and Development Institute, Icahn School of Medicine at Mt. Sinai, New York, NY, USA
| | - Kelly N. Botteron
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA; Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Priya Chandan
- Department of Neurosurgery, Division of Physical Medicine and Rehabilitation, University of Louisville School of Medicine, Louisville, KY, USA
| | - Isabelle Chase
- Department of Pediatric Dentistry, Boston Children’s Hospital, Boston, MA, USA
| | - Brian Chicoine
- Advocate Medical Group Adult Down Syndrome Center, Park Ridge, IL, USA
| | | | | | | | - Anna Esbensen
- Department of Pediatrics, University of Cincinnati College of Medicine & Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Juan Fortea
- Barcelona Down Medical Center, Fundació Catalana de Síndrome de Down, Barcelona, Spain; Sant Pau Memory Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Center of Biomedical Investigation Network for Neurodegenerative Diseases, Madrid, Spain
| | - Sandra Giménez
- Multidisciplinary Sleep Unit, Respiratory Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ann-Charlotte Granholm
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden
| | - Laura J. Hahn
- Department of Speech and Hearing Science, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Elizabeth Head
- Department of Pathology and Laboratory Medicine, UC Irvine School of Medicine, Orange, CA, USA
| | | | - Lisa M. Jacola
- Department of Psychology, St Jude Children’s Research Hospital, Memphis, TN, USA
| | | | - Joan M. Jasien
- Division of Pediatric Neurology, Duke University Health System, Durham, NC, USA
| | - Angela R. Kamer
- Department of Periodontology and Implant Dentistry, New York University, College of Dentistry, New York, NY, USA
| | - Raymond D. Kent
- Waisman Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Bernard Khor
- Benaroy Research Institute at Virginia Mason, Seattle, WA, USA
| | - Jeanne B. Lawrence
- Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA; Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Amy Feldman Lewanda
- Children s National Rare Disease Institute, Children’s National Health System, Washington, DC., USA
| | - William Mobley
- Department of Neurosciences, University of California, San Diego, CA, USA
| | - Paul E. Moore
- Division of Allergy, Immunology, and Pulmonology, Vanderbilt University Medical Center, Nashville, TN, USA; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Nicolas M. Oreskovic
- Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA; Department of Internal Medicine, Massachusetts General Hospital, Boston, Mass
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Ricardo S. Osorio
- Center for Brain Health, Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
| | - David Patterson
- Knoebel Institute for Healthy Aging, University of Denver, Denver, CO, USA
- Eleanor Roosevelt Institute, University of Denver, Denver, CO, USA; Department of Biological Sciences, University of Denver, Denver, CO, USA; Molecular and Cellular Biophysics Program, University of Denver, Denver, CO, USA
| | - Sonja A. Rasmussen
- Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL; Department of Epidemiology, University of Florida College of Public Health and Health Professions and College of Medicine, Gainesville, FL
| | - Roger H. Reeves
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Nancy Roizen
- Department of Pediatrics, UH/Rainbow Babies and Children’s Hospital and Department of Pediatrics, Case Western Reserve University, Cleveland, OH, USA
| | - Stephanie Santoro
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Down Syndrome Program, Division of Medical Genetics and Metabolism, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, USA
| | - Stephanie L. Sherman
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Nasreen Talib
- Division of General Pediatrics, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO, USA
| | - Ignacio E. Tapia
- Sleep Center, Division of Pulmonary Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Kyle M. Walsh
- Division of Neuro-epidemiology, Department of Neurosurgery, Duke University, Durham, NC, USA
| | - Steven F. Warren
- Institute for Life Span Studies, University of Kansas, Lawrence, KS, USA
| | - A. Nicole White
- Research Foundation, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Guang William Wong
- Department of Physiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA; McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Center for Metabolism and Obesity Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - John S. Yi
- Division of Surgical Sciences, Department of Surgery, Duke University Medical Center, Durham, NC, USA
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Ghosh S, Choi P, Brown SP, Motl RW, Agiovlasitis S. Levels and patterns of sedentary behavior in men and women with intellectual disability. Disabil Health J 2020; 14:101059. [PMID: 33446442 DOI: 10.1016/j.dhjo.2020.101059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND There are limited data on the levels and patterns of sedentary behavior (SB) among U.S. adults with ID. OBJECTIVE To examine SB levels and patterns in U.S. adults with ID and how these differ between sexes, age-groups, and week vs. weekend days. METHODS Fifty-two adults with ID (25 men; age 45 ± 14 years) wore a hip accelerometer (wGT3X-BT; Actigraph) during the waking hours for 7 days. We determined total sedentary time, percent of wear time spent sedentary bouts ≥1, ≥10, ≥30, and ≥60 min, and breaks in sedentary time for bouts ≥10 min. We examined differences in SB variables as a function of sex, age-group by median split (≤48 vs. >48 years), and day of the week. RESULTS Total sedentary time was 514 ± 139 min · day-1 accumulated in bouts 1-30 min and did not differ between sexes or age-groups. Bouts ≥1 min across days were longer for men than women and longer during weekend days than weekdays (p < 0.05). The number of bouts ≥1 min was greater during weekdays than weekend days (p < 0.05). Bouts ≥60 min were longer for men than women (p < 0.05). The duration of sedentary breaks was longer during weekdays than weekend days (p < 0.001). There were no differences between age-groups. CONCLUSIONS Adults with ID spend a large portion of the day in SB primarily of short bouts. Despite small differences, SB levels and patterns were similar for men and women with ID and across age-groups throughout the week.
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Affiliation(s)
| | - Poram Choi
- Mississippi State University, United States
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Choi P, Wei T, Motl RW, Agiovlasitis S. Risk factors associated with history of falls in adults with intellectual disability. Res Dev Disabil 2020; 106:103748. [PMID: 32911340 DOI: 10.1016/j.ridd.2020.103748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/17/2020] [Accepted: 07/20/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Adults with intellectual disability (ID) have a higher risk for falls than the general population. AIM The purpose of this study was to identify risk factors for falls in adults with ID using objective measurements. METHODS Eighty adults with ID (men 36 women 44 age 43 ± 13 years) provided data on falls history, health problems or limitations in daily life, physical activity (PA), and physical performance. We conducted independent-samples t-tests, and Chi-square (χ2) tests to examine the difference between fallers and non-fallers. Multivariate logistic regressions were performed to identify the independent effects of risk factors for falls in adults with ID. RESULTS Fallers had significantly lower SPPB, mobility, and moderate PA than non-fallers (p < .05). Fallers were more likely to be older, need support with activities of daily living (ADLs), and have arthritis or rheumatism, walking problem, and limitations to participating in PA than non-fallers (p < .05). Among these variables, only needing support with ADLs remained a significant independent predictor of falls in a multivariate model. CONCLUSION Support need for ADLs can predict falls in individuals with ID. Caregivers may need to closely monitor adults with ID who need support for ADLs.
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Affiliation(s)
- Poram Choi
- Mississippi State University, Department of Kinesiology, McCarthy Gym, MS, 39762, United States.
| | - Tianlan Wei
- Mississippi State University, Department of Counseling, Educational Psychology and Foundation, 175 Presidents Circle, MS, 39762, United States.
| | - Robert W Motl
- University of Alabama at Birmingham, Department of Physical Therapy, School of Health Professions Bldg. Room 360X, 1716 9th Avenue South, Birmingham, AL, 35233, United States.
| | - Stamatis Agiovlasitis
- Mississippi State University, Department of Kinesiology, McCarthy Gym, MS, 39762, United States.
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Bertapelli F, Allred AT, Choi P, Pitchford EA, Guerra-Junior G, Agiovlasitis S. Predicting the rate of oxygen uptake from step counts using ActiGraph waist-worn accelerometers in adults with Down syndrome. J Intellect Disabil Res 2020; 64:602-611. [PMID: 32511847 DOI: 10.1111/jir.12755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Step rate predicts ambulatory intensity as reflected in the rate of oxygen uptake (VO2 ) - a measure of energy expenditure. Whether step rate as measured by an accelerometer predicts VO2 in adults with Down syndrome (DS) is unknown. We examined whether step rate predicts VO2 in adults with and without DS. We also developed an equation for predicting VO2 and examined its accuracy. METHOD Sixteen adults with DS (6 women and 10 men; age 31 ± 15 years) and 19 adults without DS (9 women and 10 men; age 25 ± 6 years) performed standing and walking at their preferred speed, 0.8 and 1.4 m·s-1 . We measured VO2 with a portable spirometer and step rate with a triaxial accelerometer (wGT3X-BT; ActiGraph) on the non-dominant hip, using the low-frequency extension filter. We ran multilevel regression for predicting VO2 from linear and quadratic terms for step rate, group (1 = DS; 0 = non-DS), body mass, height, body mass index (BMI), leg length and sex. We estimated VO2 with the resultant equation and calculated the equation's absolute per cent error, which we compared between groups. RESULTS VO2 was higher in persons with than without DS only at the fast walking speed (P = 0.018). DS did not predict VO2 . Step rate, step rate squared and BMI were significant predictors of VO2 (P < 0.001; R2 = 0.80). Absolute error across walking speeds was 13.5-18.8% and 11.7-13.4% for adults with and without DS, respectively, and did not differ between groups or speeds. CONCLUSIONS Step rate, step rate squared and BMI predict VO2 in adults with and without DS. Prediction error does not differ between groups.
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Affiliation(s)
- F Bertapelli
- School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - A T Allred
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
| | - P Choi
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
| | - E A Pitchford
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - G Guerra-Junior
- School of Medical Sciences, University of Campinas, Campinas, São Paulo, Brazil
| | - S Agiovlasitis
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
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Richardson SH, McCreary CS, Choi P, Ghosh S, Agiovlasitis S. Does Heart Rate Improve Prediction Of Oxygen Uptake From Hip Or Wrist Accelerometer Output In Adults With Down Syndrome? Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000675248.50857.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Agiovlasitis S, Xu J, Choi P, Motl RW. Association Of Physical Activity With Physical Functioning In Adults With Intellectual Disability. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000678516.92976.62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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bertapelli F, Agiovlasitis S, Motl RW, de Barros-Filho MM, Guerra-Junior G. Development And Cross-validation Of A Bmi-based Equation For Percent Fat In Children With Intellectual Disability. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000685048.31939.fa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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King NL, Cook AG, Gosh S, Choi P, Agiovlasitis S. Physical Activity And Sedentary Time In Adults With Down Syndrome Estimated By Different Cut Points. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000678280.81742.85] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Ghosh S, Choi P, Brown SP, Motl RW, Agiovlasitis S. Sedentary Behavior Levels And Patterns In Men And Women With Intellectual Disability. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000678288.24317.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Cook AG, King NL, Choi P, Ghosh S, Bertapelli F, Agiovlasitis S. Accelerometer Cut Points For Adults With Down Syndrome. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000678284.89067.c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Choi P, Motl RW, Agiovlasitis S. Validity Of Physical Activity Measured By Proxy-response Questionnaire In Adults With Intellectual Disability. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000678276.01407.1f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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McCreary CS, Richardson S, Choi P, Ghosh S, Allred AT, Agiovlasitis S. Predicting Oxygen Uptake From Accelerometer Output In Adults With Down Syndrome: Vector Magnitude Vs. Vertical Axis. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000678248.72818.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jin J, Agiovlasitis S, Yun J. Predictors of perceived health in adults with an intellectual disability. Res Dev Disabil 2020; 101:103642. [PMID: 32330846 DOI: 10.1016/j.ridd.2020.103642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 02/28/2020] [Accepted: 03/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The effects of Intellectual disability (ID) levels, body mass index (BMI) categories, and other factors on perceived health status of adults with ID are not well-known. AIMS We aimed to examine: (a) the relationship between perceived health and level of intellectual function; (b) the influence of different BMI categories on a perceived health; and (c) the effect of the modifiable behavioral factors on perceived health. METHODS AND PROCEDURES We examined the aims using data from the 2013-2014 Adult Consumer Survey of the National Core Indicator. We extracted demographic (e.g. age, BMI) and modifiable behavior-related variables (e.g. physical activity participation, having a job) and used logistic regression models to analyze the relationships. OUTCOMES AND RESULTS Logistic regressions showed that more severe ID level is associated with worse perceived health, but when other variables related to personal and behavioral characteristics were accounted for, this relationship was no longer significant. Obese adults with ID had worse perceived health than those with normal weight; this effect remained significant even after considering other variables. Those in the overweight category did not differ in perceived health status from those of normal weight. The effects of all modifiable behaviors on perceived health were significant. CONCLUSIONS AND IMPLICATIONS Health promotion programs for adults with ID may benefit by consideration of modifiable behaviors.
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Affiliation(s)
- Jooyeon Jin
- University of Seoul, 163 Seoulsiripdaero, Seoul 02504, Republic of Korea.
| | - Stamatis Agiovlasitis
- Mississippi State University, PO Box 6186, Mississippi State, MS 39762, United States.
| | - Joonkoo Yun
- East Carolina University, M60 Minges, Mail Stop 559, Greenville, NC 27858, United States.
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Abstract
PURPOSE This study examined if the relationship between the rate of oxygen uptake (V̇O2) and output from hip-and wrist-worn accelerometers differs between adults with and without DS, and evaluated the accuracy of accelerometer output in estimating V̇O2. MATERIALS AND METHODS Sixteen adults with DS (10 men) and 19 adults without DS (10 men) performed 12 tasks including physical activities and sedentary behaviors. We measured V̇O2 with portable spirometry and accelerometer output (vector magnitude [VM]) with hip- and wrist-worn accelerometers. We used multi-level regressions to predict V̇O2 from VM, group, body mass index (BMI), age, height, weight, and sex. We evaluated prediction accuracy with absolute percent error and Bland-Altman plots. RESULTS For both hip- and wrist-accelerometers, VM and group significantly predicted V̇O2 (p ≤ 0.021). When BMI was added, BMI was a significant predictor but group was not. The final models included VM and BMI (p ≤ 0.001; R2 = 0.78 and 0.57, for hip and wrist accelerometer model, respectively). Absolute error was greater for the wrist- than the hip-accelerometer model (wrist: 37.9 ± 38.1%; hip: 22.5 ± 27.4%). CONCLUSIONS Adults with DS have different V̇O2 to VM responses, and this appears due to their higher BMI. Predictability of V̇O2 from accelerometer output is better for hip- than wrist-worn accelerometers.IMPLICATIONS FOR REHABILITATIONOutput from a triaxial accelerometer has high potential in predicting the energy expenditure and classifying the intensity of physical activity and sedentary behavior in adults with Down syndrome.Accuracy of predicting energy expenditure from accelerometer output is better for hip- than wrist-worn triaxial accelerometers.The development of appropriate rehabilitation interventions that include physical activity for improving health and function in adults with Down syndrome requires accurate assessments of physical activity levels.
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Affiliation(s)
- Anthony T Allred
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Poram Choi
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
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Agiovlasitis S, Choi P, Allred AT, Xu J, Motl RW. Systematic review of sedentary behaviour in people with Down syndrome across the lifespan: A clarion call. J Appl Res Intellect Disabil 2019; 33:146-159. [PMID: 31441571 DOI: 10.1111/jar.12659] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/16/2019] [Accepted: 07/31/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Individuals with Down syndrome (DS) experience health disparities possibly associated with high levels of sedentary behaviour (SB). We systematically reviewed SB measurement, levels, patterns, correlates, consequences and interventions in people with DS across the lifespan. METHOD We searched these databases: Embase; PubMed; Web of Science; Scopus; CINAHL; PsycINFO; SPORTDiscus; and Cochrane Library. We included quantitative studies published in English since 1 January 1990. RESULTS We identified 17 eligible articles. Across studies, accelerometer-determined sedentary time was 552 min/day (median: 542; range 392-680 min/day). Sedentary time appeared higher than previously reported values in the general population, especially for youth with DS. Multivariate SB correlates were primarily familial and environmental. Sedentary behaviour consequences have not been exclusively studied. Motor skills training reduced SB in youth with DS. CONCLUSIONS Sedentary behaviour research in this population is in early stages. Individuals with DS have high levels of SB that may be responsive to interventions.
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Affiliation(s)
| | - Poram Choi
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Anthony T Allred
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Jian Xu
- Department of Kinesiology, Mississippi State University, Mississippi State, MS, USA
| | - Robert W Motl
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
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Allred AT, Choi P, Agiovlasitis S. Prediction of Energy Expenditure from Accelerometers during Physical Activity in Adults with Down Syndrome: The Effect of Accelerometer Placement. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561002.83474.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Bertapelli F, Curtis JS, Carlson B, Johnson M, Abadie B, Agiovlasitis S. Step-counting accuracy of activity monitors in persons with Down syndrome. J Intellect Disabil Res 2019; 63:21-30. [PMID: 30239068 DOI: 10.1111/jir.12550] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 08/25/2018] [Accepted: 08/27/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Accelerometers and pedometers have been used to monitor the number of steps. However, the evidence on the step-counting accuracy of these devices - especially accelerometers - is limited in persons with Down syndrome (DS). This study therefore examined the accuracy of accelerometers placed on the hip or wrist and of a pedometer with a uni-axial accelerometer mechanism in measuring steps in persons with DS and whether device error is associated with walking speed, height, weight, body mass index, waist circumference, leg length, age or sex. METHOD Seventeen persons with DS (eight women and nine men; age 33 ± 15 years) walked over-ground for 6 min at their preferred speed. The steps were measured with a hip-worn and a wrist-worn ActiGraph accelerometer using the manufacturer's default (DF) and low-frequency extension (LFE) filters, and with the NL-1000 New Lifestyles pedometer on the hip. Steps were also measured with hand tally which served as the criterion. RESULTS Absolute percent error was considerable and differed statistically between devices (P = 0.001); however, error improved for accelerometers when LFE was applied (Hip-DF: 31.6 ± 18.8%; Hip-LFE: 9.7 ± 12.8%; Wrist-DF: 32.7 ± 14.2%; Wrist-LFE: 13.6 ± 10.2%; Pedometer: 23.2 ± 22.8%). Bland-Altman plots indicated underestimation of steps for accelerometers and the pedometer. Application of LFE, however, improved the prediction of the accelerometers. The number of steps measured by the hip accelerometer with LFE and by the pedometer did not differ statistically from actual steps. Steps by the remaining methods were significantly lower than hand tally (P ≤ 0.001). Correlations between percent error for each device and walking speed, anthropometry, age or sex ranged between -0.28 and +0.48, and were non-significant, except for age. CONCLUSIONS The results demonstrated that the pedometer and ActiGraph accelerometers have considerable error in measuring steps of persons with DS. Application of LFE, however, significantly improved the step-counting performance of the Actigraph accelerometers.
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Affiliation(s)
- F Bertapelli
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
- School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - J S Curtis
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
| | - B Carlson
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
| | - M Johnson
- Department of Kinesiology, University of Wisconsin-Eau Claire, Eau Claire, WI, USA
| | - B Abadie
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
| | - S Agiovlasitis
- Department of Kinesiology, Mississippi State University, Starkville, MS, USA
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Agiovlasitis S, Yun J, Jin J, McCubbin JA, Motl RW. Physical Activity Promotion for Persons Experiencing Disability: The Importance of Interdisciplinary Research and Practice. Adapt Phys Activ Q 2018; 35:437-457. [PMID: 30336682 DOI: 10.1123/apaq.2017-0103] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This paper examines the need for interdisciplinary knowledge in the formation of public health models for health-promoting physical activity (PA) for people experiencing disability. PA promotion for people experiencing disability is a multifaceted endeavor and requires navigating a multitude of complicated and interactive factors. Both disability and health are multifaceted constructs and the relationship between PA and health is embedded within a complicated web of interactive influences. PA promotion must consider interacting biological and psychosocial factors within the person and in the sociopolitical environment. Models for research and practice need to evolve from value and belief systems that center on people experiencing disability without stigmatizing them. We argue that interdisciplinary research and practice is needed in navigating the intricacies of PA promotion toward improving the health of people experiencing disability and facilitating inclusion, empowerment, and dignity.
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Agiovlasitis S, Chapman M, Carlson B, Curtis JS, Johnson M. Associations of Sleep Patterns with Physical Functioning and Physical Activity in Adults with Down syndrome. Med Sci Sports Exerc 2018. [DOI: 10.1249/01.mss.0000536665.60453.dc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Agiovlasitis S, Sandroff BM, Motl RW. Prediction of oxygen uptake during walking in ambulatory persons with multiple sclerosis. ACTA ACUST UNITED AC 2018; 53:199-206. [PMID: 27148824 DOI: 10.1682/jrrd.2014.12.0307] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 07/06/2015] [Indexed: 11/05/2022]
Abstract
People with multiple sclerosis (MS) have an increased rate of gross oxygen uptake (gross-VO2) during treadmill walking, and their gross-VO2 may further vary with walking impairment. This study attempted to develop an equation for predicting gross-VO2 from walking speed and an index of walking impairment in persons with MS and examine its accuracy. Gross-VO2 was measured with open-circuit spirometry in 43 persons with MS (47 +/- 9 yr; 38 women) during five treadmill walking trials, each lasting 6 min, at 2.0, 2.5, 3.0, 3.5, and 4.0 mph (0.89, 1.12, 1.34, 1.56, and 1.79 m/s). The 12-Item Multiple Sclerosis Walking Scale (MSWS-12) and the single-item Patient Determined Disease Steps scale (PDDS) provided indices of walking impairment. Multilevel modeling with random intercepts and slopes showed significant effects of speed and MSWS-12 on gross-VO2 (p </= 0.014; R(2) = 0.70). PDDS was not a significant predictor. Gross-VO2 estimated by the regression equation did not differ from actual gross-VO2 across speeds. Mean absolute prediction error across speeds was 9.1%. The Bland-Altman plot indicated zero mean difference between actual and predicted gross-VO2 with modest 95% confidence intervals. Therefore, speed and MSWS-12 score are jointly highly predictive of gross-VO2 during treadmill walking in persons with MS.
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Agiovlasitis S, Mendonca GV, McCubbin JA, Fernhall B. Prediction of energy expenditure during walking in adults with down syndrome. J Appl Res Intellect Disabil 2017; 31 Suppl 1:151-156. [PMID: 28815878 DOI: 10.1111/jar.12392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND When developing walking programmes for improving health in adults with Down syndrome (DS), physical activity professionals are in need of an equation for predicting energy expenditure. We therefore developed and cross-validated an equation for predicting the rate of oxygen uptake (VO2 ; an index of energy expenditure) for adults with and without DS. METHOD A total of 469 VO2 observations during walking across different speeds were available from 54 adults with DS and 61 adults without DS. RESULTS Significant predictors of VO2 were speed, speed square, group and group-by-speed interaction. Separate models for each group showed that speed and its square significantly predicted VO2 . Absolute per cent error was small and did not differ between groups. CONCLUSION Adults with DS have different VO2 response to walking speed from persons without DS. VO2 is predicted from speed with acceptable accuracy for persons with DS.
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Affiliation(s)
| | - Goncalo V Mendonca
- CIPER: Laboratory of Motor Behavior, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal, Lisbon, Portugal
| | - Jeffrey A McCubbin
- College of Health and Human Sciences, Colorado State University, Fort Collins, CO, USA
| | - Bo Fernhall
- Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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Carlson BJ, Curtis JS, Bertapelli F, Abadie B, Johnson M, Agiovlasitis S. Physical Activity and Physical Functioning in Persons with Down Syndrome. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000519484.08758.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Agiovlasitis S, Jin J, Yun J. BMI Across Age-groups In Adults With Down Syndrome And Adults With Intellectual Disability. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000517027.96306.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Yun J, Jin J, Agiovlasitis S. Associations Among Residential Settings, Physical Activity And Health Outcomes In Adults With Intellectual Disabilities. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000517026.96306.58] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Allred AT, Choi P, Webster RO, Abadie BR, Agiovlasitis S. Within-person Reliability Of Step-rate Cut-offs For Physical Activity Intensity. Med Sci Sports Exerc 2017. [DOI: 10.1249/01.mss.0000518700.88175.1c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Jin J, Yun J, Agiovlasitis S. Impact of enjoyment on physical activity and health among children with disabilities in schools. Disabil Health J 2017; 11:14-19. [PMID: 28428113 DOI: 10.1016/j.dhjo.2017.04.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 02/21/2017] [Accepted: 04/03/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Enjoyment in school-based physical activity (PA) programs, such as recess or physical education may be important for promoting children's health, but there is a lack of evidence explaining how enjoyment affects health in children with disabilities. HYPOTHESES Enjoyment in school-based PA programs will positively influence general health through participating in more daily PA, and this relationship will vary between younger and older children with disabilities. METHODS We conducted secondary analysis of data from the 2012 National Youth Fitness Survey. The sample included 241 children with disabilities (age 5-15 years; 129 boys and 112 girls) identified using three criteria: (a) having an impairment, health problem and mobility limitations; (b) needing special equipment; or (c) receiving special education services. Variables extracted were the number of days per week participating for at least 60 min in PA a day; general perceived health; enjoyment in school recess (for ages 5-11 y) or physical education (for ages 12-15 y). Mediation analysis was conducted to test the research hypotheses. RESULTS Daily PA participation significantly mediated the relationship between enjoyment in physical education/recess and general health. Children who enjoyed physical education or recess more participated in PA, and those who spent more days being physical active were healthier than their counterparts. However, this mediating relationship, when divided by age groups, was shown for only older group (ages 12-15 y) that received physical education. CONCLUSIONS Physical educators should provide enjoyable PA opportunities during physical education classes for students with disabilities for promoting their health.
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Bertapelli F, Agiovlasitis S, Machado MR, do Val Roso R, Guerra-Junior G. Growth charts for Brazilian children with Down syndrome: Birth to 20 years of age. J Epidemiol 2017; 27:265-273. [PMID: 28320584 PMCID: PMC5463025 DOI: 10.1016/j.je.2016.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 06/29/2016] [Indexed: 12/03/2022] Open
Abstract
Background The growth of youth with Down syndrome (DS) differs from that of youth without DS, and growth charts specific to DS have been developed. However, little is known about the growth of Brazilian youth with DS. The objective of this study was to construct growth charts for Brazilian youth with DS and compare the growth data with the Child Growth Standards of the World Health Organization (WHO) and charts for children with DS from other studies. Methods Mixed longitudinal and cross-sectional data were collected at University of Campinas, 48 specialized centers for people with intellectual disabilities, and two foundations for people with DS between 2012 and 2015. A total of 10,516 growth measurements from birth to 20 years of age were available from 938 youth with DS (53.7% boys) born between 1980 and 2013. The Lambda Mu Sigma method was applied to construct the curves using generalized additive models for location, scale, and shape. Results Length/height-for-age, weight-for-age, and head circumference-for-age percentile curves were generated for Brazilian boys and girls from birth to 20 years of age. Differences in growth of Brazilian youth ranged from −0.8 to −3.2 z-scores compared to WHO standards, and −1.9 to +1.3 compared to children with DS in other studies. Conclusions These specific growth charts may guide clinicians and families in monitoring the growth of Brazilian children and adolescents with DS. We constructed growth charts for Brazilian youth with Down syndrome aged 0–20 years. Brazilian youth with Down syndrome showed substantial growth restriction. There were cross-national differences in growth among youth with Down syndrome.
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Affiliation(s)
- Fabio Bertapelli
- CAPES Foundation, Ministry of Education of Brazil, Brazil; Growth and Development Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Brazil.
| | | | - Maira Rossmann Machado
- Growth and Development Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Brazil
| | - Raísa do Val Roso
- Growth and Development Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Brazil
| | - Gil Guerra-Junior
- Growth and Development Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Brazil; Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Brazil
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Agiovlasitis S, Beets MW, Lamberth J, Pitetti KH, Fernhall B. Accuracy of a piezoelectric pedometer in persons with and without Down syndrome. Res Dev Disabil 2016; 59:73-79. [PMID: 27518921 DOI: 10.1016/j.ridd.2016.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 07/19/2016] [Accepted: 08/05/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Piezoelectric pedometers with a tri-axial accelerometer mechanism may effectively monitor physical activity in persons with Down syndrome (DS), but their accuracy has not been determined in this population. AIM To examine the accuracy of a pedometer with a tri-axial accelerometer mechanism in measuring steps at different walking speeds in persons with and without DS. METHODS Eighteen persons with DS (8 women; age 25±7y) and 22 persons without DS (9 women; 26±5y) participated in this study. Participants completed six over-ground walking trials at the preferred speed and at 0.5, 0.75, 1.0, 1.25, and 1.5ms-1, each lasting 6min. The steps taken were measured with hand-tally and with the Walk4Life MVPa piezoelectric pedometer. Pedometer accuracy was assessed with absolute percent error and Bland-Altman plots. RESULTS Absolute percent error did not differ between persons with and without DS across speeds. Error decreased with increased speed (p<0.001), but leveled off at ≥1.0ms-1. Pedometers underestimated steps at 0.5 and 0.75ms-1, but were highly accurate at the preferred walking speed and at speeds ≥1.0ms-1. CONCLUSIONS A piezoelectric pedometer with a tri-axial accelerometer mechanism measures steps with high accuracy at the preferred walking speed and at speeds ≥1.0ms-1 in persons with and without DS. Accuracy, however, is compromised at slower speeds. Across speeds, pedometer error is similar between persons with and without DS.
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Affiliation(s)
- Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, 240 McCarthy Gym, P.O. Box 6186, MS 39762, USA.
| | - Michael W Beets
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, RM 131, Columbia, SC 29208, USA
| | - John Lamberth
- Department of Kinesiology, Mississippi State University, 240 McCarthy Gym, P.O. Box 6186, MS 39762, USA
| | - Kenneth H Pitetti
- Department of Physical Therapy, Wichita State University, 417 Ahlberg Hall, Wichita, KS 67260, USA
| | - Bo Fernhall
- College of Applied Health Sciences, University of Illinois at Chicago, 808 South Wood Street, 169 CMET, Chicago, IL 60612, USA
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Agiovlasitis S, Motl RW. Cross-validation of oxygen uptake prediction during walking in ambulatory persons with multiple sclerosis. NeuroRehabilitation 2016; 38:191-7. [PMID: 26889734 DOI: 10.3233/nre-161310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND An equation for predicting the gross oxygen uptake (gross-VO2) during walking for persons with multiple sclerosis (MS) has been developed. Predictors included walking speed and total score from the 12-Item Multiple Sclerosis Walking Scale (MSWS-12). OBJECTIVE This study examined the validity of this prediction equation in another sample of persons with MS. METHODS Participants were 18 persons with MS with limited mobility problems (42 ± 13 years; 14 women). Participants completed the MSWS-12. Gross-VO2 was measured with open-circuit spirometry during treadmill walking at 2.0, 3.0, and 4.0 mph (0.89, 1.34, and 1.79 m·s(-1)). REULTS Absolute percent error was small: 8.3 ± 6.1% , 8.0 ± 5.6% , and 12.2 ± 9.0% at 2.0, 3.0, and 4.0 mph, respectively. Actual gross-VO2 did not differ significantly from predicted gross-VO2 at 2.0 and 3.0 mph, but was significantly higher than predicted gross-VO2 at 4.0 mph (p < 0.001). Bland-Altman plots indicated nearly zero mean difference between actual and predicted gross-VO2 with modest 95% confidence intervals at 2.0 and 3.0 mph, but there was some underestimation at 4.0 mph. CONCLUSIONS Speed and MSWS-12 score provide valid prediction of gross-VO2 during treadmill walking at slow and moderate speeds in ambulatory persons with MS. However, there is a possibility of small underestimation for walking at 4.0 mph.
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Affiliation(s)
| | - Robert W Motl
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Bertapelli F, Pitetti K, Agiovlasitis S, Guerra-Junior G. Overweight and obesity in children and adolescents with Down syndrome-prevalence, determinants, consequences, and interventions: A literature review. Res Dev Disabil 2016; 57:181-192. [PMID: 27448331 DOI: 10.1016/j.ridd.2016.06.018] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 06/09/2016] [Accepted: 06/26/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Children with Down syndrome (DS) are more likely to be overweight or obese than the general population of youth without DS. AIMS To review the prevalence of overweight and obesity and their determinants in youth with DS. The health consequences and the effectiveness of interventions were also examined. METHODS AND PROCEDURES A search using MEDLINE, Embase, Web of Science, Scopus, CINAHL, PsycINFO, SPORTDiscus, LILACS, and COCHRANE was conducted. From a total of 4280 studies, we included 45 original research articles published between 1988 and 2015. OUTCOMES AND RESULTS The combined prevalence of overweight and obesity varied between studies from 23% to 70%. Youth with DS had higher rates of overweight and obesity than youths without DS. Likely determinants of obesity included increased leptin, decreased resting energy expenditure, comorbidities, unfavorable diet, and low physical activity levels. Obesity was positively associated with obstructive sleep apnea, dyslipidemia, hyperinsulinemia, and gait disorder. Interventions for obesity prevention and control were primarily based on exercise-based programs, and were insufficient to achieve weight or fat loss. CONCLUSIONS AND IMPLICATIONS Population-based research is needed to identify risk factors and support multi-factorial strategies for reducing overweight and obesity in children and adolescents with DS.
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Affiliation(s)
- Fabio Bertapelli
- CAPES Foundation, Ministry of Education of Brazil, Brasília, DF 70040-020, Brazil; Growth and Development Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas, SP 13083-887, Brazil.
| | - Ken Pitetti
- Department of Physical Therapy, College of Health Professions, Wichita State University, Wichita, KS 67260-0043, USA.
| | - Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, Mississippi State, Starkville, MS 39762, USA.
| | - Gil Guerra-Junior
- Growth and Development Lab, Center for Investigation in Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas, SP 13083-887, Brazil; Department of Pediatrics, Faculty of Medical Sciences, University of Campinas, Campinas, SP 13083-970, Brazil.
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Jin J, Yun J, Agiovlasitis S. Effects of School-based Physical Activity Program on Health In Children with Disabilities. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487951.72122.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Agiovlasitis S, Mendonca GV, Fernhall B. Prediction of Oxygen Uptake during Walking in Persons with Down Syndrome. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000487132.91859.bf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Yun J, Jin J, Agiovlasitis S. Relationships of Physical Activity, Muscular Strength, and BMI To General Health Among Children with Disabilities. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000486464.86488.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Agiovlasitis S, Sandroff BM, Motl RW. Step-rate cut-points for physical activity intensity in patients with multiple sclerosis: The effect of disability status. J Neurol Sci 2015; 361:95-100. [PMID: 26810524 DOI: 10.1016/j.jns.2015.12.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 12/13/2015] [Accepted: 12/17/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Evaluating the relationship between step-rate and rate of oxygen uptake (VO2) may allow for practical physical activity assessment in patients with multiple sclerosis (MS) of differing disability levels. AIMS To examine whether the VO2 to step-rate relationship during over-ground walking differs across varying disability levels among patients with MS and to develop step-rate thresholds for moderate- and vigorous-intensity physical activity. MATERIALS AND METHODS Adults with MS (N=58; age: 51 ± 9 years; 48 women) completed one over-ground walking trial at comfortable speed, one at 0.22 m · s(-1) slower, and one at 0.22 m · s(-1) faster. Each trial lasted 6 min. VO2 was measured with portable spirometry and steps with hand-tally. Disability status was classified as mild, moderate, or severe based on Expanded Disability Status Scale scores. RESULTS Multi-level regression indicated that step-rate, disability status, and height significantly predicted VO2 (p<0.05). Based on this model, we developed step-rate thresholds for activity intensity that vary by disability status and height. A separate regression without height allowed for development of step-rate thresholds that vary only by disability status. CONCLUSION The VO2 during over-ground walking differs among ambulatory patients with MS based on disability level and height, yielding different step-rate thresholds for physical activity intensity.
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Affiliation(s)
- Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, 240 McCarthy Gym, P.O. Box 6186, Mississippi State, MS 39762, US.
| | - Brian M Sandroff
- Kessler Foundation, 300 Executive Drive, Suite 70, West Orange, NJ 07052, US
| | - Robert W Motl
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 233 Freer Hall, 906 S Goodwin Ave., Urbana, IL 61801, US
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Agiovlasitis S, Rossow LM, Yan H, Ranadive SM, Fahs CA, Motl RW, Fernhall B. Predicting METs from the heart rate index in persons with Down syndrome. Res Dev Disabil 2014; 35:2423-2429. [PMID: 24981191 DOI: 10.1016/j.ridd.2014.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 06/05/2014] [Accepted: 06/06/2014] [Indexed: 06/03/2023]
Abstract
Persons with Down syndrome (DS) have altered heart rate modulation and very low aerobic fitness. These attributes may impact the relationship between metabolic equivalent units (METs) and the heart rate index (HRindex-the ratio between heart rate during activity and resting heart rate), thereby altering the HRindex thresholds for moderate- and vigorous-intensity physical activity. This study examined whether the relationship between METs and HRindex differs between persons with and without DS and attempted to develop thresholds for activity intensity based on the HRindex for persons with DS. METs were measured with portable spirometry and heart rate with a monitor in 18 persons with DS (25 ± 7 years; 10 women) and 18 persons without DS (26 ± 5 years; 10 women) during 6 over-ground walking trials, each lasting 6min, at the preferred walking speed and at 0.5, 0.75, 1.0, 1.25, and 1.5m/s. The relationship between METs and HRindex in the two groups was analyzed with multi-level modeling with random intercepts and slopes. Group, HRindex, and the square of HRindex were significant predictors of METs (p<0.001; R(2)=0.65). Absolute percent error did not differ significantly between groups across speeds (DS: 19.6 ± 14.4%; non-DS: 21.0 ± 14.5%). Bland-Altman plots demonstrated somewhat greater variability in the difference between actual and predicted METs in participants with than without DS. The HRindex threshold for moderate-intensity activity was 1.32 and 1.20 for persons with and without DS, respectively. The HRindex threshold for vigorous-intensity activity was 1.80 and 1.65 for persons with and without DS, respectively. Persons with DS have an altered relationship between METs and HRindex and higher HRindex thresholds for moderate- and vigorous-intensity physical activity.
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Affiliation(s)
- Stamatis Agiovlasitis
- Department of Kinesiology, Mississippi State University, 233 McCarthy Gym, P.O. Box 6186, Mississippi State, MS 39762, United States.
| | - Lindy M Rossow
- Department of Exercise and Sports Science, Fitchburg State University, 155 North Street, Fitchburg, MA 01420, United States
| | - Huimin Yan
- Department of Kinesiology, East Carolina University, Greenville, NC 27858, United States
| | - Sushant M Ranadive
- Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, United States
| | - Christopher A Fahs
- Department of Exercise and Sports Science, Fitchburg State University, 155 North Street, Fitchburg, MA 01420, United States
| | - Robert W Motl
- Department of Kinesiology & Community Health, University of Illinois at Urbana-Champaign, 906 S Goodwin Avenue, Urbana, IL 61801, United States
| | - Bo Fernhall
- College of Applied Health Sciences, University of Illinois at Chicago, 808 S. Wood Street, MC 518, Chicago, IL 60612, United States
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Agiovlasitis S, Webster RO, Abadie BR, Pongetti JC, Brown SP. Are Accelerometry-determined Cut-points For Activity Intensity Stable Within People? Med Sci Sports Exerc 2014. [DOI: 10.1249/01.mss.0000495876.54448.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Sandroff BM, Riskin BJ, Agiovlasitis S, Motl RW. Accelerometer cut-points derived during over-ground walking in persons with mild, moderate, and severe multiple sclerosis. J Neurol Sci 2014; 340:50-7. [PMID: 24635890 DOI: 10.1016/j.jns.2014.02.024] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 02/13/2014] [Accepted: 02/21/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND There has been increased interest in objectively quantifying time spent in moderate-to-vigorous physical activity (MVPA) using accelerometry as an outcome among persons with multiple sclerosis (MS). This requires development of a cut-point for interpreting the rate of accelerometer output based on its association with energy expenditure during physical activity. OBJECTIVE The current study measured activity counts from a waist-worn accelerometer and energy expenditure based on indirect calorimetry during three speeds of over-ground walking for deriving cut-points for interpreting accelerometer output in persons with mild, moderate, and severe MS disability. METHODS 54 participants with MS initially completed a neurological examination for generation of an EDSS score. Participants were then fitted with an ActiGraph model GT3X+ accelerometer and a Cosmed portable metabolic system, and completed three, 6-minute walk (6 MW) tests that were interspersed with 10-15 min of rest. The first 6 MW was undertaken at a comfortable walking speed (CWS), and the two remaining 6 MW tests were undertaken above (faster walking speed) or below (slower walking speed) the participant's CWS in a counterbalanced order. RESULTS The linear association between activity counts per minute and energy expenditure did not differ between persons with mild and moderate MS disability, but it was significantly different among persons with severe disability. This resulted in disability-specific cut-points for MVPA of 1980 and 1185 counts per minute for groups with mild/moderate disability and severe disability, respectively. CONCLUSIONS We believe that this research will facilitate a better understanding of time spent in MVPA across a broad range of MS disability.
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Affiliation(s)
- Brian M Sandroff
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States
| | - Barry J Riskin
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States
| | | | - Robert W Motl
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, United States.
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