A walk on water: comparing the influence of Ai Chi and Tai Chi on fall risk and verbal working memory in ageing people with intellectual disabilities - a randomised controlled trial.

BACKGROUND: Aquatic motor intervention has been found to be effective in reducing falls and improving verbal working memory among the general population. However, effects among older adults with intellectual disabilities (ID) have never been explored. The aim of this study was to examine the effects of aquatic motor intervention on fall risk and verbal working memory among older adults with ID. METHODS: Forty-one older adults with mild to moderate ID (age: 50-66 years) were randomly assigned to 14 weeks of aquatic motor intervention (Ai Chi: N = 19) or identical on-land motor intervention (Tai Chi: N = 22). Fall risk, measured with the Tinetti balance assessment tool (TBAT), and verbal working memory, measured with the digit span forward test, were assessed pre-intervention, after 7 weeks of intervention and post-intervention. RESULTS: Study results indicate positive effects of both aquatic and on-land motor intervention on TBAT fall risk score, while the aquatic motor intervention group improved TBAT fall risk score quicker as compared with the on-land motor intervention group. Moreover, the lower the pre-intervention TBAT score was, the higher the improvement. In addition, study findings support the positive effects of aquatic motor intervention on verbal working memory ability as measured with the digit span forward test. CONCLUSIONS: Motor intervention, and particularly in an aquatic environment, can potentially reduce fall risk. Aquatic motor intervention may help to improve verbal working memory among older adults with ID.

Stair climbing test post-stroke: feasibility, convergent validity and metabolic, cardiac, and respiratory responses.

BACKGROUND: The 6-minute walk test (6MWT) and treadmill walk tests (TMW) are commonly used to assess post-stroke patients (PSP) aerobic capacity. However, these tests are not without their limitations (e.g. limited sensitivity to change and the use of external pacing). Therefore, there is a need for additional tools to assess PSP aerobic capacity. OBJECTIVE: To establish the feasibility, convergent validity, and metabolic, cardiac, and respiratory responses of a stair climbing test (SC), among chronic PSP. METHODS: Nineteen chronic PSP conducted SC, TMW, and 6 MWT. Metabolic (oxygen consumption - VO2), cardiac (heart rate), and respiratory (ventilation volume, breathing frequency, and tidal volume) measures were established. Adverse events were documented. Correlations established the convergent validity of the SC test. A repeated measures analysis of variance was performed to compare the participant's physiological responses at the end of the various tests. RESULTS: SC is feasible and safe, as all participants completed the test with no adverse events. The SC demonstrated convergent validity as numerous associations were found between SC and TMW, and 6 MWT. Metabolic, cardiac, and respiratory responses to the SC were significantly higher than these of the TMW and 6 MWT (e.g. VO2= 13.43 ± 2.19, 11.01 ± 2.0, and 11.26 ± 1.87 ml/kg/min, respectively) (P < 0.05). CONCLUSIONS: SC is a feasible and valid test within chronic PSP. SC is more metabolically demanding than TMW and 6 MW and therefore, may enable appropriate endurance capacity measurement, especially for high functioning PSP. Negotiating stairs is a common community ambulation requirement. Therefore, it is appropriate to incorporate SC test in PSP testing battery.

Physical education teachers' attitudes towards children with intellectual disability: the impact of time in service, gender, and previous acquaintance.

BACKGROUND: This study investigated attitudes towards teaching students with intellectual disability (ID) within a representative sample of secondary school physical education (PE) teachers, and to determine the effects of age, gender, teaching experience, and having acquaintance with ID and students with ID on their attitudes. METHODS: Participants were 729 secondary school PE teachers who worked in 81 major cities of Turkey. The Teachers Attitudes towards Children with Intellectual Disability Scale was administered. RESULTS: The statistical analysis revealed that there was no significant effect on factors and total attitudes scores of gender and having students with ID. Significant effects on factors and total attitudes score were found in teaching experiences and having acquaintance with ID. CONCLUSIONS: It is encouraged to maintain and further develop in-service education programmes of adapted physical activity for PE teachers.

Effects of a Special Olympics Unified Sports soccer program on psycho-social attributes of youth with and without intellectual disability.

The purpose of the study was to investigate the effects of a Special Olympics (SO) Unified Sports (UNS) soccer program on psycho-social attributes of youth with and without intellectual disabilities (ID). Participants were 76 male youth with (n=38) and without (n=38) ID. Participants with ID were randomly allocated into a SO athletes group (n=23, mean age=14.5; SD=1.2 years) and a control group (CG) (n=15, mean age=14.5; SD=.8 years). Twenty-three randomly selected youth without ID formed the partner group (mean age=14.1; SD=.9 years) and 15 youth without ID (mean age=13.8; SD=.5 years) formed the CG. Instruments included the Friendship Activity Scale (FAS) (Siperstein, 1980), the Adjective Checklist (Siperstein, 1980), and the Children Behavior Checklist (Achenbach, 1991). The soccer training program lasted eight weeks, 1.5h per session, three times per week, in addition to school physical education (PE). The CG did not participate in any sports in addition to PE. The findings showed that the UNS program was effective in decreasing the problem behaviors of youth with ID and increasing their social competence and FAS scores. In addition, the program was found to be effective in improving the attitude of youth without disabilities toward participants with disabilities. In conclusion, the present findings demonstrate the utility of a UNS program for both youth with and without disabilities.

Motivational correlates of physical activity in persons with an intellectual disability: a systematic literature review.

BACKGROUND: The purpose of this study is to systematically retrieve, examine and discuss scientific studies focusing on motivational correlates that both contribute to, and can be assumed to be effects of, participation in sport, recreation, or health-related physical activities in persons with intellectual disability (ID). METHODS: A systematic analysis of the literature retrieved through electronic databases and other resources was performed, covering articles published from 1980 through 2009. Inclusion criteria were based on terms referring to the participants, the psychosocial correlates and the type of activity. RESULTS: Twenty-three articles satisfied the inclusion criteria, and were divided into four categories of studies: (1) cross-sectional designs, (2) experimental prospective one-group designs, (3) longitudinal comparative intervention designs, and (4) qualitative designs. The level of quality regarding the intervention studies was assessed using four different scales, and on average they depicted a moderate level of evidence. CONCLUSIONS: Both exercise and sport-related activities seem to contribute to well-being. Improved physical fitness and elevated skill level gained during exercise and sport activities appear to serve as mediators for increased perceptions of self-efficacy and social competence. Peer modelling, as well as video and audio reinforcement, appear to be important modalities in maintaining compliance to exercise programmes.

Compliance of children with moderate to severe intellectual disability to treadmill walking: a pilot study.

BACKGROUND: Individuals with Intellectual Disability (ID) exhibit reduced levels of compliance to exercise, including treadmill walking. The purpose of this study was to measure the effects of several training conditions on compliance to participation in treadmill walking of children with moderate to severe ID. METHOD: Criteria for compliance were the averaged number of times participants attempted to discontinue walking during two 5-min exercise sessions of treadmill walking at an intensity of 65-75% of predicted maximal HR. Fifteen children aged 5-11 with moderate to severe ID participated in the study. Training conditions were (a) close supervisor's position, (b) distant supervisor's position, (c) positive reinforcement, and (d) paired modeling. RESULTS: General linear mixed model statistics revealed significant differences in favor of the paired modeling and positive reinforcement compared to the other conditions. Leaning forward was the most frequent type of participants' attempt to stop exercising. CONCLUSIONS: Paired modeling and positive reinforcement should be considered within treadmill training programs for children with moderate to severe ID.

Reliability of isokinetic strength measurements of the knee in children with cerebral palsy.

This study evaluates the reliability of isokinetic testing of the knee flexors and extensors in children with cerebral palsy (CP). Twelve children (seven girls, five boys), aged 9 to 15 years, participated in this study. The children's strength was measured bilaterally, using a dynamometer. Each participant was tested twice at an interval of 1 week. During each session, the participant performed five consecutive cycles of knee extension and flexion. Testing velocity was set at 90 degrees/s, and the range of motion was 80 degrees, starting with the knee flexed at 80 degrees and ending in full extension. The measured variable was the peak torque. Reliabilities were determined using intraclass coefficient (ICC) with two-way ANOVA model. The ICCs for individual sessions range from 0.90 to 0.99. ICCs for the eight repetitions over the two sessions range from 0.95 to 0.98. The findings indicate that measuring isokinetic strength in the tested population is highly reliable and should be considered in rehabilitation protocols.

Computerized search of scientific literature on sport for disabled persons.

A computerized search of literature on sport for disabled persons referenced in the MEDLINE (Index Medicus) and the SPORTDiscus (Sport International Resource Center SIRC) databases yielded 253 records published during the past 15 years. An analysis of these records by disability, age, and scientific discipline indicated that (a) publications related to physiology were most frequent (41%), followed by publications related to psychology (29%); (b) 58% of all records had wheelchair users as subjects; and (c) children were exclusive subjects in 10% and females in less than 2% of the records reviewed in this search.

Effects of a movement and swimming program on vital capacity and water orientation skills of children with cerebral palsy.

Swimming and aquatic exercise are known for their effects on respiration in normal and asthmatic people. The purpose of the present study was to evaluate the effect of a 6-month movement and swimming program on the respiratory function and water orientation skills of children with cerebral palsy (CP). Forty-six kindergarten children aged 5 to 7 years were assigned either to a treatment or control group. The intervention program consisted of swimming sessions twice weekly and sessions of group physical activity in a gym once weekly, each session lasting 30 minutes, for a period of 6 months. Children in the control group were treated (30 minutes, 4 days per week) with Bobath physical therapy. The children in the treatment and control groups had comparable disability types, age, and anthropometric measurements. A 2 x 2 (group x test period) repeated measures ANOVA design confirmed a significant effect of interaction of time with group. The results also confirmed that children with CP have reduced lung function compared with normative data for children in the same age category. The treatment program improved baseline vital capacity results by 65%, while children in the control group improved by only 23%. The movement and swimming exercise program had a better effect than a physical therapy routine implemented in a previous study, consisting of respiratory exercise alone.

Effects of a movement and swimming program on water orientation skills and self-concept of kindergarten children with cerebral palsy.

In this study the effect of an experimental movement and swimming program of six months on motor function in the water measured by means of the Water Orientation Score and self-perception measured by means of the Martinek-Zaichkowsky Self-concept Scale was investigated. 23 children participated in the program, completing both tests prior to and after the intervention. An age-, sex-, and disability-matched control group of 23 children completed only the Self-concept Scale at pre- and posttest. Analysis indicated a significant improvement in Water Orientation Score of children in the trained group, but no effect on scores of the Self-concept Scale.

Aerobic and anaerobic arm-cranking power outputs of males with lower limb impairments: relationship with sport participation intensity, age, impairment and functional classification.

Fifty individuals with lower limb impairments including spinal cord injury, polio and amputations underwent aerobic and anaerobic arm-cranking tests in a standardized laboratory setting. Based on linear regression models applied with age as dependent variable aerobic performance variable including HRmax (R = 0.395, P = 0.004), and POaer (R = 0.31, P = 0.021) were subjected to ANCOVA adjusting for age in order to determine the significance of participation intensity (competitive vs leisure) and type of physical impairment. Anaerobic performance variables were not influenced by age and thereby subjected to 1-Way ANOVA with the same independent variables. Participation intensity and type of impairment significantly discriminated (P < 0.001) between athletes in all power variables. Linear regression models have shown moderate but significant (P < 0.001) relationship with functional ability (bases on International Wheelchair Basketball Federation classification system). In anaerobic mean power (MP) classification accounted for 42% of the variance, while in anaerobic peak power (PP) and aerobic Power (POaer) for 38% and 30% respectively. By means of a post hoc Tukey analysis significant differences were observed between athletes with a high level paraplegia (class 1) and those with one leg affected by polio or amputations (classes 4, 4.5). Athletes with low level paraplegia and two legs affected by polio (classes 2-3.5) had values in-between. Based on the descriptive evaluation, a three group scheme was conceptualized and resubjected to ANOVA. Significant intergroup differences were thus obtained only for PP. Descriptive PP data for each group were transformed into a five category table in order to provide reference values for fitness-estimation in males with lower limb impairments of various etiologies.

Sports-medical assessment for athletes with a disability.

The purpose of this article is to describe a Sports-Medical Assessment Protocol (SMAP) for athletes with a disability. The purposes of the SMAP are to identify medical problems and therapeutic goals for supplementary training programmes for athletes with a disability, and to provide baseline data for future follow up. The SMAP includes an interview, cardiorespiratory assessment and physical and functional examination. Data were collected from assessment protocols of 14 male athletes with various neurological disorders who qualified to participate in the Atlanta Paralympic Games in 1996. Nine of the athletes had some range of motion (ROM) limitations, one had shoulder pain and one low back pain following physical stress. Two athletes with postpolio presented muscle fasciculation and one of them also presented bilateral Carpal Tunnel Syndrome. Based on the results we concluded that utilizing the SMAP may contribute to trainers' and athletes' (with a disability) awareness of the physical needs of elite athletes as well as participants in leisure sport activities.

Anaerobic fitness testing of wheelchair users.

Anaerobic exercise testing has been applied since the 1970s as a procedure for estimating the capacity of local energy mechanisms dominating short term exercise. Compared with lower-body anaerobic testing, upper-body anaerobic testing is relatively new and less fully investigated. The reported data in this area are limited, and there is a paucity of reference values. For this review, the literature was searched by computerised inquiries of international and local databases, as well as personal access to PhD theses and congress proceedings. This article reviews the existing literature, covering a period of 20 years from 1976 to 1995. Data are reported concerning the findings of variables relevant to the anaerobic capacity of wheelchair users. The research findings revealed in the literature published so far are analysed here with particular attention paid to the methods and instrumentation used (type of ergometer and protocol utilised in the tests). Limitations in existing instrumentation and research designs and goals for further study have been suggested. Specific sections analyse the relevance of anaerobic performance variables to the classification and activity level of the individuals involved and their relevance to daily life and sports-related physical performance. Inter-relationships observed between anaerobic and aerobic capacity indices are discussed with respect to the limiting nature of local muscular fatigue over central processes. This information may be helpful in better understanding the exercise limitations and potential of wheelchair users with lower-limb impairments. Thus, clinical application of anaerobic fitness testing in these individuals may be enhanced.

Physical performance of elite wheelchair basketball players in armcranking ergometry and in selected wheeling tasks.

This study compared the aerobic and the anaerobic performance of 11 elite Israeli wheelchair basketball players in arm ergometric tests and corresponding wheeling tasks, derived from basketball practice. The ergometric tests included a continuous aerobic maximal peak work capacity test (PWCmax), and a 30-second arm-all-out anaerobic test of mean anaerobic capacity (MANC) and peak anaerobic power (PANP). The wheeling tasks included a 428 meter race, slalom and 6-minute endurance race. We examined the relationship of performance variables to personal variables, age, bodyweight and classification as athletes. The results were analysed by Spearman correlation tables, revealing the following: (1) HRmax (maximal heart rate) correlated highly (r = .884-.962) with performance in all wheeling tasks; (2) no relationship was found between variables in the arm ergometric tests and variables in the wheeling tasks; (3) bodyweight correlated significantly with MANC and PWCmax (r = .817 and .783 respectively). This relationship was better than the other independent variables (classification and age). It is concluded that HRmax can be used for performance evaluation in wheelchair basketball practice, and that arm ergometric work capacity has only limited predictive value of performance in wheeling tasks.