The effects of a 24-week exercise intervention and detraining on individuals with Intellectual and Developmental Disabilities

Abstract

Objetive Regular physical exercise can promote physical fitness, reduce the risk of chronic diseases, increase independence and success in daily activities, and promote quality of life for individuals with intellectual and developmental disabilities (IDD). On the one hand, if this exercise practice is discontinued or interrupted, the associated beneficial effects can be lost. The aim of this study was to examine possible changes in body composition and physical and functional fitness variables after regular practice of a physical exercise program, as well as after the same period of detraining.

Materials and Methods This study followed a quasi-experimental methodology of 6 months of physical exercise, followed by 6 months of interruption. The sample consisted of 10 individuals with IDD, with an average age of 43.2 years (SD=9.47). Weight, body mass index, handgrip, Timed Up and Go and Sit to Stand were assessed at initial intervention, post-intervention, and follow-up.

Results Participants improved in all variables after the intervention program, but only significantly in the handgrip test (Bonferroni corrected: t=1.05; p=0.019; W=0.21). After 6 months without regular exercise, the participants showed a decline in physical and functional fitness variables, but only in handgrip significantly (p=0.044).

Conclusions Although there are some gains from physical exercise program, there seems to be a loss of these gains after the end of the program. It is therefore recommended to avoid the period of detraining, which is fundamental to promoting the benefits of exercise, healthy ageing, independence, success in carrying out activities of daily living and quality of life.

Zusammenfassung

Fragestellung und Hintergrund Bei Menschen mit Intelligenzminderung und Entwicklungsstörungen (Intellectual and Developmental Disabilities, IDD) kann körperliche Bewegung die körperliche Fitness fördern, das Risiko der Entwicklung chronischer Krankheiten verringern, die Unabhängigkeit sowie den Erfolg bei täglichen Aktivitäten steigern und die Lebensqualität verbessern. Allerdings können die mit dem Training einhergehenden positiven Effekte verloren gehen, wenn die Bewegungsübungen vorübergehend oder dauerhaft eingestellt werden („Detraining“). Ziel der vorliegenden Studie war es, mögliche Veränderungen der Körperzusammensetzung und von Variablen der körperlichen und funktionellen Fitness nach regelmäßiger Durchführung eines körperlichen Trainingsprogramms sowie nach dem gleichen Zeitraum ohne Training zu untersuchen.

Material und Methoden Die Studie verwendete ein quasi-experimentelles Design, bei dem eine sechsmonatige Phase mit körperlichem Trainingsprogramm von einer sechsmonatigen Phase ohne Training gefolgt wurde. Die Stichprobe bestand aus 10 Personen mit IDD; das mittlere Alter betrug 43,2 Jahre (SD 9,47). Gewicht, Body-Mass-Index, Handgriffstärke, Zeitdauer für Aufstehen und Gehen (TUG-Test) und vom Sitzen zum Stehen wurden zu Beginn der Intervention, nach der Intervention und bei der Nachuntersuchung bestimmt.

Ergebnisse Die Teilnehmenden verbesserten sich nach dem Interventionsprogramm in allen Variablen, wobei aber nur die Veränderung im Handgriff-Test statistisch signifikant war (Bonferroni-korrigiert: t=1,05; p=0,019; W=0,21). Nach 6 Monaten ohne regelmäßiges Training zeigten die Teilnehmenden Verschlechterungen bei den körperlichen und funktionellen Fitnessvariablen, aber nur die Abnahme im Handgrifftest war signifikant (p=0,044).

Schlussfolgerung Obwohl mit einem körperlichen Trainingsprogramm einige Verbesserungen erzielt werden, scheinen diese nach Beendigung des Programms wieder verloren zu gehen. Es empfiehlt sich daher, die Phase des Detrainings zu vermeiden. Dies ist für die Verbreitung der positiven Wirkungen körperlicher Betätigung, für ein gesundes Altern, für Unabhängigkeit, für den Erfolg bei den Aktivitäten des täglichen Lebens und für die Lebensqualität von grundlegender Bedeutung.

Keywords

body composition - exercise - Intellectual Disability - physical fitness

Schlüsselwörter

Körperzusammensetzung - Bewegung - Intelligenzminderung - körperliche Fitness

Publikationsverlauf

Eingereicht: 21. Mai 2024

Angenommen nach Revision: 02. November 2024

Artikel online veröffentlicht:
10. Dezember 2024

• References

• 1 Schalock R, Luckasson R, Tassé M. et al. Intellectual disability: Definition, diagnosis, classification, and systems of supports (12th Edition). Washington, DC: American Association on Intellectual and Developmental Disabilities; 2021
• 2 Cartwright L, Reid M, Hammersley R. et al. Barriers to increasing the physical activity of people with intellectual disabilities. British Journal of Learning Disabilities 2017; 45: 47-55
• 3 Jacinto M, Vitorino AS, Palmeira D. et al. Perceived Barriers of Physical Activity Participation in Individuals with Intellectual Disability – A Systematic Review. Healthcare (Basel) 2021; 9: 1521
• 4 Dairo YM, Collett J, Dawes H. et al. Physical activity levels in adults with intellectual disabilities: A systematic review. Preventive medicine reports 2016; 4
• 5 Oppewal A, Hilgenkamp TIM, Elinder LS. et al. Correlates of sedentary behaviour in adults with intellectual disabilities – A systematic review. International Journal of Environmental Research and Public Health 2018; 15
• 6 Anderson WL, Wiener JM, Khatutsky G. et al. Obesity and people with disabilities: the implications for health care expenditures. Obesity (Silver Spring) 2013; 21: E798-E804
• 7 Krahn GL, Fox MH. Health Disparities of Adults with Intellectual Disabilities: What Do We Know? What Do We Do?. J Appl Res Intellect Disabil 2014; 27: 431-446
• 8 Lunsky Y, Balogh R, Durbin A. et al. The Mental Health of Adults with Developmental Disabilities in Ontario: Lessons from Administrative Health Data. Healthc Q 2018; 21: 6-9
• 9 Bull FC, Al-Ansari SS, Biddle S. et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med 2020; 54: 1451-1462
• 10 González-Agüero A, Vicente-Rodríguez G, Moreno LA. et al. Health-related physical fitness in children and adolescents with Down syndrome and response to training. Scand J Med Sci Sports 2010; 20: 716-724
• 11 Torr J, Strydom A, Patti P. et al. Aging in Down Syndrome: Morbidity and Mortality. Journal of Policy and Practice in Intellectual Disabilities 2010; 7: 70-81
• 12 Jacinto M, Monteiro D, Antunes R. et al. Effects of exercise on body mass index and waist circumference of individuals with intellectual and developmental disabilities: a systematic review with meta-analysis. Frontiers in Physiology 2023; 14
• 13 Jacinto MÂ, Domingos C, Antunes R. et al. O papel do técnico de exercício físico como promotor da qualidade de vida na Dificuldade Intelectual e Desenvolvimental. 2022; 18: 1-22
• 14 Jacinto M, Matos R, Gomes B. et al. Physical Fitness Variables, General Health, Dementia and Quality of Life in Individuals with Intellectual and Developmental Disabilities: A Cross-Sectional Study. Healthcare 2023; 11: 2688
• 15 Anderson LL, Humphries K, McDermott S. et al. The State of the Science of Health and Wellness for Adults With Intellectual and Developmental Disabilities. Intellect Dev Disabil 2013; 51: 385-398
• 16 Jacinto M, Monteiro D, Rodrigues F. et al. Gender Differences in Anthropometric, Functional Capacity Measures and Quality of Life in Individuals with Intellectual and Developmental Disabilities. Journal of Functional Morphology and Kinesiology 2024; 9: 84
• 17 Bartlo P, Klein PJ. Physical activity benefits and needs in adults with intellectual disabilities: systematic review of the literature. Am J Intellect Dev Disabil 2011; 116: 220-232
• 18 Jacinto M, Rodrigues F, Monteiro D. et al. Effects of combined training in individual with Intellectual and Developmental Disabilities: a systematic review and meta-analysis of randomized controlled trials. Disabil Rehabil 2024; 1-16
• 19 Jacinto M, Frontini R, Matos R. et al. Effects of Exercise Programs on Anxiety in Individuals with Disabilities: A Systematic Review with a Meta-Analysis. Healthcare (Basel) 2021; 9: 1047
• 20 Jacinto M, Monteiro D, Oliveira J. et al. The Effects of Physical Activity, Exercise, and Sports Programs on Depressive Symptoms in Individuals with Disabilities: A Systematic Review with Meta-Analysis. International Journal of Environmental Research and Public Health 2023; 20: 6134
• 21 Reppermund S, Trollor JN. Successful ageing for people with an intellectual disability. Curr Opin Psychiatry 2016; 29: 149-154
• 22 Alghadir AH, Gabr SA, Alghadir AH. et al. Physical activity impact on motor development and oxidative stress biomarkers in school children with intellectual disability. Revista da Associação Médica Brasileira 2020; 66: 600-606
• 23 Calders P, Elmahgoub S, Roman de Mettelinge T. et al. Effect of combined exercise training on physical and metabolic fitness in adults with intellectual disability: a controlled trial. Clin Rehabil 2011; 25: 1097-1108
• 24 Cowley PM, Ploutz-Snyder LL, Baynard T. et al. Physical fitness predicts functional tasks in individuals with Down syndrome. Med Sci Sports Exerc 2010; 42: 388-393
• 25 Jeon B, Son S. Effects of the Health Management Importance Awareness on Occupational Performance and Basic Fitness among Intellectually Disabled Participated the Muscle Strengthening Exercise. Journal of Cardiac and Pulmonary Rehabilitation 2017; 1: 1-5
• 26 Raulino AGD, Brito CJ, Barros JF. Efeito do Treinamento com Pesos nas Atividades da Vida Diária em Deficientes Intelectuais. Revista Brasileira de Ciências do Esporte 2014; 36: 13-25
• 27 Hilgenkamp TIM, van Wijck R, Evenhuis HM. (Instrumental) activities of daily living in older adults with intellectual disabilities. Res Dev Disabil 2011; 32: 1977-1987
• 28 Oppewal A, Hilgenkamp TIM, van Wijck R. et al. Physical fitness is predictive for a decline in daily functioning in older adults with intellectual disabilities: results of the HA-ID study. Res Dev Disabil 2014; 35: 2299-2315
• 29 Casey AF. Measuring body composition in individuals with intellectual disability: a scoping review. J Obes 2013; 2013: 628428
• 30 Diz S, Jacinto M, Costa AM. et al. Physical Activity, Quality of Live and Well-Being in Individuals with Intellectual and Developmental Disability. Healthcare 2024; 12: 654
• 31 Lante K, Stancliffe RJ, Bauman A. et al. Embedding sustainable physical activities into the everyday lives of adults with intellectual disabilities: a randomised controlled trial. BioMed Centra Public Health 2014; 14: 1038
• 32 Pestana MB, Barbieri FA, Vitório R. et al. Effects of physical exercise for adults with intellectual disabilities: a systematic review. J Phys Educ 2018; 29
• 33 Tamin TZ, Idris FH, Mansyur M. et al. Model and effectiveness of endurance exercise to increase physical fitness in intellectual disability subjects with obesity: a randomized controlled trial. Acta Med Indones 2015; 47: 127-135
• 34 Fornieles G, Rosety MA, Elosegui S. et al. Salivary testosterone and immunoglobulin A were increased by resistance training in adults with Down syndrome. Brazilian Journal of Medical and Biological Research 2014; 47: 345-348
• 35 Shields N, Taylor NF. A student-led progressive resistance training program increases lower limb muscle strength in adolescents with Down syndrome: a randomised controlled trial. J Physiother 2010; 56: 187-193
• 36 Carvalho MJ, Marques E, Mota J. Training and detraining effects on functional fitness after a multicomponent training in older women. Gerontology 2009; 55: 41-48
• 37 Kalapotharakos VI, Diamantopoulos K, Tokmakidis SP. Effects of resistance training and detraining on muscle strength and functional performance of older adults aged 80 to 88 years. Aging Clin Exp Res 2010; 22: 134-140
• 38 Toraman NF, Ayceman N. Effects of six weeks of detraining on retention of functional fitness of old people after nine weeks of multicomponent training. Br J Sports Med 2005; 39: 565-568 discussion 568
• 39 Teixeira-Salmela LF, Santiago L, Lima RCM. et al. Functional performance and quality of life related to training and detraining of community-dwelling elderly. Disabil Rehabil 2005; 27: 1007-1012
• 40 Rodrigues F, Teixeira JE, Monteiro AM. et al. The Effects of 6-Month Multi-Component Exercise Intervention on Body Composition in Aged Women: A Single-Arm Experimental with Follow-Up Study. Applied Sciences 2023; 13: 6163
• 41 World Medical Association. World medical association declaration of Helsinki. JAMA. 2013 310. 2191-2194
• 42 Temple VA, Walkley JW, Greenway K. Body mass index as an indicator of adiposity among adults with intellectual disability. J Intellect Dev Disabil 2010; 35: 116-120
• 43 Wouters M, van der Zanden AM, Evenhuis HM. et al. Feasibility and Reliability of Tests Measuring Health-Related Physical Fitness in Children With Moderate to Severe Levels of Intellectual Disability. Am J Intellect Dev Disabil 2017; 122: 422-438
• 44 Oppewal A, Hilgenkamp TIM. The association between gait and physical fitness in adults with intellectual disabilities. Journal of Intellectual Disability Research 2018; 62: 454-466
• 45 Cabeza-Ruiz R, Alcántara-Cordero FJ, Ruiz-Gavilán I. et al. Feasibility and Reliability of a Physical Fitness Test Battery in Individuals with Down Syndrome. Int J Environ Res Public Health 2019; 16: 2685
• 46 Oppewal A, Hilgenkamp TIM. Adding meaning to physical fitness test results in individuals with intellectual disabilities. Disability and Rehabilitation 2020; 42: 1406-1413
• 47 Winnick JP, Short FX. Brockport Physical Fitness Test Manual: A Health-related Assessment for Youngsters with Disabilities. Human Kinetics. 2014
• 48 Rikli RE, Jones CJ. Development and Validation of Criterion-Referenced Clinically Relevant Fitness Standards for Maintaining Physical Independence in Later Years. The Gerontologist 2013; 53: 255-267
• 49 Rikli RE, Jones CJ. Development and Validation of a Functional Fitness Test for Community-Residing Older Adults. Journal of Aging and Physical Activity 1999; 7: 129-161
• 50 American College of Sports Medicine. ACSM’s guidelines for exercise testing and prescription. Eleventh edition. Philadelphia: Wolters Kluwer; 2021
• 51 Ferreira JP, Matos R, Campos MJ. et al. Effects of Physical Exercise Program in Adults with Intellectual and Developmental Disabilities – A Study Protocol. J Clin Med 2022; 11: 7485
• 52 Jacinto M, Oliveira R, Brito JP. et al. Prescription and Effects of Strength Training in Individuals with Intellectual Disability – A Systematic Review. Sports (Basel) 2021; 9: 125
• 53 Jacinto M, Oliveira R, Martins AD. et al. Prescription and Effects of Cardiorespiratory Training in Individuals with Intellectual Disability: A Systematic Review. Healthcare 2023; 11: 2106
• 54 Borg GAV. Psychophysical bases of perceived exertion. Medicine & Science in Sports & Exercise 1982; 14: 377-381
• 55 Ho R. Handbook of Univariate and Multivariate Data Analysis with IBM SPSS. CRC Press; 2014
• 56 Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2. Aufl.. New York: Routledge; 1988
• 57 Fritz CO, Morris PE, Richler JJ. Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen 2012; 141: 2-18
• 58 Tomé A, Antunes R, Monteiro D. et al. Efeitos de um programa de exercícios na autonomia, independência e aptidão física de pessoas com deficiência intelectual e de desenvolvimento – Um estudo piloto. Retos 2024; 53: 147-156
• 59 Jacinto M, Matos R, Monteiro D. et al. 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. Front Physiol 2023; 14: 1205463
• 60 Wang DXM, Yao J, Zirek Y. et al. Muscle mass, strength, and physical performance predicting activities of daily living: a meta-analysis. J Cachexia Sarcopenia Muscle 2020; 11: 3-25
• 61 Borji R, Zghal F, Zarrouk N. et al. Individuals with intellectual disability have lower voluntary muscle activation level. Res Dev Disabil 2014; 35: 3574-3581
• 62 Farías-Valenzuela C, Arenas-Sánchez G, Cofré-Bolado C. et al. Pruebas dinamometricas y desempeño funcional en adolescentes con discapacidad intelectual moderada. Journal of Sport and Health Research 2019; 11
• 63 Forte P, Pinto P, Barbosa TM. et al. The effect of a six months multicomponent training in elderly’s body composition and functional fitness – A before-after analysis. Motricidade 2021; 17: 34-41
• 64 Frasca D, Blomberg BB, Paganelli R. Aging, Obesity, and Inflammatory Age-Related Diseases. Front Immunol 2017; 8: 1745
• 65 Rosety-Rodriguez M, Diaz AJ, Rosety I. et al. Exercise reduced inflammation: but for how long after training?. Journal of intellectual disability research 2014; 58: 874-879
• 66 Boer PH. Effects of detraining on anthropometry, aerobic capacity and functional ability in adults with Down syndrome. J Appl Res Intellect Disabil 2018; 31: 144-150
• 67 United Nations. Convention on the Rights of Persons with Disabilities. Treaty Series. 2006
• 68 Bossink LWM, van der Putten AAJ, Steenbergen HA. et al. Physical-activity support for people with intellectual disabilities: development of a tool to measure behavioural determinants in direct support professionals. J Intellect Disabil Res 2019; 63: 1193-1206
• 69 Heller T, Hsieh K, Rimmer J. Barriers and Supports for Exercise Participation Among Adults with Down Syndrome. Journal of Gerontological Social Work 2003; 38: 161-178
• 70 Kreinbucher-Bekerle C, Melville C, Wells JSG. et al. The relationship between direct care providers’ physical activity behaviour and perceived physical activity needs for people with intellectual disabilities. J Intellect Disabil Res 2022; 66: 1023-1033
• 71 Barr M, Shields N. Identifying the barriers and facilitators to participation in physical activity for children with Down syndrome. J Intellect Disabil Res 2011; 55: 1020-1033
• 72 Mahy J, Shields N, Taylor NF. et al. Identifying facilitators and barriers to physical activity for adults with Down syndrome. J Intellect Disabil Res 2010; 54: 795-805