The effect of a physical exercise package on the motor proficiency of students with down syndrome

Objectives: The purpose of this study was to evaluate the feasibility and potential effect of a physical exercise package on the motor proficiency of children and adolescents with Down syndrome. Methods: In this research, an experimental design was conducted in two special schools to evaluate the effectiveness of this package and identify its strengths and weaknesses. Forty students with Down syndrome were selected and randomly divided into intervention and control groups. A total of 36 (22 male and 14 female) students out of 50 at two special schools for children with special needs between October 2020 and March 2021 were recruited for the study. Participants were aged 12.888 +or- 2.375 (12.954 +or- 2.609 for boys and 12.785 +or- 2.044 for girls) years. The 18 students in the intervention group participated in the exercise sessions, 2 or 3 sessions per week for 12 weeks. Pre- and post-tests were performed on both groups. The Physical Exercise Package included the principles of exercise, the preferred exercise methods, and the details of exercise planning for Down syndrome individuals (FITT-VP) based on the etiology of Down syndrome and the characteristics of people with this syndrome. Motor proficiency was measured using the Bruininks Oseretsky Test of Motor Proficiency (BOT-2). Results: The results of the study showed that the designed exercise package was adhered to with all the participants attending 93.2% of the sessions, and participants significantly improved their total motor proficiency score, manual dexterity, upper-limb coordination, strength, balance, upper-limb coordination, running speed and agility and fine motor Integration (P < 0.05). However, the exercises did not significantly change the bilateral coordination and fine motor precision (P > 0.05). Conclusions: the current study result shows that developing and implementing the individualized exercise package and observing the principles set out in the program could have significant positive impacts on the motor proficiency of students with Down syndrome.

What effect does interaction with a physiotherapist have on self-rated confidence, capacity, and motivation to exercise?

Keywords: Exercise;Motivation;Confidence Purpose: The purpose of this study was to determine if seeing a physiotherapist affects self-rated confidence, capacity and motivation to exercise. Methods: The sample consisted of participants from the intervention arm of the AERO feasibility study, which tested an individually tailored exercise adherence intervention for older people with musculoskeletal problems. Participants were asked three questions prior to starting their first physiotherapy session. • Do you feel you have the necessary capacity (e.g. strength, flexibility, fitness, etc.) to undertake an exercise programme? Score on a scale 0–10 where 0 is ‘I definitely don’t have capacity’, to 10: ‘I definitely do have the capacity’ • How confident do you feel that you can undertake an exercise programme? (i.e. Do you feel you have the time, any equipment that you might need etc.) Score on a scale of 0–10, where 0 is ‘not confident at all’, and 10 is ‘totally confident’ • How motivated do you feel to undertake your exercise programme on a scale of 0–10? Where 0 is ‘completely unmotivated’ and 10 is ‘completely motivated’ Participants were then assessed and treated by a physiotherapist. After seeing the physiotherapist, the same questions were asked. The time frame between completing the questions for the first and second time was roughly 2 h. Mean scores and standard deviation for the two timepoints were calculated. Group differences were compared using Wilcoxon signed rank test and effect sizes were calculated with Cohen's D. All data were analysed using SPSS. Results: 21 participants were recruited to the intervention arm of the AERO feasibility RCT, with a mean age of 74.1 years (SD 6.2 years), 8 of the participants were male and 13 female. Self-reported confidence, capacity and motivation to exercise increased after seeing a physiotherapist – • self-rated confidence = pre-physio mean 6.63 (SD 2.59), post-physio mean 9.26 (SD 0.99) Z = −3.304, P = 0.001, d = 1.34 • Capability pre-physio mean 6.84 (SD 2.50), post-physio mean 8.21 (SD 2.50) Z = −2.684, P = 0.007, d = 0.53 • Motivation pre-physio mean 7.47 (SD 2.41) post physio mean 9.16 (SD 1.07) Z = −2.680, P = 0.007, d = 0.90 Conclusion(s): This study found that participants self-reported confidence, capability and motivation to exercise increased following an appointment with a physiotherapist. This is important given the challenge of adherence to exercise reported in the previous literature. If interaction with a physiotherapist has the ability to improve behavioural regulation related to exercise, it should continue to be seen as important, particularly as services emerge from COVID-19 restrictions. The results of this study need to be understood in the context of a small sample size that was recruited for a feasibility trial. However, the difference in group means and effect sizes indicate that this is an area that warrants further investigation. Future research should consider testing for this effect in an appropriately large sample size. Impact: The importance of seeing a physiotherapist to improve behavioural regulation in regard to exercise is underlined. Further research needs to confirm these findings in a large sample and across different populations. Funding acknowledgements: This work was funded by the Physiotherapy Research Unit, Nuffield Orthopaedic Centre, Oxford, UK and The Centre for Movement, Occupational and Rehabilitation Sciences (MOReS), Oxford Brookes University, Oxford, UK.