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

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Table 3. Mean peak heart rate achieved with aSRT and 6MWD*Mean peak heartrate (SD)Mean estimatedpeak heart rate (SD)p Wilcoxon testaSRT 126 bpm (20) 172 bpm (6) P
the effects of considerable physical effort, due to their intellectual disabilities and reinforcedby their visual disabilities. In order to get an adequate interpretation of the test results, werecommend to include both the comparison of estimated peak heart rate with the achieved peakheart rate and the score on motivation into the protocols of the aSRT and 6MWD.Another complex question in these participants is informed consent: they are unable to giveconsent themselves. Therefore, extra care and attention was given to asking informed consent,the measurement procedure and the construction of the study group by formulating exclusioncriteria and contraindications. All persons involved in the study were fully aware of the vulnerableposition of the participants. If a participant did not like the testing, further participation wasstopped.In our study, the reliability of the 6MWD showed to be in line to that of similar measurementsin other studies, and so was the aSRT. Several studies have used the 6MWD in participantshaving a variety of diseases. For participants with fibromyalgia, the ICC of 6MWD test-retestmeasurements was 0.73 [47]. For participants with heart failure, the ICC was 0.91 [48] and 0.82[49]; and for participants with pulmonary disease, the ICC was 0.99 [50]. In our study, the ICC was0.92, which is notable, because the comorbidities of the participants under study could potentiallyaffect reliability. The reliability of the SRT-I and II was described by Verschuren et al.[30], whoobtained an ICC of 0.97 for GMFCS-I participants. In our study, the ICC for comparable participantswas 0.96. For GMFCS-II participants, Verschuren et al. [30] obtained an ICC of 0.99. In our study,the ICC was 0.82; however, the 95% CI were too wide and the LOA of the aSRT was unacceptablefor GMFCS-II participants. This suggests, that aerobic capacity cannot be reliably assessed inGMFCS-II participants. A hypotheses might be that their locomotor skills do not allow them toincrease their speed consequently.The participants in our study first practiced twice before we measured their performanceon the 6WMD and aSRT. Stevens et al. [51] described several studies that showed that practisesessions are necessary to promote optimal performance in participants. These investigatorsindicated that two practise sessions are required in order to allow participants to learn and toestablish optimal performance when conducting repeated measures at relatively short intervals.This was also necessary for the participants of our study.We compared the achieved mean distance in the 6MWD of our participants with that ofothers. The mean distance (SD) of our participants was 389 m (107). In healthy elderly persons,the mean distance was 631 m (93) [33]; in people with heart failure, the mean distance was 419m (120) [31]; and in people with COPD, the mean distance was 369 m (18) [32]. This comparisonindicates that persons with severe multiple disabilities performed poorer on the 6MWD than otherpersons with specific (chronic) health conditions.In conclusion, the 6MWD is feasible and reliable for measuring functional exercise capacity inGMFCS-I and II participants with severe intellectual and multiple disabilities. The aSRT is feasibleand reliable for measuring aerobic capacity in GMFCS-I participants. The participant’s motivationallevel can influence test outcomes, so we recommend to insert both heart rate monitoring andmotivational score into the protocols of the aSRT and 6MWD. The poor 6MWD results we observedindicate that the poor functional exercise capacity of persons with severe multiple disabilities is aserious health problem, which may burden their independence in day-to-day activities. Based onthis result, further research should be aimed at developing, implementing and evaluation of anappropriate intervention to reduce problems in functional exercise and aerobic capacity in theseparticipants.64 | Chapter 4
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Measuring physical fitnessin person
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Rijksuniversiteit GroningenMeasurin
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Chapter 1IntroductionChapter 1 | 9
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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 58 and 59: Eighty representatives gave permiss
Page 60 and 61: 3) The measurement procedure: The m
Page 62 and 63: and whether motivation influenced t
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
Page 108 and 109: IntroductionPersons with profound i
Page 110 and 111: DesignThe muscle tone and spasticit
Page 112 and 113: 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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