Measuring physical fitness in Persons with Severe/Profound ...

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Eighty representatives gave permission. After informed consent was obtained, we screenedthese participants based on the examination findings of a physician specialised in intellectualdisabilities and of a behaviour scholar and excluded seven participants. Another eight participantswere excluded as they did not live at the centre for people with severe intellectual and sensorydisabilities where the tests were performed. Eighteen participants were excluded because theypresented with exclusion criteria at the time the tests were administered (Figure 1).200 persons92 persons108 persons with insufficient motor capacities12 persons lacked permission from representatives80 persons7 persons excluded for medical or behavioural reasons73 persons8 persons did not live at the examination centre65 persons47 persons18 persons excluded because of exhibiting exclusion criteriaat the time of the testFigure 1 Inclusion stepsIn all, 47 persons participated in this study: 18 were female, mean (SD) age 44 (10) years and29 were male, mean (SD) age 38 (11) years. Participants were classified according to the adaptedGross Motor Function Classification System (GMFCS) [38]. Twenty-seven participants wereclassified as GMFCS level I, and 20 participants as GMFCS level II (see below for more informationabout GMFCS). Eighty-seven percent (41) of the participants had severe intellectual disabilities and13% (6) had profound intellectual disabilities, according to the classification of the ICD-10 [36].Most of the participants also had impaired vision. According to WHO guidelines [39], 53% (25) ofthe participants were severely partially sighted, 40% (19) were partially sighted, and 7% (3) wereslightly limited in sight. Most participants had impaired motor abilities: 60% (28) had orthopaedicdefects and 8% (4) were diagnosed with spasticity. In addition, 28% (13) of the participants hadslight hearing problems, 9% (4) had loss of hearing, and 4% (2) had severe loss of hearing orwere completely deaf.As a group, individuals with severe or profound intellectual disabilities possess severalco-morbidities simultaneously, and thus combinations of co-morbidities are also present in ourChapter 4 | 57
participants (Table 1). Thirty-six percent (17) of the intellectual disabled participants had bothhearing problems and visual disabilities; 60% (28) had both visual and orthopaedic disabilities;19% (9) had hearing problems and orthopaedic disabilities. 4 Participants were diagnosed withspasticity and they also had visual, and orthopaedic disabilities.Table 1. Combinations of co-morbidities of participants with severe intellectual disabilitiesHearingdisabilitiesOrthopaedicdefectsSpasticityVisual disabilities 36% 60% 4%Hearing disabilities - 19% 2%Orthopaedic defects - - 9%Participants were classified according to an adapted GMFCS [38], a five-level system usedto classify the severity of motor abilities in people with physical disabilities. Participants witha “Level I” classification can generally walk without restrictions but tend to have limitations insome more advanced motor skills. Participants with a “Level V” classification generally havevery limited mobility, even with the use of assistive technology. These participants always usea wheelchair. The original GMFCS was adapted because most of our participants had impairedvision, and as a result they could not jump and run spontaneously. If persons spontaneouslyincreased their speed during walking, instead of jumping and running, they were classified asGMFCS level I. Participants with a “Level II” classification can walk with slight restrictions and donot spontaneously increase their speed during walking. The adapted version of the GMFCS waspresented to the investigator, who translated the original version of the GMFCS into Dutch [40]and he concluded that the adaptations did not influence the reliability of the system.Study DesignParticipants were tested twice, with one week between the test and the retest. Test and retestwere conducted at the same point in time. The participants performed first the aSRT (Netchild,the Netherlands). In order to let the participants take sufficient rest, at least after 48 hours, the6MWD [35] was performed.Ethical statementThe study was performed in agreement with the guidelines of the Helsinki Declaration as revisedin 1975. Permission to carry out the study was obtained from an institutional ethics committee. Allparticipants were unable to give consent. Therefore, extra care and attention was given to:1) Asking informed consent: Informed consent was obtained from legal representatives of allparticipants and also the caregivers of all participants were asked for informed consent;2) The construction of the study group by formulating exclusion criteria and contraindications:We screened the participants based on the examination findings of a physician specialised inintellectual disabilities and also of a behaviour scholar;58 | Chapter 4
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Measuring physical fitnessin person
Page 4:
Rijksuniversiteit GroningenMeasurin
Page 10 and 11: Chapter 1IntroductionChapter 1 | 9
Page 12 and 13: overweight [15]. This prevalence is
Page 14 and 15: Theoretical framework of the studyI
Page 16 and 17: Components of physical fitnessThe a
Page 18 and 19: Therefore, a study is put forward w
Page 20 and 21: 2002;40:436-444.19 Temple VA, Frey
Page 22 and 23: Chapter 2Feasibility and reliabilit
Page 24 and 25: IntroductionPhysical fitness and he
Page 26 and 27: GMFCS was presented to the investig
Page 28 and 29: Body weightTo determine the body we
Page 30 and 31: Table 1 Results of Wilcoxon rank te
Page 32 and 33: Calculation of heightThe mean (SD)
Page 34 and 35: DiscussionThe results of our study
Page 36 and 37: References1 Bouchard C, Shepard RJ,
Page 38 and 39: 37 Rimmer J, Kelly LE, Rosentswieg
Page 40 and 41: Chapter 3Measuring waist circumfere
Page 42 and 43: IntroductionChildren and adults wit
Page 44 and 45: participants. These calculations as
Page 46 and 47: Data analysisThe data were analyzed
Page 48: Table 2. Simple regression analysis
Page 56 and 57: IntroductionPeople with intellectua
Page 60 and 61: 3) The measurement procedure: The m
Page 62 and 63: and whether motivation influenced t
Page 64 and 65: Table 3. Mean peak heart rate achie
Page 66 and 67: AcknowledgementsThis research was f
Page 68 and 69: 21 Hopkins WG, Gaeta H, Thomas AC,
Page 70 and 71: Chapter 5Psychometric quality of a
Page 72 and 73: IntroductionIntellectual disability
Page 74 and 75: Exclusion criteria were mental or p
Page 76 and 77: participant had fulfilled the task.
Page 78 and 79: Table 2. Descriptive results peak h
Page 80 and 81: Table 3. Test-retest reliability of
Page 82 and 83: Table 4. Correlation scored motivat
Page 84 and 85: preceding GXT results on HR peak. G
Page 86 and 87: References1 Schalock R, Brown I, Br
Page 88 and 89: 37 Stanish HI, Temple VA, Frey GC.
Page 92 and 93: IntroductionLocomotor skills in peo
Page 94 and 95: this study was to evaluate the feas
Page 96 and 97: obtained from the legal representat
Page 98 and 99: Modified Berg Balance Scale scoresI
Page 100 and 101: Modified Berg Balance Scale scoresT
Page 102 and 103: References1 Van Erkelens-Zwets JHJ
Page 104 and 105: 39 Dorai-Raj S. Binomial Confidence
Page 106 and 107: Chapter 7Feasibility, test-retest r
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IntroductionPersons with profound i
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DesignThe muscle tone and spasticit
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Interrater reliabilityFirstly, to d
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Table 3. Summary of the statistical
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Table 6. Summary of the statistical
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RecommendationsThe feasibility of c
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18 Gielen EJJM. Is spasticiteit te
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Chapter 8Heart Rate Pattern as an I
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IntroductionIt is important to gain
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48 persons18 persons lacked permiss
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Furthermore, the mean and the range
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Table 3. Day-to-day outline of the
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Relation between heart rate pattern
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patterns in this study we can concl
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References1 Emerson E. Underweight,
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38 Multilevel Models Project (2004)
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Chapter 9General DiscussionChapter
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on this. To sum up, testing in pers
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for future research it is recommend
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studies. Randomized Controlled Tria
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of these individuals require more?
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19 Lahtinen U, Rintala P, Malin A.
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SummarySummary | 151
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problems in both locomotor skills a
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subjects are to be applied to perso
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may be an indicator of activity lev
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SamenvattingSamenvatting | 159
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InleidingVoldoende bewegen en fithe
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verstandelijk niveau en bepaalde mo
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Hieruit bleek, dat de motivatie van
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Verder is duidelijk geworden dat me
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DankwoordDankwoord | 169
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De leden van de leescommissie, prof
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Judith van der Boom, dank je wel vo
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Dankwoord | 175
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Curriculum vitaeCurriculum vitae |
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Curriculum vitae | 179
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