Individuals with intellectual disability have lower voluntary muscle activation level

Impact of Resistance Training on Body Composition and Physical Function in Individuals with Down Syndrome: A Meta-Analysis

Objectives: Down syndrome (DS) is associated with challenges like increased fat mass and reduced muscle tone. This study aims to analyze the impact of resistance training on improving muscle strength and physical function in individuals with DS. Methods: We conducted a comprehensive search of PubMed, Scopus, Google Scholar, Cochrane Library, and China National Knowledge Infrastructure for studies published up to August 2023. Standardized mean differences and 95% confidence intervals were used to evaluate the efficacy of resistance training. Results: Eight randomized controlled trials (RCTs), including 127 participants with DS, met the inclusion criteria. Resistance training significantly improved muscle strength in the knee extensors (SMD: 1.009, 95% CI: 0.505-1.513), knee flexors (SMD: 1.133, 95% CI: 0.106 to 2.16), and upper limbs (SMD: 0.748, 95% CI: 0.152-1.343). The SMD for upper limb function was 0.385 (95% CI: 0.004-0.765), showing a small improvement. For walking ability, the SMD was 0.259 (95% CI: -0.171-0.690), and for stair climbing ability, the SMD was 0.257 (95% CI: -0.189-0.703), both indicating no significant changes. Improvements in upper limb physical function were significant, but no notable improvements were seen in lower limb functions. Conclusions: Resistance training for more than four weeks enhances muscle strength in individuals with DS, with greater gains seen in younger participants. While improvements were noted in upper limb physical function, lower limb function remained largely unchanged. These findings suggest that resistance training is a valuable exercise for improving muscle strength and physical function in individuals with DS.

Gender Differences in Anthropometric, Functional Capacity Measures and Quality of Life in Individuals with Intellectual and Developmental Disabilities

The aim of the of the current investigation was to investigate the possible differences concerning males and females in anthropometry, body composition, functional capacity, strength and quality of life variables. After obtaining signed informed consent, 37 participants (18 males; 19 females), with mean age of 39.08 and standard deviation of 11.66 years, voluntarily participated in this study. Anthropometry, body composition, functional capacity, strength, and quality of life were assessed using validated and reliable instruments and tests for this population. The males and females were compared using a Mann-Whitney U signed rank test. Significant differences were detected among the following variables, height (p = 0.028), body mass index (p = 0.033), fat mass (p = 0.002), muscle mass (p ≤ 0.001), phase angle (p = 0.005), medicine ball throwing strength (p = 0.010), and peak toque left knee (p = 0.028), with males showing better results in all the variables. The sample in this study showed differences in the anthropometric, composition, and strength variables. Studying this population can help ensure that everyone has equal access to services and adequate support for their personal needs, improving their quality of life.

The Relationship between Dynamic Balance, Jumping Ability, and Agility with 100 m Sprinting Performance in Athletes with Intellectual Disabilities

Sprinting is a competitive event in athletics that requires a combination of speed, power, agility, and balance. This study investigated the relationship between dynamic balance, jumping ability, and agility with 100 m sprinting performance in athletes with intellectual disabilities, addressing an underexplored connection. A sample of 27 sprinters with intellectual disabilities participated in this study and completed 100 m sprint and various tests, including the Y Balance Test (YBT), the Crossover hop test, squat jump (SJ), countermovement jump (CMJ), and t-test to evaluate their dynamic balance, jumping ability, and agility, respectively. The findings revealed significant negative correlations between the YBT, Crossover hop test, SJ, and CMJ and 100 m sprint performance (r range: -0.41 to -0.79, p < 0.05). Regression analysis identified these variables as significant predictors (R2 = 0.69; p < 0.01). SJ exhibited the strongest association with 100 m sprint performance, (R2 = 0.62, p < 0.01). The agility t-test did not show a significant association. The combination of the YBT ANT and SJ demonstrated a predictive capability for 100 m sprint performance (R2 = 0.67, p < 0.001). In conclusion, this study revealed predictive capabilities between dynamic balance, jumping ability, and 100 m sprint performance in sprinters with intellectual disabilities.

Effects of a 24-week exercise program on anthropometric, body composition, metabolic status, cardiovascular response, and neuromuscular capacity, in individuals with intellectual and developmental disabilities

Introduction: The prevalence of overweight and obesity has increased in the last decades, including in people with Intellectual and Developmental Disabilities (IDD). This is even more concerning when it is globally accepted that a low physical condition contributes to the deterioration of functionality and increases the risk of developing chronic diseases during life, with effective implications for health and well-being. The aim of the present study is to investigate the effects of two physical exercise intervention programs on institutionalized individuals with IDD. Methods: Twenty-one adults with IDD (43.04 ± 11.18 years) were split by convenience into three groups: i) an indoor training group (IG; N = 7; 24-week machine-based gym intervention), ii) an outdoor training group (OG; N = 7; 24-week outdoor intervention with low-content materials), and iii) a control group (CG; N = 7). Assessed outcomes included indicators of health and neuromuscular capacity. The ShapiroWilk (n < 50) and Levene tests were used to verify data normality and homoscedasticity. A Kruskal-Walli test was performed to understand if there were differences between the groups. For comparison purposes and to assess hypothetical differences between groups, the Wilcoxon signed-rank test and the Friedman test were used. The respective effect size was calculated, and the significance level was defined at 0.05. Results/Discussion: There was a difference in fat mass in OG (initial ≠ intermediate; Bonferroni corrected: t = 2.405; p = 0.048; W = 0.08 and initial ≠ final moments; Bonferroni corrected: t = 2.405; p = 0.048; W = 0.08). Indoor intervention programs seem to be more effective than outdoor intervention programs for reducing heart rate rest (t = -2.912; p = 0.011; W = -0.104) when compared with CG. Conclusion: A low-cost outdoor intervention in contact with nature appears to be more effective for fat mass reduction. The results for heart rate variability are not clear and robust. Finally, an indoor intervention using weight-training machines appears to be a good method to promote neuromuscular capacity.

The effect of strengthening and aerobic exercises on balance and functional independence levels in students with intellectual disabilities

Purpose

This study was planned to examine the effects of strengthening and aerobic exercise training applied to students with intellectual disabilities on balance and functional independence.

Methods

A total of 107 intellectually disabled students, 36 girls, and 71 boys, aged between 11 and 18 years, studying at Denizli Çamlık Special Education Practice Center School were included in the study. In the study, a training program consisting of twice-a-week aerobic exercises was applied for one year and home strengthening exercises three days a week was applied for three months. Participants were assessed before and after the training program. Balance was assessed with the 10-meter walk test and Pediatric Balance Scale (PDS). Functional independence was assessed with the Children's Functional Independence Measure (WeeFim).

Results

Participants demonstrated significant improvements in 10-meter walking test, PDS and WeeFim scores (p < 0.05).

Conclusion

The results obtained from the study showed that strengthening and aerobic exercise training applied to students with intellectual disabilities positively affected walking, balance, and functional independence.

Effect of the environmental factor of coexistence on the physical condition of people with mild and moderate intellectual disabilities

BACKGROUND

The main objective of this study was to compare the physical condition of people with intellectual disabilities living in residential homes (RH; restricted residential environment) versus independent homes (IH; family houses while performing paid work). The effect of gender on physical condition was also evaluated separately for each group.

METHOD

Sixty individuals with mild to moderate intellectual disability, 30 living in RH and 30 living in IH, participated in this study. The RH and IH groups were homogeneous in terms of gender distribution (17 males and 13 females) and intellectual disability level. Body composition, postural balance, and static and dynamic force were considered as dependent variables.

RESULTS

The IH group performed better in the postural balance and dynamic force tests compared to the RH group, but no significant differences between the groups were observed for any body composition or static force variable. Women in both groups tended to have better postural balance than men, while men presented higher dynamic force.

CONCLUSIONS

The IH group presented a higher physical fitness compared to RH group. This result emphasises the need to increase the frequency and intensity of the physical activity sessions commonly programed for individuals living in RH.

The Role of Cognition and Social Factors in Competition: How Do People with Intellectual Disabilities Respond to Opponents?

Exploring pacing behaviour in people with intellectual disabilities (ID) in competition will help to better understand the impact of cognition and social environment in sports, providing support for the shaping of proper inclusive sports environments. The present experimental study aimed to (1) compare the pacing behaviour and performance between people with and without ID who are inexperienced in cycling and (2) investigate how these are influenced by an opponent. Participants with (n = 8) and without ID (n = 10) performed two randomised 4-km maximal cycling trials, alone and against an opponent. Non-parametric tests for repeated measures data (p ≤ 0.05) revealed that people with ID cycled slower, but with higher inter-individual variation (both conditions) and paced themselves differently compared to people without ID when competing against an opponent. In contrast to the previous literature in athletes without ID, the presence of a faster opponent resulted in a decrease in the performance in the participants with ID. The negative influence of the opponent highlights the potential difficulties people with ID experience to adequately use their opponents to enhance their self-regulatory processes and optimize their pacing and performance in maximal exercise trials. Coaches who want to offer inclusive sports environments for people with ID could take these findings into consideration.

Reference Values of Absolute and Relative Handgrip Strength in Chilean Schoolchildren with Intellectual Disabilities

Handgrip strength is a simple measure of general muscle strength and is related to functionality in people with intellectual disabilities. The objective of this research was to describe the normative values of absolute and relative handgrip strength in children, adolescents and adults according to sex. The sample was made up of 264 schoolchildren (n = 168 men) belonging to five special education schools in Santiago of Chile. The results show higher levels of absolute handgrip strength in males compared to females. The maximum peak of the absolute manual handgrip is reached in females in adolescence with a decrease in adulthood. Relative handgrip strength levels are similar in boys and girls. In females, the relative handgrip strength is similar in childhood and adolescence. Relative handgrip strength declines in both sexes from adolescence to adulthood. The reference values of this study can be used by professionals in the areas of health and education as a guide for interpretation, monitoring and follow-up of Chilean schooled people with intellectual disabilities.

Acute effects of aerobic versus resistance exercises on cognitive function in individuals with intellectual disability

BACKGROUND

This study compared the acute effects of aerobic (AE) and resistance (RE) exercise on reaction time (RT) and working memory (WM) in individuals with intellectual disability.

METHODS

RT tests and Corsi test for WM were performed before and after three intervention sessions: AE, RE, or control session consisting on watching video.

RESULTS

The RT values decreased significantly (p < .001) after both of AE and RE with higher extend after the RE but did not vary following the control session. Corsi scores increased significantly (p < .001) after AE but not after RE or control session.

CONCLUSIONS

These findings suggest that the effects of acute exercise on cognitive function in individuals with intellectual disability depend on the exercise mode as well as the nature of the cognitive task. The RE seems to be more recommended for RT enhancement whereas only the aerobic one could improve WM in these individuals.

Neuromuscular, kinetic and kinematic differences in drop jumping between male adolescents with and without intellectual disability

BACKGROUND

Individuals with intellectual disability (ID) have lower performance in vertical jumps compared to individuals without ID. Training programmes including drop jump (DJ) exercises to gap this deficit are required. However, there is a lack of knowledge on biomechanical variables may influence DJ performance in young people with ID.

RESEARCH QUESTION

Are there differences in the neuromuscular, kinetic and kinematic parameters in DJ between male adolescents with and without ID (WID and NID, respectively).

METHODS

Thirteen male adolescents WID (Wisk III intelligence quotient: 55.6 ± 11.2) and thirteen age-matched boys NID executed DJ from 30 cm on a force-plate. The vastus lateralis (VL) and biceps femoris (BF) electromyogram (EMG) as well as the knee kinematics and kinetics were obtained.

RESULTS

WID had significantly (p < .05) lower DJ height, knee power, peak angular velocity and stiffness compared to NID. VL activity was higher and BF/VL co-activation was lower in WID than NID.

SIGNIFICANCE

The deficit in DJ performance shown in WID was accompanied with lower power and stiffness, as well as lack of coordination in the lower limb muscles. Improving these variables, with specific and targeted training interventions, may diminish the performance gap with their age-matched counterparts.

Perceived Barriers of Physical Activity Participation in Individuals with Intellectual Disability-A Systematic Review

Individuals with intellectual disability (ID) tend to have a sedentary lifestyle, with low physical fitness and an increased risk of chronic diseases. One reason for the prevalence of a sedentary lifestyle is the existence of barriers to participation in physical activity (PA). The purpose of this systematic review is to update knowledge about the perceived barriers of PA participation in individuals with ID. Electronic searches were carried out in the PubMed, Scopus, SPORTDiscus and Web of Science databases, from September 2020 to May 2021, and included articles published between January 2016 and May 2021. The terms used were: "mental retardation", "intellectual disability", "intellectual disabilities", "physical activity", "motor activity", "barriers", "obstacles", "embarrassment" and "constraint", in combination with the Boolean operators "AND" or "OR". After the methodological process, five studies were included for analysis. These studies revealed the existence of several perceived barriers to regular PA participation, which were grouped into five main groups: personal (6 topics), family (4 topics), social (13 topics), financial (1 topic) and environmental (1 topic). The knowledge and identification of participation barriers can be of extreme importance both to institutions and professionals aiming to enhance the participation of individuals with ID in regular PA programs.

Biomechanical analysis of gait patterns in children with intellectual disabilities

BACKGROUND

Children with intellectual disabilities (ID) typically master walking skills much later than typically developing (TD) children and have poor postural control ability. This study aimed to explore the gait ability and characteristics of children with ID and whether there is any difference in walking ability between them and TD children.

METHOD

In this study, integrating kinematic-biomechanic-dynamic measurement methods and corresponding analysis methods (video analysis, three-dimensional force analysis and electromyography test analysis) were used to characterise and compare the gait patterns between ID children and TD children.

RESULTS

ID children's step length/leg length ratio was lower than TD children. The left-leg single-leg support time and step length of ID children were shorter than TD children. While walking, ID children touched the ground with the whole foot pad and could not powerfully thrust against the ground with their toes. Their left legs had obvious disadvantages compared with their right legs. ID children's lower limb muscle strength was lower than TD children, and their thigh muscles had an obvious compensation function.

CONCLUSIONS

Correcting ID children's gait should be an important teaching goal for physical education institutors and teachers. Muscle-strength and flexibility training can help ID children reinforce core strength and better coordinate lower limbs.

Prescription and Effects of Strength Training in Individuals with Intellectual Disability-A Systematic Review

The practice of physical exercise (PE), especially strength training (ST), has health benefits in the healthy population; however, the literature is scarce in the recommendations related to the population with intellectual disability (ID). This study represents the first analysis on the topic and aims to examine the structure and efficacy of ST experimental intervention programs in individuals with ID. This systematic review was carried out between January and April 2021, using the PubMed, Web of Science, Scopus, and SPORTDiscus databases, according to the PRISMA guidelines. From a total of 166 studies, eight were included in the present systematic review. The studies included a total of 280 individuals (18.23 ± 2.86 years old). The main features of the exercise programs are: 12 weeks average duration, three weekly sessions of 45–60 min, six to seven exercises targeting the main muscle groups, two to three sets, 6–12 repetitions, and avoiding free weights for safety reasons. The main results showed increments in strength, balance and fat-free mass and decrements in fat mass and waist circumference. It is a useful guideline for PE technicians to prescribe and adjust correctly in order to not only promote physical fitness, but improve the quality of life of individuals with ID.

Static postural balance between male athletes with intellectual disabilities and their sedentary peers: A comparative study

BACKGROUND

Previous reports showed that athletes without disabilities have better postural skills than their sedentary peers. This finding has not been elucidated in athletes with intellectual disabilities despite their decreased postural balance. This study aims to investigate static postural balance in track and field athletes with intellectual disabilities compared to their sedentary peers.

METHODS

Eighteen track and field athletes with intellectual disabilities (23.5 ± 4.52 years) and 18 sedentary peers (20.3 ± 3.4 years) participated in this study. A stabilometric platform was used to assess static postural balance in bipedal and unipedal stances with open (OE) and closed (CE) eyes.

RESULTS

In OE, the result showed significantly better static postural balance (CoP_Vm : p < .001; CoP_area : p < .001) in athletes compared to the sedentary ones in both stances. In CE, this difference was not observed in the unipedal stance.

CONCLUSION

Track and field experience may improve static postural balance in athletes with intellectual disabilities, mainly when visual input is available.

Motor strategy during postural control is not muscle fatigue joint-dependent, but muscle fatigue increases postural asymmetry

The aim of this study was to investigate the effects of ankle and hip muscle fatigue on motor adjustments (experiment 1) and symmetry (experiment 2) of postural control during a quiet standing task. Twenty-three young adults performed a bipedal postural task on separate force platforms, before and after a bilateral ankle and hip muscle fatigue protocol (randomized). Ankle and hip muscles were fatigued separately using a standing calf raise protocol (ankle fatigue) on a step and flexion and extension of the hip (hip fatigue) sitting on a chair, at a controlled movement frequency (0.5Hz), respectively. In both experiments, force, center of pressure, and electromyography parameters were measured. The symmetry index was used in experiment 2 to analyze the postural asymmetry in the parameters. Our main findings showed that muscle fatigue impaired postural stability, regardless of the fatigued muscle region (i.e., ankle or hip). In addition, young adults used an ankle motor strategy (experiment 1) before and after both the ankle and hip muscle fatigue protocols. Moreover, we found increased asymmetry between the lower limbs (experiment 2) during the quiet standing task after muscle fatigue. Thus, we can conclude that the postural motor strategy is not muscle fatigue joint-dependent and a fatigue task increases postural asymmetry, regardless of the fatigued region (hip or ankle). These findings could be applied in sports training and rehabilitation programs with the objective of reducing the fatigue effects on asymmetry and improving balance.

Dynamic Balance in Athletes With Intellectual Disability: Effect of Dynamic Stretching and Plyometric Warm-Ups

CONTEXT

Athletes with intellectual disability (ID) have a high risk of injury while participating in various sports. Warm-up (WU) is the most preventive measure to reduce injuries in sports.

OBJECTIVE

To investigate the effects of dynamic stretching WU (DS-WU) and plyometric WU (PL-WU) on dynamic balance in athletes with ID.

DESIGN

Crossover study.

SETTING

Research laboratory.

PARTICIPANTS

A total of 12 athletes with ID (age 24.5 [3.22] y, height 165.7 [8.4] cm, weight 61.5 [7.1] kg, intelligence quotient 61.1 [3.5]).

MAIN OUTCOME MEASURES

Dynamic balance was assessed using the Star Excursion Balance Test (SEBT) at pre-WU, post-WU, and 15 minutes post-WU for both the DS-WU and the PL-WU. A 2-way analysis of variance (3 sessions × 2 WU methods) with repeated-measures was used in this study.

RESULTS

Following the DS-WU, participants demonstrated significant improvements in the SEBT composite score post-WU (89.12% [5.54%] vs 87.04% [5.35%]; P < .01) and at 15 minutes post-WU (89.55% [5.28%] vs 87.04%, P < .01) compared with pre-WU. However, no significant difference between these two post-WU scores (post-WU and 15 min post-WU) was found. For the PL-WU, participants demonstrated a significant decrease in the SEBT composite score at post-WU (85.95% [5.49%] vs 87.02% [5.73%]; P < .05); however, these scores increased significantly at 15 minutes post-WU (88.60% [5.42%] vs 87.02% [5.49%]; P < .05) compared with that at pre-WU. The SEBT composite scores are significantly higher in the DS-WU than in the PL-WU at both post-WU sessions (P < .05).

CONCLUSION

Both DS-WU and PL-WU could improve dynamic balance and may be recommended as WUs in athletes with ID; however, particular caution should be exercised immediately after the PL-WU.

Neuromuscular characteristics in trained vs. sedentary male adults with intellectual disability

BACKGROUND

This study aimed to explore muscle strength production and its underlying neuromuscular characteristics in sedentary and trained individuals with intellectual disability (ID) compared with healthy sedentary individuals.

METHODS

Three adult groups (age: 25.07 ± 0.70) consisting of sedentary individuals with ID (IDSG), trained individuals with ID (IDTG) and a control group (CONT) participated in the present study. Peak torque (PT) during maximal voluntary isometric contraction, voluntary activation level (VAL), surface electromyography (sEMG) recordings, electrophysiological (M_max ) and potentiated twitch torque (PTT responses) of the knee extensor muscles and thigh muscle volume were assessed.

RESULTS

Compared with CONT and IDTG, respectively, IDSG presented significantly lower PT (-48% and -42%), VAL (-24% and -9%), sEMG (-49% and -29%), M_max (-41% and -39%) and PTT (-32% and -28%) values. These deficits were reduced between IDTG compared with CONT (i.e. PT: -10%; VAL: -16%; and sEMG: -28%) or did not differ anymore (PTT and M_max ). Normalising PT to thigh muscle volume and/or computing theoretical PT value overwhelm strength production differences between IDTG and CONT. Training background influences the outcomes with IDTG exhibiting greater PT, VAL, sEMG, M_max and PTT than IDSG.

CONCLUSIONS

Strength production deficit in IDSG was related to both muscular and neural characteristics compared with healthy controls whereas this deficit mainly arises from neural characteristics for IDTG.

Progressive resistance training for persons with intellectual disabilities and visual impairment

BACKGROUND

Knowledge concerning the feasibility and effects of progressive resistance training (PRT) for persons with intellectual disabilities and visual impairment who are categorized in Gross Motor Function Classification System (GMFCS) Level 1 is limited. The aim of our study was to evaluate feasibility and effect of PRT on participants' Quadriceps strength and personal goals.

METHODS

Eight Participants followed a PRT program for 10 weeks. Feasibility was determined by percentage of attendance and compliance. The effect of PRT was analyzed with a linear mixed model (p < 0.05) and by normalized bootstrap (95% CI).

RESULTS

Participants attended 87.8% of the sessions and trained according to the PRT program, indicating sufficient compliance. Quadriceps strength increased significantly by 69%, and participants' personal goals were achieved.

CONCLUSION

PRT is a feasible and potentially effective method for increasing Quadriceps strength as well as achieving personal goals in persons with intellectual disabilities and visual impairment with GMFCS Level 1.

Neuromuscular fatigue and recovery profiles in individuals with intellectual disability

PURPOSE

This study aimed to explore neuromuscular fatigue and recovery profiles in individuals with intellectual disability (ID) after exhausting submaximal contraction.

METHODS

Ten men with ID were compared to 10 men without ID. The evaluation of neuromuscular function consisted in brief (3 s) isometric maximal voluntary contraction (IMVC) of the knee extension superimposed with electrical nerve stimulation before, immediately after, and during 33 min after an exhausting submaximal isometric task at 15% of the IMVC. Force, voluntary activation level (VAL), potentiated twitch (Ptw), and electromyography (EMG) signals were measured during IMVC and then analyzed.

RESULTS

Individuals with ID developed lower baseline IMVC, VAL, Ptw, and RMS/M_max ratio (root-mean-square value normalized to the maximal peak-to-peak amplitude of the M-wave) than controls (p < 0.05). Nevertheless, the time to task failure was significantly longer in ID vs. controls (p < 0.05). The 2 groups presented similar IMVC decline and recovery kinetics after the fatiguing exercise. However, individuals with ID presented higher VAL and RMS/M_max ratio declines but lower Ptw decline compared to those without ID. Moreover, individuals with ID demonstrated a persistent central fatigue but faster recovery from peripheral fatigue.

CONCLUSION

These differences in neuromuscular fatigue profiles and recovery kinetics should be acknowledged when prescribing training programs for individuals with ID.

Development of a new index of strength in adults with intellectual and developmental disabilities

Background: Given the increase in the prevalence of muscular strength problems in people with intellectual and developmental disability and the potentially serious consequences for their day-to-day life, there is a need for comprehensive evaluations of strength.Aims: To design a new index of the muscular strength of people with intellectual and developmental disability using principal components analysis.Methods and procedures: The sample consisted of 978 individuals with intellectual and developmental disability, 637 men and 341 women, with a mean age of 34.8 years (±11.2) who were recruited from the European Special Olympics Games. All participants were measured with the following functional tests: timed stand test, partial sit-up test, seated pushup and handgrip test.Outcomes and results: Data was analyzed using principal components analysis with Oblimin rotation and Kaiser normalization. The Component Plot and Rotated Space indicated that a one-factor solution was optimal. The principal component analysis revealed a satisfactory percentage of total variance explained.Conclusions: Based on the data analyzed above we believe that the strength index developed in this study could help to facilitate the assessment and follow-up of people with intellectual and developmental disability in the clinical setting, because it offers a broad measure of an individual's muscular response generated to the various stimuli presented by the evaluator. In addition, because it is economical, and easy and quick to administer, this index could easily be applied in clinical and research settings.Implications for rehabilitationThe developed index allows to classify people with intellectual and developmental disability according to their strength, knowing, in addition, the variance that each of the four tests explains about that index.The strength index developed in this study could help to facilitate the assessment and follow-up of people with intellectual and developmental disability due to its ease of use, economy and time required for its execution, could lead to an easy transfer and use in clinical setting.

Assessment of Foot Shape in Children and Adolescents with Intellectual Disability: A Pilot Study

BACKGROUND Available publications provide little evidence pertaining to assessment of foot shape in children with intellectual disability. The aim of this study was to assess the parameters of foot shape in children and adolescents with intellectual disability and to evaluate the relationship between the degree of disability and these parameters. MATERIAL AND METHODS The study involved 90 individuals aged 7-15 years, including 45 subjects with mild and moderate levels of intellectual disability (study group) and 45 peers with normal intellectual development (control group). Each participant was subjected to photogrammetric assessment of foot shape based on the projection moire effect. RESULTS Analysis of the relationship between the disability level and the assessed parameters showed that the length of the right (p=0.006) and left (p=0.004) foot, as well as Wejsflog's rate for the right (p<0.001) and left (p<0.001) foot, were significantly higher among children with mild disability, whereas GAMMA angle of the right (p=0.028) and left (p=0.006) foot was significantly higher among children with moderate disability. CONCLUSIONS The findings show a significant relationship between the degree of disability and the assessed foot parameters. Significant differences between the subjects with intellectual disability and the control group were identified in the basic parameters defining foot structure.

Effects of a 3-month recreative exercise applied to individuals with intellectual disability on their electromyogram (EMG) variations and balance performance

Objective: The objective of the present study was to determine how 3-month recreative exercises affect the balance performance of individuals with intellectual disability (ID) and to evaluate the electromyogram (EMG) changes following exercises. Methods: Eleven individuals (M=14.18, S.D=1.94) with mild intellectual disability (MID) who attend the school for children with ID and to the vocational school were included in the study. In the study, the subjects were applied a recreative exercise program (60 min/3 days/12 weeks) and their balance, EMG, and aerobic and anaerobic performances were evaluated by means of the pretest-posttest model. Results: When the EMG values in our study were examined, differences were found in terms of EMG₃-VL muscle variable (P=0.075/2=0.038), EMG₃-RF muscle variable (P=0.080/2=0.040), and EMG₅-RF muscle variable (P=0.066/2=0.033). The exercise program decreased the EMG values significantly. When the balance scores were evaluated, significant differences were found in terms of the variables of Balance 2 (after 30 s) (P=0.077/2=0.039) and Balance 3 (after 3 min) (P=0.084/2=0.042). The exercise program significantly decreased the balance values. Conclusion: Consequently, it was determined that 3-month recreative exercises applied to individuals with ID lowered the EMG and Balance values during and after the exercise. In this context, it is thought that the people working with the children with MID need to consider the parameters constituting the balance in a detailed way in their exercise practices and to include activities improving their balance skills into their programs, and that recreative exercises can also provide contribution in this term.

Pacing Profiles in Competitive Track Races: Regulation of Exercise Intensity Is Related to Cognitive Ability

Pacing has been defined as the goal-directed regulation of exercise intensity over an exercise bout, in which athletes need to decide how and when to invest their energy. The purpose of this study was to explore if the regulation of exercise intensity during competitive track races is different between runners with and without intellectual impairment, which is characterized by significant limitations in intellectual functioning (IQ ≤ 75) and adaptive behavioral deficits, diagnosed before the age of 18. The samples included elite runners with intellectual impairment (N = 36) and a comparison group of world class runners without impairment (N = 39), of which 47 were 400 m runners (all male) and 28 were 1500 m-runners (15 male and 13 female). Pacing was analyzed by means of 100 m split times (for 400 m races) and 200 m split times (for 1500 m races). Based on the split times, the average velocity was calculated for four segments of the races. Velocity fluctuations were defined as the differences in velocity between consecutive race segments. A mixed model ANOVA revealed significant differences in pacing profiles between runners with and without intellectual impairment (p < 0.05). Maximal velocity of elite 400 m runners with intellectual impairment in the first race segment (7.9 ± 0.3 m/s) was well below the top-velocity reached by world level 400 m runners without intellectual impairment (8.9 ± 0.2 m/s), and their overall pace was slower (F = 120.7, p < 0.05). In addition, both groups followed a different pacing profile and inter-individual differences in pacing profiles were larger, with differences most pronounced for 1500 m races. Whereas, male 1500 m-runners without intellectual impairment reached a high velocity in the first 100 m (7.2 ± 0.1 m/s), slowly decelerated in the second race segment (−0.6 ± 0.1 m/s), and finished with an end sprint (+0.9 ± 0.1 m/s); the 1500 m runners with intellectual impairment started slower (6.1 ± 0.3 m/s), accelerated in the second segment (+0.2 ± 0.7 m/s), and then slowly decreased until the finish (F = 6.8, p < 0.05). Our findings support the hypothesis that runners with intellectual impairment have difficulties to efficiently self-regulate their exercise intensity. Their limited cognitive resources may constrain the successful integration of appropriate pacing strategies during competitive races.

Unilateral Fatigue Affects the Unipedal Postural Balance in Individuals With Intellectual Disability

This study aimed to explore the effect of local muscle fatigue on the unipedal stance in men with intellectual disability (ID). The Centre of pressure (CoP) excursions and the isometric maximal voluntary contraction (MVC) were measured before and after a fatiguing exercise. Higher baseline values of CoP excursions and lower MVC values were recorded in the ID group. After the fatiguing exercise, this group showed higher MVC decrease and higher percentage of increase of the mean CoP velocity. In conclusion, men with ID are more vulnerable to the disturbing effects of fatigue during the unipedal stance compared to men without ID.

The effect of a combined strength and proprioceptive training on muscle strength and postural balance in boys with intellectual disability: An exploratory study

The aim of our study was to investigate the effect of a combined strength and proprioception training (CSPT) program on muscle strength and postural balance in children with intellectual disability (ID). The maximum voluntary contraction (MVC) and postural parameters (CoPVm, CoPLX, CoPLY) of 20 children with ID were recorded before and after 8 weeks of a CSPT program. The participants were divided into two groups: an experimental group who attended a CSPT program and a control group who continued with daily activities. In the trained group, the MVC increased significantly (p<0.001) after the training period and the postural parameters decreased significantly in Double-Leg Stance (DLS) and One-Leg Stance (OLS) during the firm surface condition as well as in the DLS during the foam surface condition; in both eyes open (EO) and eyes closed (EC) conditions. A CSPT program improves postural balance in children with ID could be due to the enhancement in muscle strength and proprioceptive input integration.